title: Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments? A systematic review and meta analysis.
abstract: A systematic review and meta-analysis was conducted to answer the clinical question "Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments?" A systematic and electronic search of several databases with specific key words, a reference search, and a manual search were performed from respective dates of inception through November 2014. The inclusion criteria were clinical human studies, including randomized controlled trials (RCTs), controlled clinical trials (CCTs), and retrospective studies, with the aim of comparing the piezoelectric surgical osteotomy technique to the standard rotary instrument technique in lower third molar surgery. Postoperative sequelae (oedema, trismus, and pain), the total number of analgesics taken, and the duration of surgery were analyzed. A total of nine articles were included, six RCTs, two CCTs, and one retrospective study. Six studies had a low risk of bias and three had a moderate risk of bias. A statistically significant difference was found between piezoelectric surgery and conventional rotary instrument surgery for lower third molar extraction with regard to postoperative sequelae (oedema, trismus, and pain) and the total number of analgesics taken (P=0.0001, P=0.0001, P<0.00001, and P<0.0001, respectively). However, a statistically significant increased surgery time was required in the piezoelectric osteotomy group (P<0.00001). The results of the meta-analysis showed that piezoelectric surgery significantly reduced the occurrence of postoperative sequelae (oedema, trismus, and pain) and the total number of analgesics taken compared to the conventional rotary instrument technique in lower third molar surgery, but required a longer surgery time.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen. Electronic address: dressamalmoraissi@gmail.com.
authors.forename: E A
authors.initials: EA
authors.lastname: Al-Moraissi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Cairo University, Cairo, Egypt.
authors.forename: Y A
authors.initials: YA
authors.lastname: Elmansi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen.
authors.forename: Y A
authors.initials: YA
authors.lastname: Al-Sharaee
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tripoli University, Tripoli, Libya.
authors.forename: A E
authors.initials: AE
authors.lastname: Alrmali
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen.
authors.forename: A S
authors.initials: AS
authors.lastname: Alkhutari
mesh_terms: D003762:Dental Instruments; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008964:Molar, Third / Q000601:surgery*; D059745:Piezosurgery; D011183:Postoperative Complications / Q000517:prevention & control*; D014095:Tooth, Impacted / Q000601:surgery*
keywords: conventional rotary osteotomy; lower third molar surgery; meta-analysis; piezoelectric surgery; postoperative sequelae