Clinical research on therapeutic effect of pulling out the mandibular third impacted molar with piezosurgery and highspeed rotary handpiece

doi:10.19438/j.cjoms.2019.06.012

Abstract

Abstract: PURPOSE: This research aimed at evaluating the efficacy of different types of impacted mandibular third molars removed by piezosurgery and highspeed rotary handpiece. METHODS: One hundred and twenty low-positioned impacted mandibular third molars were assigned to 3 groups (vertically impacted group, mesially impacted group and horizontally impacted group) and each group included 40 teeth. Twenty teeth in each group were treated with piezosurgery and another 20 teeth with highspeed rotary handpiece. The operation time, degree of postoperative pain and swelling, mouth opening and serious complications (such as permanent nerve injury) were recorded. SPSS 17.0 software package were used for statistical analysis. RESULTS: All cases treated with piezosurgery showed minor postoperative pain at 1 d and 3 d than those with highspeed rotary handpiece, but no significant difference at 7 d. In vertically impacted group, no significance was shown in the operation time, swelling, mouth opening between two methods. In mesially impacted group, piezosurgery had the advantages of reducing operation time and mouth opening limitation than highspeed rotary handpiece, but with the same degree of swelling. In horizontally impacted group, piezosurgery was superior to highspeed rotary handpiece in all postoperative clinical indexes. No serious complication was observed in each group. CONCLUSIONS: Comparing to highspeed rotary handpiece, piezosurgery achieves minimally invasive surgery via selectively cutting bone tissue, accurate osteotomy, less postoperative trauma. It is recommended to use piezosurgery to remove low positioned mesially or horizontally impacted third molars to reduce postoperative trauma and improve surgical outcomes.

Key words: Impacted mandibular third molars, Piezosurgery, Highspeed rotary handpiece

CLC Number:

R782.1

SONG Yong, LI Xiang, CAI Man, WANG Yao-hui. Clinical research on therapeutic effect of pulling out the mandibular third impacted molar with piezosurgery and highspeed rotary handpiece[J]. China Journal of Oral and Maxillofacial Surgery, 2019, 17(6): 540-544.

References

[1] Kugelberg CF.Impacted lower third molars and periodontal health. An epidemiological, methodological, retrospective and prospective clinical study[J]. Swed Dent J Suppl, 1990, 68(1): 1-52.
[2] Hamasha AA, Al Qudah MA, Bataineh AB, et al.Reasons for third molar teeth extraction in Jordanian adults[J]. J Contemp Dent Pract, 2006, 7(5): 88-95.
[3] Borgonovo AE, Giussani A, Grossi GB, et al.Evaluation of postoperative discomfort after impacted mandibular third molar surgery using three different types of flap[J]. Quintessence Int, 2014, 45(4): 319-330.
[4] Kerawala CJ, Martin IC, Allan W, et al.The effects of operator technique and bur design on temperature during osseous preparation for osteosynthesis self-tapping screws[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1999, 88(2): 145-150.
[5] Barone A, Marconcini S, Giacomelli L, et al.A randomized clinical evaluation of ultrasound bone surgery versus traditional rotary instruments in lower third molar extraction[J]. J Oral Maxillofac Surg, 2010, 68(2): 330-336.
[6] Rullo R, Addabbo F, Papaccio G, et al.Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery: relationships between surgical difficulty and postoperative pain with histological evaluations[J]. J Craniomaxillofac Surg, 2013, 41(2): e33-38.
[7] Kunkel M, Morbach T, Kleis W, et al.Third molar complications requiring hospitalization[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 102(3): 300-306.
[8] Vercellotti T.Technological characteristics and clinical indications of piezoelectric bone surgery[J]. Minerva Stomatol, 2004, 53(5): 207-214.
[9] Bartuli FN, Luciani F, Caddeo F, et al.Piezosurgery vs high speed rotary handpiece: a comparison between the two techniques in the impacted third molar surgery[J]. Oral Implantol (Rome), 2013, 6(1): 5-10.
[10] Sivolella S, Berengo M, Bressan E, et al.Osteotomy for lower third molar germectomy: randomized prospective crossover clinical study comparing piezosurgery and conventional rotatory osteotomy[J]. J Oral Maxillofac Surg, 2011, 69(6): e15-23.
[11] Piersanti L, Dilorenzo M, Monaco G, et al.Piezosurgery or conventional rotatory instruments for inferior third molar extractions?[J]. J Oral Maxillofac Surg, 2014, 72(9): 1647-1652.
[12] Bains VK, Mohan R, Bains R.Application of ultrasound in periodontics: Part Ⅱ[J]. J Indian Soc Periodontol, 2008, 12(3): 55-61.
[13] Harder S, Wolfart S, Mehl C, et al.Performance of ultrasonic devices for bone surgery and associated intraosseous temperature development[J]. Int J Oral Maxillofac Implants, 2009, 24(3): 484-490.
[14] Rahnama M, Czupkallo L, Czajkowski L, et al.The use of piezosurgery as an alternative method of minimally invasive surgery in the authors' experience[J]. Wideochir Inne Tech Maloinwazyjne, 2013, 8(4): 321-326.
[15] Goyal M, Marya K, Jhamb A, et al.Comparative evaluation of surgical outcome after removal of impacted mandibular third molars using a Piezotome or a conventional handpiece: a prospective study[J]. Br J Oral Maxillofac Surg, 2012, 50(6): 556-561.
[16] Dolan EB, Vaughan TJ, Niebur GL, et al.How bone tissue and cells experience elevated temperatures during orthopaedic cutting: an experimental and computational investigation[J]. J Biomech Eng, 2014, 136(2): 021019.
[17] Labanca M, Azzola F, Vinci R, et al.Piezoelectric surgery: twenty years of use[J]. Br J Oral Maxillofac Surg, 2008, 46(4): 265-269.
[18] Mantovani E, Arduino PG, Schierano G, et al.A split-mouth randomized clinical trial to evaluate the performance of piezosurgery compared with traditional technique in lower wisdom tooth removal[J]. J Oral Maxillofac Surg, 2014, 72(10): 1890-1897.