Postsurgical consequences in lower third molar surgical extraction using micromotor and piezosurgery

Abstract

Background:One of the most critical and crucial steps in surgical extraction is cutting the bone or osteotomy, for which many techniques are used, e.g., chisels and mallet, rotary instruments, and ultrasound bone-cutting instruments. If they are not used judiciously, they can be hazardous.Objectives:To assess the efficiency of piezosurgery unit over micromotor while performing surgical extraction of lower third molars by assessing the time taken for the surgery and measuring postoperative parameters such as pain, trismus, and swelling.Materials and Methods:Thirty patients having bilateral impacted third molars with the same difficulty index were selected for the study. One side surgical removal was done using micromotor and other side by piezosurgery with an interval of 15 days. After each surgery, time taken to finish was measured and patients were followed up on postoperative days 1, 3, 5, 7, and 15 for assessing pain, trismus, and swelling. Data obtained were statistically analyzed.Results:The mean time taken for the micromotor group is 37.90 min whereas by the piezosurgery group is 54.63 min, showing a statistically significant difference (P < 0.001). Furthermore, there is statistically significant difference (P < 0.001) in the level of pain, trismus, and swelling on postoperative days 1, 3, 5, and 7. Even the intragroup comparison of piezosurgical group for trismus and swelling showed no statistically significant difference on postoperative day 7, indicating faster recovery of trismus and swelling. On postoperative day 15, there was no difference in any parameter in both groups indicating complete symptom-free recovery in both groups.Conclusion:It takes more time to perform surgical extraction of third molars when piezosurgical unit is used. Despite that, it causes less pain postoperatively with faster improvement in trismus and quicker reduction in swelling.

Randomized clinical study comparing Piezoelectric Surgery with conventional rotatory osteotomy in mandibular third molars surgeries

“…The rotary procedure showed a greater clinical value of facial swelling compared to the piezoelectric surgery in all the postoperative times, especially at postoperative day 3, which is in agreement with others ( Jiang et al, 2015 ; Mantovani et al, 2013; Mistry et al, 2016 , Sortino et al, 2008 , Troedhan et al, 2011 ).…”

“…There is a great deal of literature ( Arakji et al, 2016 , Badenoch-Jones et al, 2016 , Bartuli et al, 2013 ; Bhati et al, 2010; Bhati et al, 2017 ; Mantovani et al, 2013; Mistry et al, 2016 , Sortino et al, 2008 ) on the relationships between the postoperative complications following extraction of the lower third molars using piezoelectric surgery. However, little has been published ( Basheer et al, 2017 , Chang et al, 2015 , Goyal et al, 2012 , Piersanti et al, 2014 ) regarding patient perceptions on postoperative quality of life.…”

Application of Piezosurgery in Surgical Extraction of Impacted Mandibular Third Molars Versus Conventional Rotatory Technique: A Randomized Controlled Trial

“…However, there was no significance in the values recorded on day 7 and 14, which indicated recovery would be between 3 and seven days concerning trismus. In the rotatory group, values were significantly lower on days 1, 3 and 7, which indicated that recovery would be between 7 to 14 days, which was in accordance with previous authors [18]. The pain was evaluated by asking the patient to score on facial pain scale during the followup.…”

Effect of Total Surgical Time on Patient’s Complaint of Mouth Opening After Transalveolar Removal of Impacted Mandibular Wisdom Teeth- A Randomised, Controlled, Clinical Trial

“…[14] A similar study stated that males usual lifestyle activities were resumed by four days after surgery, while difficulties due to trismus were resolved after five days post-surgery, but females had greater surgical time than males; average of 30 minutes; the resolution of trismus took a longer time than males. [15] Consistent results were obtained using micromotor and piezosurgery; longer surgical time meant trismus persisted for more number of days; follow-up of trismus for this study was for 15 days. [16] Another study stated that meticulous surgical techniques minimises total surgical time and hence severity of pain, swelling and trismus.…”