Piezosurgery Versus Rotary Instruments for Mandibular Impacted Third Molars Extractions. A Prospective, Randomized Clinical Study

The extraction of impacted lower third molars is a common but complex procedure in oral surgery, sometimes accompanied by various complications. This study aimed to compare 2 surgical methods for extracting impacted or semi-impacted lower third molars: the traditional rotary instrument and the newer piezosurgery. A prospective, randomized, non-blinded clinical study was conducted over a 12-month period, involving 18 patients aged 18 to 40 years, treated at the Department of Maxillo-Facial Surgery of Policlinico Umberto I–Sapienza University of Rome. Each patient underwent extraction of both lower third molars: one side was treated using rotary instruments and the other side with piezosurgery. The postoperative clinical variables, such as trismus, edema, and pain were assessed 3 times: 3 hours, 48 hours, and 7 days after surgery. Results: Showed that the piezosurgery group experienced significantly less pain, reduced edema, and better trismus recovery compared with the rotary instrument group, despite a longer surgical time for the piezosurgery group. These findings suggest that piezosurgery provides more favorable postoperative outcomes in terms of pain, swelling, and mouth opening, though at the expense of increased surgical duration. This technique may offer significant benefits in improving patient recovery following the extraction of impacted lower third molars.