Piezosurgery or conventional rotatory instruments for inferior third molar extractions?

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Technology
• Minimally Invasive Surgical Techniques

Background:

• Lower third molar extraction is a common surgical procedure.
• Conventional rotary instruments can cause significant patient discomfort and postoperative sequelae.
• Piezosurgery offers a potential alternative with enhanced precision and safety.

Purpose of the Study:

• To compare patient-reported discomfort and surgical outcomes between piezosurgery and rotary instruments for lower third molar extraction.
• To evaluate pain, trismus, swelling, and surgical time as secondary outcomes.

Main Methods:

• A split-mouth, randomized clinical trial design was employed.
• Ten patients underwent lower third molar extraction with piezosurgery on one side and a conventional handpiece on the contralateral side.
• Patient discomfort was assessed using the Postoperative Symptom Severity (PoSSe) scale; pain, trismus, and swelling were also measured.

Main Results:

• Piezosurgery demonstrated significantly lower total PoSSe scores compared to the conventional handpiece (24.7 vs 36.0, P = .002).
• Postoperative swelling at one week was significantly reduced with piezosurgery (2.75 cm vs 3.1 cm, P = .027).
• No significant differences were reported for pain or trismus in the abstract.

Conclusions:

• Piezosurgery is associated with reduced postoperative discomfort and swelling following lower third molar extraction.
• The technique appears beneficial for surgical procedures requiring precision and soft tissue preservation.
• Piezosurgery is a viable option for daily surgical practice, particularly in critical interventions.