Abstract
Introduction: Impacted third molar surgery is a frequently performed procedure in clinical work. Surgical removal of impacted third molars is often required in symptomatic conditions. Conventional rotary cutting instruments may be potentially injurious, so piezosurgery has been introduced as a new osteotomy technique with promising outcome. Purpose of this study was to compare techniques of surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique. The parameters were time required, patient satisfaction, severity of pain and mouth opening postoperatively. Materials and Methods: This prospective study consisted of 20 medically fit patients between 18–40 years of age with bilateral impacted mandibular third molars from both the genders. On one side surgical extraction was done using conventional rotary technique and contra lateral side was treated using piezosurgery (split mouth study design). Statistical analysis was done between these two techniques for patient satisfaction, duration of surgery, pain perception and trismus. Results: Piezoelectric surgery took more time than rotary, but patient satisfaction, pain, mouth opening was statistically poor with conventional rotary technique. Conclusion: Piezoelectric device is a promising, meticulous, innovative ultrasonic technique for safe and effective bone removal when compared with rotary technique. Keywords: Piezoelectric surgery, Rotary surgical technique, Surgical removal, Mandibular impacted third molar.
Highlights
Impacted third molar surgery is a frequently performed procedure in clinical work
Intra-operatively, the time taken and patient satisfaction of the procedure was evaluated and post operatively, clinical assessment of mouth opening was done on day 3, day 5 and day 7, correlating with that of preoperative value
The conclusions drawn from this study are: 1. Piezoelectric device is a promising, meticulous, innovative ultrasonic technique for safe and effective bone removal when compared with rotary technique because of the absence of macrovibrations and noise, its ease of use and safer cutting, in anatomical areas closer to neurovascular bundles
Summary
Impacted third molar surgery is a frequently performed procedure in clinical work. Surgical removal of impacted third molars is often required in symptomatic conditions. Factors contributing to the occurrence of pain and oedema after 3rd molar extractions are complex, but are related to the inflammatory process that is initiated by surgical trauma.[2] Injury to tissue during surgical procedure results in the release of chemical mediators of inflammation.[3] Trismus might occur as a direct consequence of Masseter muscle trauma, due to prolonged surgery or due to excessive periosteal stripping, having as a consequence of diffused swelling.[4] Initially bone removal was performed using chisel and mallet, which later benefitted from the introduction of rotary devices to oral surgery, becoming less time consuming procedures with increased comfort to the patient and subsequent better technical and biological outcomes due to a more accurate cut definition.[5] Rotary speed ranging from 15,000 to 25,000 rpm used in oral surgery produces macrovibration and
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