Conventional Rotary Instruments Research Articles

A randomized controlled trial comparing conventional and piezosurgery methods in mandibular bone block harvesting from the retromolar region

BackgroundAlthough piezosurgery is now commonly used for various applications in maxillofacial surgery, its advantages over conventional rotary instruments in terms of postoperative edema, ecchymosis, postoperative morbidity, and prolonged osteotomy time have been questioned.Materials and methodsThis study aimed to compare the efficiency, postoperative morbidity, and complication rates of piezosurgery and conventional methods in harvesting autogenous ramus grafts. In this randomized controlled trial, 21 patients (32 sides) underwent autogenous graft harvesting from the ramus area, with 16 sites treated using piezosurgery and 16 using the conventional method. The primary outcomes measured were osteotomy time, total operation time, and postoperative morbidity. Complication rates were also evaluated.ResultsThe final analysis encompassed 19 patients, accounting for a total of 30 donor sites, following the exclusion of two patients who were unable to attend the scheduled follow-up visits. A total of 19 patients (30 donor sites) were included in the final analysis. No statistically significant difference was found in the mean osteotomy time between the piezosurgery group (mean: 10.35, SD: 2.74 min) and the conventional group (mean: 8.74, SD: 2.74 min) (95% CI: -3.67 to 0.442, p = 0.119). The total operation time, postoperative pain, and swelling were not significantly different between the two groups (p > 0.05). The complication rates, including wound dehiscence and inferior alveolar nerve exposure, were similar in both groups.ConclusionsPiezosurgery can be safely used for harvesting autogenous ramus grafts and does not increase osteotomy or total operation time compared to the conventional method. The postoperative morbidity and complication rates were also similar, indicating that both techniques can be effectively employed in clinical practice.Clinical Trial RegistrationThe protocol was registered on clinicaltrials.gov (ID: NCT05548049, First registration date: 21/09/2022).

Comparison of Shaping Ability of a Newly Developed Pediatric Rotary File and the Conventional Rotary Instruments in Simulated Curved Canals: 2-Dimensional Computerized Study

Comparison of Shaping Ability of a Newly Developed Pediatric Rotary File and the Conventional Rotary Instruments in Simulated Curved Canals: 2-Dimensional Computerized Study

Efficiency of ER:YAG laser therapy in combination with behaviour management technique in reducing anxiety among paediatric dental patients – a study protocol for a randomised clinical trial

IntroductionWhen providing dental care to children with a high level of dental anxiety, the range of approaches is divided into two sections: use of behaviour management techniques (BMTs) and application...

A COMAPARATIVE STUDY OF THE CLINICAL EFFICIENCY OF A CHEMO MECHANICAL AGENT, BRIX- 3000, ROUND BUR FOR CARIES REMOVAL. AN IN VIVO STUDY.

AIM: To compare and evaluate the effectiveness of caries removal using two methods: a chemo mechanical agent, Brix3000 and conventional rotary instruments. This study also compared the difference in pain and discomfort caused by both the methods. METHODOLOGY: Owing o the power of the study, forty young participants aged between 20-30yrs, were enrolled in this study. The patient with a deep Class I carious lesion extending upto middle third of dentin and no symptoms were selected. The patients were randomly divided into 2 groups: Group I Brix3000 (n=20), Group II conventional method (n=20). Complete caries was excavated in both groups and then analyzed with tactile assessment. The parameters assessed were: pain, discomfort level throughout the procedure and mean time required for the treatment. RESULTS: The study showed that conventional rotary instrumentation method required significantly less time for caries removal (p = .001). but resulted in statistically higher pain score (p = .002) and discomfort to the patient as compared to the BRIX3000. CONCLUSION: These findings suggest that BRIX3000 is an excellent treatment option for caries removal with the same effectiveness and less trauma than the conventional method, inspite of it taking a longer time to remove the caries.

