Piezosurgery versus conventional rotary instrument for Inferior Alveolar Nerve lateralization prior to implant placement: (Comparative Clinical Study)

Abstract

Aim of the study: Evaluation of the inferior alveolar nerve (IAN) neurosensory function, postoperative pain and edema following the placement of an implant with inferior alveolar nerve lateralization using piezo-surgery versus conventional rotary instruments. Materials and methods: Twenty four partially edentulous patients were selected for this study. Twelve patients underwent inferior alveolar nerve lateralization for Implants placement using Piezosurgery device (Group A), while the other twelve patients underwent inferior alveolar nerve lateralization for implant placement using conventional rotary surgical bur (Group B). Operation duration, postoperative pain, edema, and patient satisfaction were primary assessed and compared between the two groups at 2, 5 and 7days postoperatively, also inferior alveolar nerve affection as a secondary outcome was assessed subjectively and objectively and compared between the two groups throughout the follow up intervals occurred at 2, 8 & 24 weeks postoperatively. Results: There was a statistical significant difference in all of the primary and secondary assessments between the two groups in favor of group A at all of the follow up intervals, except at the operation duration assessment where piezosurgey ( Group A) had statistically significant higher operation duration than group B. Conclusion: The inferior alveolar nerve lateralization (IANL) technique using conventional surgical burs has a higher initial rate of sensory dysfunction, postoperative pain and edema than with using Piezosurgery. The somatosensory evoked potential method is considered more informative, reliable and diagnostic parameter than other subjective and conventional clinical methods.