Piezosurgery Versus Conventional Osteotomy: A Comparison of Techniques in the Extraction of Unerupted Mandibular Third Molars in Children

Purpose: Piezoelectric bone surgery is a precise and effective osteotomy technique used in maxillofacial surgery. The purpose of this study was to compare postoperative sequelae and efficacy of extractions of unerupted mandibular third molars in children by piezosurgery and conventional osteotomy. Methods: Healthy subjects, aged 10 to 14 years, needing removal of their bilateral lower third molars were included in this study. The right or left unerupted mandibular third molars were randomly extracted by either piezosurgery or conventional osteotomy. Pain (qualified by the visual analog scale), facial swelling, trismus, and operation duration were evaluated. Results: All 32 study patients (40.6% males and 59.4% females with an average age of 11.91 +/- 1.40 years) completed the entire trial. Swelling and trismus experienced by the conventional osteotomy were more severe than the piezosurgery group on the third (10.34 +/- 2.36 mm vs 4.9 +/- 1.95 mm and 6.09 +/- 2.08 mm vs 2.34 +/- 1.79 mm, respectively) and seventh (2.03 +/- 1.26 mm vs 0.25 +/- 0.57 mm and 0.91 +/- 1.00 mm vs 0.09 +/- 0.30 mm, respectively) days postoperatively (P < .01). Visual analog scale showed that pain levels of children in the piezosurgery group were significantly less than the conventional osteotomy group on third day postoperatively (2.06 +/- 1.41 vs 4.81 +/- 1.94; P < .01). The operation duration of the piezosurgery group was significantly longer than the conventional osteotomy group (27.16 +/- 5.75 minutes vs 16.69 +/- 3.22 minutes; P < .01). Conclusion: Compared with conventional osteotomy, piezosurgery can effectively reduce the severity of postoperative sequelae for the extraction of unerupted lower third molars in children. (C) 2022 American Association of Oral and Maxillofacial Surgeons