Handpiece speed and postoperative outcomes in third molar surgery

This study was performed to assess surgical outcomes when externally irrigated slow-speed surgical handpieces (30,000 rpm) were compared to externally irrigated high-speed handpieces (90,000 rpm) in the removal of impacted lower third molar teeth.

One hundred patients with bilater ally impacted third molar s were enrolled in the study; 53 remained to completion. Each patient served as his/her own control. The experimental side was treated using a 30,000 rpm electric rotary drill incorporating irrigation, while the control side was treated using the same drill system, but with a 90,000 rpm handpiece. Drill speeds used were alternated between the right and left sides of patients to avoid bias introduced by the dominant hand of the surgeon. Patients were blinded to drill speed, and were asked to complete a standardized pain/swelling questionnaire for seven days immediately following surgery. Data was analyzed to determine differences in pain, swelling, and complications in relation to the drill type used.

No statistically significant differences were found in degree of pain, swelling, or complications when the slower drill was compared to the high-speed instrument.

The study suggests that there is no difference in postoperative outcome when impacted third molar teeth are removed with either slow- or high-speed instrumentation, and that the choice of the drill type should be determined solely by the preference of the operator.