Application of Piezosurgery in Surgical Extraction of Impacted Mandibular Third Molars Versus Conventional Rotatory Technique: A Randomized Controlled Trial

Objective: To compare the effectiveness of conventional rotatory and piezosurgery technique for surgical removal of lower third molars.  Material and Methods: Twenty patients with impacted lower third molars (with no acute symptoms) were divided into two groups (G1 and G2) and evaluated clinically and radiographically. They were allotted alternately into rotatory (G1) and piezotome (G2). Parameters assessed were the pain, swelling, trismus, comfort, analgesics consumed, the time taken for the procedure, intraoperative soft tissue damage and any other complications. Findings were then tabulated and analyzed.  Results: Findings of pain, swelling, trismus, analgesics consumed and tissue damage were favorable in the piezosurgery group. However, the time taken for the procedure was significantly more as compared to the rotatory group. Post-operative trismus, values from the piezosurgery group were found to approach normality by day seven while in the rotatory group, a significant difference was found to exist up to day 14, suggesting that patients tend to return to normal function faster in the piezo group.  Conclusion: Piezosurgery was found to be a good alternative to the conventional rotatory handpiece in select cases where extraction of the tooth could be carried out with minimal bone removal.