Comparative Evaluation of Postoperative Healing Following Surgical Removal of Impacted Mandibular Third Molars using Piezoelectric Surgery Versus Conventional Rotary Instruments: A Clinical & Radiological Study

Abstract

Introduction: Bone removal is an essential component of third molar extractions, particularly in cases involving erupted, partially erupted, or fully impacted teeth. Therefore, selecting a surgical technique & instruments that respect anatomical boundaries & adhere to physiological principles is critical. This study aimed to evaluate & compare the postoperative healing outcomes of third molar extractions performed using piezoelectric surgery versus traditional rotary instruments.

Materials & Methods: This interventional study was carried out over a one-year period in the departments of Oral & Maxillofacial Surgery & Radiology at a dental hospital. A total of 50 patients requiring extraction of impacted third molars were enrolled & randomly divided into two groups. Evaluated parameters included procedure duration, postoperative pain levels, degree of trismus, & bone density.

Results: The average surgical time was significantly greater in the piezoelectric group (Group I: 48.2 ± 5.6 minutes) compared to the rotary group (Group II: 36.5 ± 4.9 minutes), with a statistically significant difference (p < 0.05). Over the 7-day postoperative period, both groups experienced a reduction in pain, but Group I consistently reported lower VAS scores than Group II, which was statistically significant (p < 0.05). Trismus was also significantly less in Group I by day 7 (p < 0.05), indicating better functional recovery. Radiographic assessment showed progressive improvement in bone density for both groups; however, Group I demonstrated significantly greater bone regeneration at 3 & 6 months postoperatively (p < 0.05).

Conclusion: Within the scope of this study, piezoelectric surgery was found to minimize postoperative pain, trismus, & swelling. It also appeared to promote enhanced bone healing in the extraction site & potentially reduce bone loss adjacent to the mandibular second molar. Compared to conventional rotary techniques, piezosurgery was associated with fewer postoperative complications.