A Pilot Randomized Controlled Clinical Trial Comparing Piezo Versus Conventional Rotary Surgery for Removal of Impacted Mandibular Third Molars.

Background: The extraction of impacted mandibular third molars is a frequent dental surgery, interfering with patients’ quality of life. Ultrasonic surgery is an alternative to osteotomy with conventional rotary instruments. This study compares postoperative signals and symptoms after extracting impacted mandibular third molars using ultrasonic surgery or conventional rotary osteotomy. Methods: A pilot randomized controlled clinical trial was conducted. Thirty patients were randomly divided into the test group (ultrasonic technique) and a control group (conventional rotatory technique). All surgeries were timed. Swelling parameters, trismus and paraesthesia were evaluated on the day of surgery and the third, fifth and seventh postoperative days. Intraoperative bleeding was evaluated during surgery. Postoperative pain was evaluated daily by the patient through a visual analogue scale and the number of ingested analgesics. Results: Pain, swelling and trismus present beneficial results with the ultrasonic technique but without statistical significance. Intraoperative bleeding was significantly lower with ultrasonic surgery (t(28) = 3.258; p = 0.003). Operating time was significantly higher in extractions involving osteotomy and cutting crown and roots either with the conventional technique (p = 0.020) or ultrasonic technique (p = 0.039). Regardless of the surgical difficulty, no statistically significant results were detected between techniques regarding the procedure duration. Conclusions: The beneficial postoperative signs and symptoms make ultrasonic surgery a favourable therapeutic option, especially when the integrity of noble anatomical structures is the most important risk factor. Further studies with larger samples are needed to support the use of piezosurgery as a valid option for impacted mandibular third molar extraction.

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

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.

Microtomography Evaluation of The Efficacy of Reciprocating And Rotary Instruments Followed By Different Complementary Steps In The Retreatment of Curved Root Canals

Objectives: The purpose of this study was to evaluate the efficacy of steps, isolated or in cumulative means, in the endodontic retreatment of curved canals. Methodology: Forty mesial roots of mandibular molars were divided into two groups. In the group 1 the filling removal was done with NiTi reciprocating M-wire and NiTi control memory wire rotary instruments followed by a passive ultrasonic irrigation solution agitation. In the group 2, the initial filling removal was done with NiTi reciprocating M-wire and conventional NiTi wire rotary instruments followed by a rotary plastic instrument for irrigation solution agitation. The results were analyzed through micro-computed tomography. Results: The filling material was not completely removed for both groups. All steps did not statically differ between groups regarding to the filling removal. In the intragroup analyses, the results differed in some levels, mainly in the apical level, but did not statistically differ in all the different levels after each step. A statistical significant increase (P<.05), for both groups, in the volume of filling material in the isthmus was observed. Conclusions: None of the protocols completely removed the filling material. The better results were found for the apical level and after passive ultrasonic irrigation. Vertical warm condensation filling technique enhanced the volume of filling material in the root canal system including the isthmus. Clinical relevance: the control memory NiTi instruments could be considered a good choice for use as an additional step in the procedure of filling removal from curved mesial root canals.

Postoperative neurosensory impairment perception using ultrasonic BoneScalpel and conventional rotary instruments after bilateral split sagittal osteotomy.

