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

Abstract

Purpose The aim of this study was to evaluate the performance and to assess the postoperative sequel and quality of life after removal of impacted mandibular third molars using piezoelectric surgery compared with conventional rotatory osteotomy. Patients and methods A single blinded, randomized, control clinical study was performed. Sixty-three patients (44 males, 19 females) who presented with bilaterally asymptomatic impacted mandibular third molars were included in this analysis. Each patient was treated, at two separate sessions approximately 4 weeks apart, with a conventional rotatory hand piece on one side of the mandible and a piezoelectric device on the contralateral side. Patients were followed up on postoperative days 1, 3, 5, 7, and 15 to rate the pain, swelling and trismus. Inferior alveolar nerve paresthesia was evaluated up to 12 months postoperatively. Results The severity of the pain, trismus and swelling using the piezosurgery were significantly different from the rotary group. In both groups, pain was most intense and peaked during the first post-operative day, while swelling and trismus reached peak levels on the third postoperative day. The piezoelectric procedure resulted in a significantly longer procedural duration compared to the rotatory surgery ( P < 0.001). Conclusion Piezoelectric surgery is considered a viable alternative technique compared to the conventional rotary systems and can improve a patient’s quality of life. Thus, piezoelectric surgery might be a preferred modality for patients undergoing complicated surgical extraction of impacted lower third molars.

Risk factors for sinus membrane perforation during lateral window maxillary sinus floor elevation surgery: A retrospective study

“…Scarano and colleagues 32 randomly assigned 30 cases into two groups, which were given lateral window SFE respectively by traditional rotary instruments or piezoelectric tools, finding significantly higher SMP rate in the rotary instrument group. Because piezoelectric tools conduct osteotomy by low‐frequency ultrasonic vibration, allowing precise ectomy of bone tissue without injuring soft tissue like sinus membrane 33 . In a recent meta‐analysis, 25 the SMP rate of traditional instruments was estimated to be 24%, while that of piezoelectric tools being 8%, with statistical significance ( p < 0.05), which proves that application of piezoelectric tools could rescue the risk of SMP.…”

Piezo-surgery technique and intramuscular dexamethasone injection to reduce postoperative pain after impacted mandibular third molar surgery: a randomized clinical trial

“…In 2019, Gumrukcu et al also performed a retrospective clinical study to compare the post-operative effects of the conventional surgery, piezo surgery technique and submucosal dexamethasone injection in lower third molars extractions, and concluded that dexamethasone was effective in reducing swelling, pain, mouth opening restriction, and that Piezosurgery has positive effects on pain, swelling, trismus, and number of used analgesics compared to the control group [ 28 ]. In 2021, Al-Delayme et al compared piezo-electric surgery with conventional and concluded that piezosurgery reduces postoperative pain, trismus, and swelling [ 51 ]. Furthermore, Gulnahar et al compared postoperative morbidity between piezoelectric surgery and conventional rotary instruments in mandibular third molar surgery, and concluded that piezosurgery is a safe alternative method that can be used for the removal of impacted mandibular third molars, but did not provide a significant benefit in terms of postoperative pain and trismus [ 52 ].…”

New bone conservation technology of impacted teeth extraction

“…Through this window, with the proper selection of the instruments, the alveolar bone will be retained to the greatest extent and the bone damage will be reduced. 15,16 Extraction of impacted teeth based on the concept of bone preservation can effectively reduce bone damage. In order to protect the alveolar bone as much as possible, we can increase the gap inside the tooth, to transfer the space needed for extraction of impacted teeth to the inside of the tooth, which would provide enough space by removing/ grinding the unnecessary tooth tissue.…”

“…There is a window around the crown of the impacted teeth or even around the neck of the teeth. Through this window, with the proper selection of the instruments, the alveolar bone will be retained to the greatest extent and the bone damage will be reduced 15,16 …”