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Updated: Nov 26, 2025
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Postoperative evaluation of Er:YAG laser, piezosurgery, and rotary systems used for osteotomy in mandibular
Tayfun Civak1, Tugba Ustun2, Hanife Nuray Yilmaz3
1Oral and Maxillofacial Surgery, Istanbul Yeni Yuzyil University, Faculty of Dentistry, Istanbul, Turkey.
Objective:
This study compared patient postoperative pain, swelling, and trismus after usage of rotary instruments, piezosurgery, and Er:YAG lasers in mandibular third-molar extraction.
Materials And Methods:
This prospective study was executed with class II and position B vertically impacted mandibular third molars. Patients were divided into three groups according to the osteotomy system used to remove retentive bone: rotary instruments, piezosurgery, and Er:YAG laser. Postoperative pain was evaluated using VAS questionnaires at 12 h, 24 h, 48 h, and 7 days after procedures. Trismus was evaluated by measuring the distance between the maxillary and mandibular incisors at maximum mouth opening, and comparing preoperative measurements with those for postoperative days 2 and 7. Analyses of swelling were carried out via a stereophotogrammetry system. Operation times were measured using a digital stopwatch from the initial incision to the final suture.
Results:
There were no statistically significant differences between the groups in terms of pain, trismus, or swelling (p > 0.05). Pain persisted more in the rotary instrument group 24 h later (0 ± 1.3; p = 0.001). The pain scores obtained after 48 h for the piezosurgery (1.81 ± 2.29) and rotary (2.2 ± 2.12) groups were observed at 24 h in the laser group (2.19 ± 1.52). The mean operation time was highest using the laser (19.1 ± 3.85 min; p = 0.001) and lowest using rotary instruments (9.88 ± 2.97 min; p = 0.001).
Conclusion:
Piezosurgery and Er:YAG laser are good alternatives to rotary instrument systems in third-molar extraction, but both systems are slower than traditional rotary instruments.