Although bilateral sagittal split osteotomy (BSSO) is the most widely used surgical technique for the correction of mandibular dentofacial anomalies, it is associated with lesion of inferior alveolar nerve (IAN) and unwanted neurosensory disorders. The aim of this study was to document the perception of changes in sensitivity and mean recovery time after BSSO, using an ultrasonic BoneScalpel versus the conventional rotary instruments. This retrospective observational study included all patients with diagnosis of skeletal anomaly who underwent advancement or setback BSSO of less than 10 mL, using the ultrasonic osteotome or conventional rotary instruments. The patients were operated on at the Hospital Universitario Clínica San Rafael, Bogotá Colombia, between 2017 and 2018. The primary predictor variable was the osteotomy technique. The primary outcome was the presence or absence of postoperative sensory alteration, whereas secondary outcomes were time of appearance and recovery, affected anatomical region, laterality, and disturbance in daily activities. Data were analyzed using Chi-square, Mann-Whitney U, and Fisher's exact test. Data of 38 patients were retrieved, of which 23 were operated with BoneScalpel and 13 with the conventional technique. Twenty patients were women and 18 were men. All patients reported experiencing at least one type of sensory disturbance immediately after the surgical procedure. There was a significant difference (p = 0.0001) in the time that the alteration was present between the two groups, in favor of the BoneScalpel group. The chin and the lower lip were the anatomical regions with the greatest alteration in sensitivity and persistence of it. The results of this study indicate that BoneScalpel is effective in performing BSSO. They also suggest that it may reduce the occurrence of nerve damage during BSSO, although more research on this topic is required.

Comparison of postoperative morbidity between piezoelectric surgery and conventional rotary instruments in mandibular third molar surgery: a split-mouth clinical study.

Background The extraction of impacted third molar teeth is a common procedure in maxillofacial surgery. The aim of this study was to compare of piezoelectric surgical technique with the one with conventional rotary instruments in terms of edema, trismus and pain, in mandibular third molar surgery. Material and Methods 20 individuals with symmetrically impacted lower mandibular third molars and 40 teeth were included in the study. Third molars on the left side of each patient were removed with piezosurgery, while the counterparts on the right side were removed with conventional rotary instruments. Postoperatively, the same antibiotic, analgesic, and mouthwash were recommended to both groups. Ultrasound, edema, trismus measurements were performed before surgery, postoperative, postoperative day 2 and postoperative day 7. VAS scale was used to evaluate the pain. Results The average age of 20 individuals included in the study was found to be 21.85 ± 3.08 years. The operation time of the individuals who underwent the surgery with conventional rotary instruments was found to be 12 minutes 31.70 ± 167.03 seconds, and the operation time in the Piezosurgery group was 19 minutes 10.60 ± 306.59 seconds. There was no significant difference between the two groups in terms of trismus, edema, and pain. Conclusions Piezosurgery is a safe method that can be used in molar removal, but in this split-mouth study, it is not found advantageous in terms of postoperative morbidity due to the longer working time compared to the one performed with conventional rotary instruments. Key words:Edema, impacted third molar, pain, piezosurgery, trismus.

Comparison of piezosurgery and conventional rotary instruments in schneider's membrane sinus lifting: A pilot randomized trial.

BackgroundThe present study aimed to evaluate and compare the postoperative effects of the piezoelectric device and conventional rotary instruments in Schneider’s membrane sinus lifting procedure. Material and MethodsTwenty patients requiring bilateral maxillary bone graft augmentation in the posterior maxillary region were selected. Piezoelectric surgery was performed on one side and conventional surgery with a rotary diamond bur on the other. Postoperative pain, swelling, edema, and mouth opening were evaluated at one hour and two and seven days after the procedures. All variables were submitted to Friedman or Wilcoxon tests at a 5% significance level. ResultsThe comparison between groups showed that postoperative pain after one hour and two days was significantly lower (p< 0.05) in the piezoelectric device group. Regarding the edema, the results of both techniques were similar at all times assessed (p> 0.05). Piezosurgery was statistically associated (p< 0.05) with greater mouth opening only at the 48-hour evaluation. ConclusionsOsteotomy with a piezoelectric device causes less pain and greater mouth opening postoperatively compared with the conventional technique. Key words:Piezosurgery, sinus lift, edema, pain, rotative instruments.

A comparative survival analysis of high viscosity glass ionomer restorations using conventional cavity preparation and atraumatic restorative treatment technique in primary molars: A randomized clinical trial.

