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20 June 2021

Piezoelectric surgery vs conventional technique in third molar extraction

Alessandra Abbà

Piezoelectric surgery is a relatively new minimally invasive technique which has achieved popularity in many dentistry branch as implantology, periodontics and oral surgery. Piezosurgery is based on ultrasonic microvibrations which provide extreme precision and safety during bone cutting. Moreover it allow soft tissue protection, less vibration and noise -that increased comfort for the patient- and even less bleeding during and after the operation with a shortened the healing process.

All this advantages combined with the decreased risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa, made the piezosurgery the most suitable technique for the third molar surgery. 

As third molar surgery is a common procedure performed in dentistry and may be accompanied by serious disorders such as pain, edema and trismus, this study aimed to evaluate if piezosurgery would be able to reduce such postoperative features. 

Material and methods: Twenty patients with impacted mandibular third molars were included in this splith-mouth study and underwent tooth extractions using two different methods. In the Piezo Flap Group (PFG- 10 patients) the flap was elevated using piezosurgery  and in the Piezo Ostectomy Group (POG – 1o patients) osteotomy and odontosection were carried out with ultrasound tips. The contralateral tooth was included in the Control Group (CG). Duration of surgery, pain, trismus and swelling were the parameters taken in consideration. The patients were evaluated after 1, 3, 7 and 14-days. 

Results: The mean duration of surgery for the PFG was 17.21 minutes (CG 10.07 minutes) and POG was 40.09 minutes (CG 15.97 minutes). When compared three days after surgery, the swelling in the PFG and POG was statistically significantly less than the CG (p=0.038 and p<0.001).  Nevertheless there was no statistically significant difference in pain and trismus for any of the postoperative periods evaluated in PFG and POG (p>0.05). 

Conclusions: piezosurgery is a promising technique for different aspects of bone surgery with a rapidly increasing number of indications. When applied at the third molar surgery, it promoted less edema in the early postoperative stages despite the longer surgical duration.

For additional information: Influence of surgical ultrasound used in the detachment of flaps, osteotomy and odontosection in lower third molar surgeries. A prospective, randomized, and "split-mouth" clinical study

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