Effect of Piezosurgical Bone Removal on Postoperative Sequelae of Impacted Mandibular Wisdom Extraction

Abstract

Objectives: This study was conducted to evaluate the effect of piezosurgery device as a recent modality for bone removal of impacted lower eight in comparison to high speed hand piece regarding its effect on postoperative pain, trismus and oedema. Materials and methods: Fifty patients presenting with impacted mandibular third molars were selected from the out-patient clinic of the Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al Azhar University girls’ branch. All patients were followed up clinically at 1, 3, 5, 7, 15 days postoperatively. Histological examination of bone after ostectomy was performed. Results: The caliper measurements of oedema of group I (high speed) at day 1, 3 showed statistically significant higher mean measurements than group II (piezosurgery group). piezosurgery group showed statistically significant higher mean IID compared to high speed group at days 1, 3, 5. High speed group showed statistically significant higher mean VAS score than piezosurgery group at days 1, 3, 5, 7. High speed group showed statistically significant higher mean number of consumed analgesic tablets than piezosurgery group at days 1, 3, 5. Regarding histopathological examination, bone samples of piezosurgery were made up of well organized and well vascularized bone with lamellar architecture surrounding the haversian channels and with a linear and well formed osteotomy lines, while the bone samples from high speed group were badly cut with irregular osteotomy lines and with evidence of bone heat osteonecrosis. Conclusions: The results of this study suggest that piezosurgery should be a suitable modality of osteotomy during surgical removal of impacted lower third molar with less postoperative complications than the conventional method.