Background:This randomized clinical trial (RCT) aimed to compare the 3-year survival rates of high viscosity glass ionomer restorations (HVGIC) using conventional cavity preparation and atraumatic restorative technique (ART) in primary molars.Materials and Methods:In this RCT, 139 schoolchildren aged 6–9 years with dentinal caries in primary molars were randomly allocated to groups, i.e. the ART group and the conventional group, utilizing a random number generator. Adequate allocation concealment was done. Intervention was delivered using standard procedure and GC Fuji IX ART HVGIC was used as restorations in both the groups. Analysis was carried in 92 participants, and survival rates in both the groups were compared at 12, 24, and 36-month intervals. IBM SPSS software was utilized to analyze the time taken for the procedure and the Kaplan–Meier estimate was used to assess the survival rates. P value of 0.05 was considered statistically significant.Results:The ART took longer to complete (16.48 ± 2.02 min) versus conventional rotary instrumentation (13.15 ± 1.32 min). The conventional method was slightly superior as compared to ART; excellent survival rates (i.e. >90%) were achieved in both groups at the end of 12-month follow-up with no significant differences at the end of 24 and 36 months as evident from Kaplan–Meier estimate (P = 0.255).Conclusion:Three-year follow-up showed that GIC restorations with ART and conventional method carried out using GC Fuji IX ART HVGIC were acceptably successful, substantiating the use of ART for the primary dentition in areas with high caries prevalence and limited access to dental care.

Evaluation of the effect of using ultrasonic instruments to improve the shoulder of the preparations

OBJECTIVE To provide the basis for the clinical development of ultrasonic shoulder preparation by comparing the roughness and three-dimensional topography of shoulder surface between ultrasonic instruments and conventional rotary instruments, to make preliminary suggestions for clinical use of ultrasonic instruments. METHODS (1) Four areas of buccal and palatal surfaces of six extracted human premolars were prepared with different grit size of rotary instruments. Polyether was used to take impression of the shoulder area, 3-D topography measurement laser microscope (3-D TMLM) was used to scan the impressions and compare the shoulder surface roughness of the four areas. (2) Six extracted human premolars were prepared, mesial half of the shoulder was finished with traditional rotary instruments and distal half with ultrasonic instruments. Polyether was used to take impression of the shoulder area, 3-D TMLM was used to scan the impressions and compare the shoulder surface roughness and 3-D topography, and the shoulder surface morphology was observed by surgical microscope (×25 magnification). (3) Twenty extracted human maxillary symmetrical homonymous anterior teeth were poured into die stone using artificial gingiva, ultrasonic instruments group and rotary instruments group were divided randomly. After preparing the teeth and taking the shoulder impression with polyether in dental simulate on the training system, the surface roughness of the shoulder impression in mesial, middle and distal areas was scanned and compared. The data were analyzed using SPSS 25.0 software package. RESULTS (1) There was no significant difference in Ra and Rz values between the abutment shoulder and impression shoulder in different areas. (2) The surface roughness of the shoulder impression prepared by ultrasonic instruments [Ra:(6.59±2.33) μm, Rz:(34.69±7.29) μm] was significantly smaller than that of the rotary instruments [Ra:(21.79±4.89) μm, Rz:(91.69±14.82) μm] (P < 0.05). The morphology of the shoulder prepared by ultrasonic instruments was clear and continuous under microscope observation. (3) The surface roughness of each area of the shoulder prepared by ultrasonic instruments was significantly lower than that of the rotary instruments (P < 0.001); there was no significant difference of the surface roughness (Ra) in each area of the shoulder impression after ultrasonic instrument preparation, while the shoulder impression roughness in the mesial and distal areas was significantly higher than that in the middle area (P < 0.001) after rotary instrument preparation. CONCLUSION Compared with the rotary instruments, the ultrasonic instruments can obtain a smoother shoulder surface, especially can significantly improve the shoulder preparation effect near the proximal surface.

