Piezosurgery or Conventional Rotatory Instruments for Inferior Third Molar Extractions?

Purpose: The purpose of this study was to compare the discomfort and surgical outcomes of a piezosurgery device with those of rotatory instruments in lower third molar extraction. Materials and Methods: A split-mouth, randomized, unblinded clinical study was designed; the 2 molars had to have the same extraction difficulty score. The test side was extracted using a piezosurgery technique and the control side was extracted using a conventional handpiece. The primary endpoint was patient discomfort evaluated with the Postoperative Symptom Severity (PoSSe) scale, which was administered to each patient; secondary endpoints were pain, trismus, swelling, and surgical time evaluation. Paired-samples t test and repeated-measures analysis of variance were used to compare outcomes within patients. Results: Ten consecutive patients (6 female, 4 male; mean age, 22.4 +/- 2.3 yr) were recruited. The total score on the PoSSe scale was significantly lower for piezosurgery compared with the conventional rotating handpiece (24.7 +/- 10.3 vs 36.0 +/- 7.6; t = -4.27; P = .002). Moreover, postoperative swelling 1 week after surgery was significantly lower for piezosurgery than for the conventional rotating handpiece (2.75 +/- 0.23 vs 3.1 +/- 0.39 cm; t = -2.63; P = .027). Conclusions: Piezosurgery was associated with less postoperative discomfort and yielded better results for swelling. Piezosurgery seems to be a good technique in daily surgical practice, especially if applied in the critical steps in which safety and respect for soft tissue, bone, and nerves are necessary. (C) 2014 American Association of Oral and Maxillofacial Surgeons.