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

Freddy Kersi Mistry¹, Nidarsh Diwakar Hegde¹, Mithra Nidarsh Hegde²

¹Department of Oral and Maxillofacial Surgery, A. B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India.

Annals of Maxillofacial Surgery

|March 17, 2017

Summary

Piezosurgery for lower third molar extraction takes longer than micromotor use but results in less postoperative pain, quicker recovery from trismus, and reduced swelling. Both methods ensure complete symptom-free recovery by day 15.

Keywords:

Extraction lower third molars micromotor odontectomy pain piezosurgery swelling trismus

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Area of Science:

Oral and Maxillofacial Surgery
Surgical Techniques
Dental Research

Background:

Surgical extraction of impacted third molars involves osteotomy, a critical step with potential hazards if not performed judiciously.
Traditional methods like chisels, mallets, and rotary instruments are commonly used for osteotomy.
Advanced techniques such as ultrasound bone-cutting instruments (piezosurgery) are emerging alternatives.

Purpose of the Study:

To compare the efficiency of piezosurgery versus micromotor for surgical extraction of lower third molars.
To evaluate operative time and postoperative outcomes including pain, trismus, and swelling.

Main Methods:

A comparative study involving 30 patients with bilateral impacted lower third molars of similar difficulty.
Unilateral extraction performed using a micromotor, with the contralateral side using piezosurgery after a 15-day interval.
Postoperative assessment of pain, trismus, and swelling on days 1, 3, 5, 7, and 15.

Main Results:

Piezosurgery required significantly more operative time (54.63 min) compared to the micromotor (37.90 min) (P < 0.001).
Piezosurgery demonstrated significantly reduced postoperative pain, trismus, and swelling on days 1, 3, 5, and 7 (P < 0.001).
Faster recovery from trismus and swelling was observed with piezosurgery, with no significant differences in parameters by postoperative day 15.

Conclusions:

While piezosurgery increases surgical time for third molar extraction, it offers significant advantages in reducing postoperative pain and improving recovery from trismus and swelling.
Piezosurgery appears to be a valuable alternative for managing impacted third molars, promoting better patient comfort and faster healing.
Both techniques ultimately lead to complete symptom resolution by day 15 post-surgery.