Histological evaluation of inferior alveolar nerve injury after osteotomy of mandibular buccal cortex using piezoelectric versus conventional rotary devices: a split-mouth randomised study in rabbits

Up until now, only a limited number of evidence-based studies with different results has evaluated traumatic nerve injury after maxillofacial surgery using piezoelectric devices versus rotary instruments. The present experiment was performed to evaluate damage to the inferior alveolar nerve (IAN), histologically, after osteotomy of the buccal cortex of the mandible using piezoelectric devices versus surgical handpieces. Forty rabbits underwent bilateral osteotomy of the mandibular buccal cortex. For the osteotomy of one side, piezoelectric devices were used, and for the other, conventional rotary handpieces. After cleavage of the osteotomised cortical bone segments, the exposed part of the IAN was excised and examined histologically for nerve injury. IAN damage was scored histologically from Grade 0 (no nerve damage) to Grade 4 (complete nerve transection). It was found that 25% and 17.5% of nerves had Grade 0; 17.5% and 10% had Grade 1; 25% and 20% had Grade 2; 17.5% and 27.5% had Grade 3; and 15% and 25% had Grade 4 injury in piezosurgery and rotary groups, respectively. Statistical analyses revealed no significant difference between groups in damage to the IAN. The present study showed that piezosurgery devices, similar to conventional rotary instruments, have the potential to cause severe nerve damage during surgery and should therefore be used with care.

Surgical management of compound odontomas: piezoelectric surgery or rotary instruments? A clinical study.

Odontomas are odontogenic tumors with a clinicopathological heterogeneity and a variable biological behavior. They usually are asymptomatic and can be discovered by routine radiographic investigations. This study aims to examine and compare intra- and postoperative consequences associated with use of piezosurgery and conventional rotary instruments for the removal of these oral lesions. Clinical and histological data of 120 consecutive patients with a mean age of 22 years and 1 month (age range from 19 years and 1 month to 25 years and 3 months) with compound odontomas, diagnosed by biopsy, were assembled. Of a total of 120, 100 oral lesions were placed in the anterior region of the maxilla; of these, 50 were extracted through traditional rotary instruments (GROUP 1) and 50 with piezoelectric surgery (GROUP 2). The remaining 20 oral masses took place in the posterior area of the same bone; of these, 10 were extracted through traditional rotary instruments (GROUP 1a) and 10 with piezosurgery. (GROUP 2b). The piezoelectric cutting device was (Mectron Medical Technology) with MT1-10 insert, pump level 4, vibration level 7. Finally, pain, swelling, and surgical time evaluation were measured 24-48-72 hours after the intervention. As regards the mean time of surgery, in Group (1 and 1a) were 12 minutes, while in Group (2 and 2a) were 18 minutes. Regarding surgery, the osteotomy of the cortical bone was performed in all cases. As regards the measure of bone saved, calculated through a surgery gauge, it was greater of 3.2 mm in Group (2 and 2a) than in Group (1and 1a). The main of facial swelling in both Groups (1 and 1a) was 5.82 mm and 2.23 mm for the Groups (2 and 2a) immediately after surgery. Piezosurgery produced less postoperative discomfort about the swelling. It is an effective technique in daily surgical practice, especially as regards the safety of soft tissues, bone, and nerves.

Comparing the efficacies of two chemo-mechanical caries removal agents (2.25% sodium hypochlorite gel and brix 3000), in caries removal and patient cooperation: A randomized controlled clinical trial

