Heat Generation and Pain Assessment in Piezosurgery Versus Conventional Drilling for Implant Placement: A Systematic Review

The development of new technologies in implant dentistry has led to the introduction of piezosurgery, which utilizes ultrasonic vibrations for micrometric and selective bone cutting. It is hypothesized to reduce trauma to bone tissue, thereby potentially improving the healing process compared to traditional drilling methods. This systematic review examines the differences in heat generation and pain perception between piezosurgery and conventional drilling techniques for dental implant placement. An extensive review of literature was performed using various databases, including PubMed via MEDLINE, EBSCO, and Google Scholar. Out of an initial pool of 2,279 articles, nine studies met the predefined inclusion criteria and were included in the final analysis following title and abstract screening and subsequent full-text evaluation. The quality of the selected studies was rigorously assessed using the Risk of Bias (RoB 2.0), Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I), and Quality Assessment Tool for In Vitro Studies (QUIN) tools. Data pertaining to thermal effects and postoperative pain associated with piezosurgery relative to conventional drilling protocols were collected. The results indicated a significant reduction in postoperative pain with piezosurgery; however, the technique was associated with higher intraoperative temperatures during osteotomy. These findings provide valuable insights into the potential benefits and limitations of piezosurgery in dental implant procedures.