1. Materials and Methods Abstract Results Purpose Conclusions
Comparison of between The Piezoelectric and Classical Osteotomy
Techniques in Impacted Third Molar Surgery
Academy of Osseointegration’s 2015 Annual Meeting, March , 2015
Kirli Irem, DDS,PhD; Palancioglu Alen, DDS; Yaltirik Mehmet, DDS, PhD.
Istanbul University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery ISTANBUL- TURKEY
The mean intraoperative pain level in Group I was 1,66±1,79, in Group II was 1,21±1,61. The mean postoperative 2nd day pain level was 2,93±1,89 in Group I, and 3,65±1,99 in Group II. The mean postoperative 7th day pain level was 0±0 in both groups. No statistically significant differences in intraoperative and postoperative pain levels attributable to the osteotomy technique (p>0.05).
We found no statistically significant correlation between sex and postoperative 2nd and 7th days pain level. On the contrary, Benediksdottir et al. indicated that women had felt 3 times more severe pain than males in the postoperative period of impacted mandibular third molar surgical extraction. Benediksdottir et al were on oral contraceptive treatment, and as a fact that oral contraceptive can promote the infection, alveolitis and pain, it was already inevitable to have more severe pain in women then men in the postoperative period.
No sign of nerve damage such as paresthesia or dysesthesia was seen postoperatively in netiher of two groups. Only young individuals to this study may give rise to this result.
Of the 21 patients, only 2 (9.5 %) complained of an unpleasant buzzing in their ears at the extraction site during piezosurgical osteotomy, the other patients (%90,5) found the unique sound of piezoelectric device more tolerable than the sound of classical drill method. To our knowledge, no hearing deficits have been reported in relation to this method.
Although piezosurgery has many advantages like selective, precise, less agressive osteotomy and protecting nerve and vessels; it is not seemed to be significantly morereducing beneficial than classical osteotomy method in terms of perioperative anxiety, pain and paresthesia.
Materials and Methods
Abstract
Results
Objective In order to decrease the perioperative and postoperative complications and morbidity in oral surgery, many researches are done for developing a safer and less agressive osteotomy technique. As a result of these researches piezoelectric surgery is introduced as a safe, effective and new osteotomy technique that can support conventional osteotomy techniques in oral and maxillofacial surgery. The aim of this presentation is to compare piezosurgery and classical for mandibular third molar surgery.
Study design Bilateral symmetrical mandibular third molars patients (14 female, 7 male) which were concluded to extract were included in our study.
Conclusion Although piezosurgery has many advantages like selective, precise, less agressive osteotomy and protecting nerve and vessels; it is not seemed to be significantly more beneficial than classical osteotomy method in terms of reducing perioperative anxiety and pain.
Keywords: Piezosurgery, impacted tooth, pain
The most common postoperative complications after third molar surgery are pain, edema and trismus ,necrosis of the bone and pain and iatrogenic damage to adjacent soft tissues. One of the most important problem in oral surgery is providing a more comfortable postoperative period.
One of the important advantages of piezosurgery is micrometric and selective cutting of the bone and minimizes the risk of injury to adjacent soft tissues such as nerves, vessels, mucosa and periosteum. It also does not produce excessive temperatures in the bone during osteotomy.
The aim of our study is comparing intraoperative and postoperative pain and nerve injury between piezosurgery and classical osteotomy in the surgical extractions of impacted mandibular third molars patients.
Twenty-one bilateral symmetrical impacted mandibular third molars patients who required indication for removal of the impacted mandibular third molar were pressure pain, chronic pericoronitis, orthodontic and prosthetic treatment from the out patient Department of Oral Surgery, Faculty of Dentistry, Istanbul University.
The treatment method (osteotomy -piezosurgery) was randomly assigned to be performed on one or the other side of the patient’s. Patients with a history of systemic diseases such as uncontrolled diabetes, blood dyscrasias, alcoholism, drug abuse, and heavy smoking, patients who are allergic to local anesthetics, antibiotics and antiiflamatuars were excluded.
After we had taken a detailed history and orthopantomogram (OPG), treatment started. Our study was approved ethically by Istanbul University Faculty of Medicine Council of Ethics. All patients were inform about the procedure, and the possible complications.
All the operations were done by the same surgeon under local (inferior alveolar nerve and buccal nerve block) anaesthesia.
In conventional group, a No. 6 carbide round bur in a straight handpiece was used at 35,000 rpm for trephination was accompanied by copious irrigation with chilled saline solution.
In the Piezosurgery group, vibration frequency was maintained between 28 and 36 kHz and the microvibration amplitude between 30 and 60 µ/s. After the tooth had been removed, the extraction socket was debrided and closed.
Postoperatively, patients were instructed to take amoxicillin with clavulanic acid 1000 mg, 2 times daily for 5 days, and analgesics and next appointment was scheduled two weeks after.
Neurosensory paraesthesiae was evaluated at postoperative days 2 and 7. using the cotton wool test.
Pain was evaluated intraoperatively and on postoperative days 2. and 7. Pain was assessed with a 10-cm visual analogue scale (VAS).
There were 7 male and 14 female patients age between ,mean age was 22,38. In the Group I, piezosurgery was used , and in the Group II conventional rotary handpiece was used randomly assigned to be performed on one or the other side of the patient’s mouth.
The control examinations in postoperative 2nd and 7th days revealed no sign of nerve damage in Group I and II.
Group I and II consists of 14 vertical and 7 mesioangular teeth. In Group I and II both vertical and mesioangular teeth showed statistically significant decrease of pain levels in 7. day with respect to 2. day (p<0.01).
In Group I, mean intraoperative pain level in females was 1,59±1,42, and in males, it was 1,80±2,51. Mean postoperative 2. day pain level was 3,40±1,90 in females and 2,01±1,59 in males. Mean postoperative 7. day pain level was 0±0 in both genders. Mean postoperative 2. day pain level was higher in females than males, but this difference was not statistically significant. No statistically significant difference in intraoperative and postoperative pain levels was seen between genders (p>0.05).
In Group II, mean intraoperative pain level in females was 1,59±1,42, and in males, it was 0,87±1,32. Mean postoperative 2. day pain level was 4,04±1,88 in females and 2,88±2,14 in males. Mean postoperative 7. day pain level was 0±0 in both females and males. Mean postoperative 2. day pain level was higher in females than males, but this difference was not statistically significant. No statistically significant difference in intraoperative and postoperative pain levels was seen between males and females(p>0.05).
Group I and II both males and females showed statistically significant decrease of pain levels in 7. day with respect to 2. day (p<0.01).
Purpose
Conclusions
References
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