IntroductionThis study compared and evaluated the effectiveness of Brix 3000 and 2.25 % sodium hypochlorite (NaOCl) gel with conventional rotary instrumentation method in caries excavation of primary molars. The null hypothesis: no difference between the two tested chemo-mechanical caries removal (CMCR) agents used in this trial. Materials and methodsa randomized controlled clinical trial conducted with 32 children suffering from proximal caries of primary maxillary molars, age ranging between 6 and 9 years old. Subjects were randomly assigned into three groups: Brix 3000, NaOCl gel, and conventional with 10, 12, and 10 teeth in each group, respectively. After isolation of selected teeth, either CMCR agent were applied for two minutes. The application was repeated as needed until a caries-free surface was obtained. The conventional group used low-speed burs to excavate all carious lesions. The time required to obtain a caries-free result for each testing method was recorded. Wong-Baker FACES pain rating scale was used to assess the acceptance of the technique used by the child. ResultsConventional treatment required significantly less time for caries removal compared to Brix 3000 (P = .002) and NaOCl gel (P = .000). No significant difference observed between Brix 3000 and NaOCl gel (P = .679). Statistically higher pain scores were observed with conventional treatment compared to both Brix 3000 (P = .000) and NaOCl gel (P = .005). Pain scores were lower with Brix 3000, and NaOCl gel with no significant difference observed between the CMCR agents (p = .690). ConclusionsCMCR agents that are effective in removing the carious dentine of primary teeth without negatively affecting the cooperation of children. Clinical SignificanceThe use of a 2.25 % sodium hypochlorite gel can be an effective and well-tolerated method of removing decay from primary teeth and reduce the trauma associated with conventional rotary caries removal.

Comparative evaluation of the efficiency of caries removal using various minimally invasive techniques with conventional rotary instruments using cone beam computed tomography: An in vitro study

Aim: The aim of this in vitro investigation was to assess the most efficient minimally invasive technique (MIT) by comparing the change in volume after caries removal using cone beam computed tomography (CBCT) and the time taken for each technique. Materials and Methods: Forty human extracted molars, stored in 0.1% thymol solution, with carious lesions extending into the dentin were used in the study. The caries status of dentin was judged initially by visual inspection and probing and confirmed by caries detector dye. A pre-scan CBCT was performed before assessing the volume of the carious lesion. Teeth were assigned into four groups (n = 10): Group 1 = Carisolv gel, Group 2 = Carie Care, Group 3 = ultrasonic tips, and Group 4 = slow-speed rotary instruments. The caries removal was performed according to the manufacturer’s instructions. Time taken was recorded for each method. A postoperative scan was conducted, and volumetric analysis was carried out. The amount of removal of sound tooth structure was assessed to determine the most MIT. Descriptive and inferential statistics were used to analyze the data. The intergroup volume change of caries was carried out using the Kruskal–Wallis test, whereas comparison within the group was carried out using Wilcoxon signed-rank test. The assessment of time taken during each procedure was analyzed with one-way analysis of variance and Tukey honest significant difference test. The results were tabulated accordingly. Significance was set at P value ≤ 0.05. Results: The chemomechanical agents (Carisolv and Carie Care) showed minimal change in volume when compared to conventional diamond points. The time taken with conventional diamond point was minimum, and it was maximum for ultrasonic tips. Conclusion: Chemomechanical caries removal is the most minimalistic approach when compared to the other techniques.

Piezoelectric Device versus Conventional Rotary Instruments in Implant Site Preparation (Comparative Clinical Study)

Purpose: This study was designed to evaluate and compare the efficiency of piezoelectric device for implant site preparation clinically and radiographically. Materials and methods: The study included 12 patients divided into two groups. The group A received implants prepared with the conventional drills (CDs), while, group B, the piezoelectric devices (PEDs) were used. The stability of implant was measured, immediately, at 2 months, and 4 months after the implant insertion. Also, the drilling time was recorded. While, the Marginal bone loss (MBL) and Bone mineral density (BMD) were recorded immediately, at 3, and 6 months after implant insertion. Results: Group B had a significant higher ISQ values all over the follow up periods. The drilling time of ISP was significantly higher in group B. Regarding the MBL, there was no a statistical significant difference. The BMD increased significantly in group B immediately, and at 3 month. Conclusion: The osseointegration of implants prepared with PED was significantly greater than that of implants which prepared with the CDs all over the time points, but the PEDs need significantly longer surgical time than the CDs

A prospective split-mouth clinical study: comparison of piezosurgery and conventional rotary instruments in impacted third molar surgery.

