title: Piezosurgery or conventional rotatory instruments for inferior third molar extractions?
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: PhD Student, Faculty of Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy. Electronic address: ggpiersanti@gmail.com.
authors.forename: Luigi
authors.initials: L
authors.lastname: Piersanti
authors.affiliation: Department of Oral and Dental Science, Alma Mater Studiorum University of Bologna, Bologna, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Dilorenzo
authors.affiliation: Clinical Assistant, Department of Oral and Dental Science, Alma Mater Studiorum University of Bologna, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Monaco
authors.affiliation: Professor, Department of Oral and Dental Science, Alma Mater Studiorum University of Bologna, Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Marchetti
mesh_terms: D000293:Adolescent; D000328:Adult; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008964:Molar, Third / Q000601:surgery*; D061646:Operative Time; D010027:Osteotomy / Q000295:instrumentation; D010149:Postoperative Pain / Q000209:etiology; D059745:Piezosurgery / Q000295:instrumentation*; D011183:Postoperative Complications; D014081:Tooth Extraction / Q000295:instrumentation*; D014095:Tooth, Impacted / Q000601:surgery*; D016896:Treatment Outcome; D014313:Trismus / Q000209:etiology; D055815:Young Adult