Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial.

Hani Arakji,Nayer Aboelsaad,Mohamed Shokry

doi:10.1155/2016/8169356

Hani Arakji, Nayer Aboelsaad + Show 1 more

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https://doi.org/10.1155/2016/8169356

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Abstract

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing. Material and Methods. This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively. Results. Test and control sites were compared using paired t-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results. Conclusion. Piezosurgery technique improves quality of patient's life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar.

Highlights

20% of the population has impacted teeth, where mandibular and maxillary third molars are the most common [1].The highest incidence of impaction has been shown in mandibular wisdom teeth which may lead to pathologies like pericoronitis, periodontitis, second molars tooth-crown resorption, pain, cysts or odontogenic tumors, and primary or secondary crowding of the dentition
Removal of these teeth to prevent the abovementioned problems is widely approved [2]. Surgical removal of these teeth is usually correlated with postoperative pain, swelling, and trismus whereas complications such as infection, dry socket, trigeminal nerve injuries, and, rarely, fracture of the mandible are less common to occur [1, 3]
The estimated sample size was calculated according to http://epitools.ausvet.com.au/, by taking the means of mouth opening from a previous similar study conducted by Goyal et al [10] where mean for test site = 2.54 ± (0.93) and mean for control site = 3.91 ± (0.99), where the variance was calculated to be 0.92, assuming a confidence level of 95% and a study power of 80%

Summary

Introduction

The highest incidence of impaction has been shown in mandibular wisdom teeth which may lead to pathologies like pericoronitis, periodontitis, second molars tooth-crown resorption, pain, cysts or odontogenic tumors, and primary or secondary crowding of the dentition. Removal of these teeth to prevent the abovementioned problems is widely approved [2]. Hard tissue cutting is a common procedure in the dental fields, especially during maxillofacial, oral, and periodontal surgeries. Bone overheating and damage to adjacent tissues are disadvantages that are related to the use of these methods [4]

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