Our purpose was to compare the effects of piezosurgery and conventional rotary instruments on postoperative pain, swelling, trismus, and patients' comfort after mandibular third molar surgery. Thirty patients (27 women and 3 men) with bilateral impacted mandibular third molars were included in this split-mouth clinical study. Sixty impacted third molars were divided into a control group (n = 30), in which the osteotomies were performed using a conventional rotary handpiece technique and an experimental group (n = 30), in which the osteotomies were done by piezosurgery technique. Duration of the procedure was recorded. Postoperative pain was assessed using a visual analogue scale (VAS). All the patients were given a form containing verbal rating scale for evaluating the swelling. Trismus was evaluated using a caliper at maximum mouth opening (cm). In postoperative seventh day, patients were asked to fill a global quality of life (QoL) scale as well. There was no significant difference in postoperative pain, trismus, and swelling between control and experimental groups (p > 0.05). However, time of the procedure increased in control group (p < 0.05). Piezosurgery is a safe way for performing the osteotomies during third molar surgery. However, regarding the postoperative morbidity, it does not have an advantage over conventional rotary instruments. Piezosurgery took longer to complete the osteotomy than the rotary handpiece technique.

Using of piezoelectric surgical instruments in oral and maxillofacial surgery

Piezoelectric surgery is a relatively new technique that provides safe and effective osteotomies using piezoelectric ultrasonic vibrations, and every day new devices with new features are produced and marketed. Piezosurgery instruments have superior properties compared to conventional rotary surgical instruments. Because of its micrometric and selective cutting, the piezoelectric surgery device provides a safe and sensitive osteotomy without causing necrotic damage to the bone. Compared to conventional rotary instruments, the most important feature is that it works only on mineralized tissues while maintaining soft tissue and blood support. It does not damage the tissues in contact with soft tissues such as the bone and mucous membranes in and around the operation area. In this study, properties, usage areas, advantages and disadvantages of piezoelectric surgical instruments which are frequently preferred in Oral, Dental and Maxillofacial Surgery applications as in many fields of orthopedics and brain surgery of medicine are explained.

Comparative Analysis of Biofilm Removal Efficacy by Multisonic Ultracleaning System and Passive Ultrasonic Activation.

The purpose of this study was to compare disinfection and the biofilm removal efficacy of the GentleWave System (Sonendo, Inc., Laguna Hills, CA, USA) with passive ultrasonic activation method. Forty-seven freshly extracted human molars were inoculated with Enterococcus faecalis and cultured for five weeks to establish biofilm. Eight molars were tested for confirmation of infection. Four of the eight teeth were not inoculated in order to provide a negative control. The remaining 39 inoculated molars were randomly separated into three treatment groups (n = 13 per group): Group 1—no treatment, Group 2—conventional rotary instrumentation and passive ultrasonic activation, and Group 3—minimal instrumentation and the GentleWave System treatment. Roots were subsequently prepared per standard histological tissue processing procedures. Modified Brown and Brenn stained sections and Hematoxylin and Eosin stained sections were visualized at 4× and 13.5× magnification using a stereomicroscope. The sections were scored and blindly analyzed by two independent evaluators, including a histopathologist, to evaluate the presence of biofilm on canal wall. A significant difference was found between Group 2 and Group 3 in both apical and middle regions (p = 0.001) of the mesial roots of mandibular molars and mesiobuccal roots of maxillary molars. Group 3 revealed significantly less biofilm than the controls (p = 0.003). The GentleWave System demonstrated significantly greater reduction in biofilm within the mesial roots of mandibular molars and mesiobuccal roots of maxillary molars than those treated with conventional rotary instrumentation and passive ultrasonic activation protocol.