Scholarlink

Objectives <p>This split-mouth randomized controlled trial aimed to compare a novel piezosurgery protocol versus a conventional rotary technique for the extraction of mesio-angulated and horizontally impacted mandibular third molars (MA-HM3Ms), evaluating postoperative inflammatory sequelae and patient-centered outcomes.</p> Materials and methods <p>Forty-seven healthy adult patients underwent bilateral MA-HM3M extraction with piezosurgery protocol (test group, TG) and, contralaterally, with conventional rotary instruments and manual elevators (control group, CG). Facial swelling was objectively quantified using three-dimensional facial scans at 2 and 7&#xa0;days postoperatively. Secondary outcomes included postoperative pain, maximum mouth opening, bleeding, surgical time, analgesic intake, complications, and patient-reported outcomes assessed using the PoSSe scale. Statistical analysis was performed using paired comparisons and regression models (α = 0.05).</p> Results <p>Ninety-four extractions were analyzed. After 2&#xa0;days, lower facial swelling was significantly reduced in TG compared with CG (<i>p</i> = 0.01), together with less pronounced trismus (<i>p</i> = 0.016). Pain was consistently lower in the TG at all timepoints, while postoperative bleeding and analgesic intake were significantly higher in the CG (<i>p</i> &lt; 0.05). Surgical time was longer in TG than in CG (<i>p</i> &lt; 0.001). The piezosurgery protocol significantly reduced interference with daily activities and resulted in higher patient satisfaction. Regression analyses showed a direct association between swelling and PoSSe scale in both groups. No permanent neurological complications were observed; alveolitis occurred in 3 CG and 2 TG sites.</p> Conclusions <p>This split-mouth randomized controlled trial suggests that piezosurgery for MA-HM3M extraction effectively reduces early postoperative inflammatory sequelae, improving patient-centered outcomes and quality of life, despite longer operative times.</p> Clinical relevance <p>The proposed piezoelectric protocol could represent a minimally invasive alternative to conventional rotary techniques, particularly in complex MA-HM3M extractions, enhancing patient comfort and quality of life during the most critical postoperative period while supporting a more controlled and refined surgical approach.</p> <p><b>Registry: </b>ClinicalTrials.gov, TRN: NCT06212232, Registration date: 25 January 2024.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Piezosurgery-assisted protocol for impacted mandibular third molar removal with 3D facial swelling analysis: a randomized split-mouth clinical trial on post-surgical sequelae

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月18日

查看全文
  • Alessandro Antonelli,
  • Giulia Brunello,
  • Marianna Salviati,
  • Selene Barone,
  • Francesco Bennardo,
  • Jason Motta Jones,
  • Amerigo Giudice

摘要

Objectives

This split-mouth randomized controlled trial aimed to compare a novel piezosurgery protocol versus a conventional rotary technique for the extraction of mesio-angulated and horizontally impacted mandibular third molars (MA-HM3Ms), evaluating postoperative inflammatory sequelae and patient-centered outcomes.

Materials and methods

Forty-seven healthy adult patients underwent bilateral MA-HM3M extraction with piezosurgery protocol (test group, TG) and, contralaterally, with conventional rotary instruments and manual elevators (control group, CG). Facial swelling was objectively quantified using three-dimensional facial scans at 2 and 7 days postoperatively. Secondary outcomes included postoperative pain, maximum mouth opening, bleeding, surgical time, analgesic intake, complications, and patient-reported outcomes assessed using the PoSSe scale. Statistical analysis was performed using paired comparisons and regression models (α = 0.05).

Results

Ninety-four extractions were analyzed. After 2 days, lower facial swelling was significantly reduced in TG compared with CG (p = 0.01), together with less pronounced trismus (p = 0.016). Pain was consistently lower in the TG at all timepoints, while postoperative bleeding and analgesic intake were significantly higher in the CG (p < 0.05). Surgical time was longer in TG than in CG (p < 0.001). The piezosurgery protocol significantly reduced interference with daily activities and resulted in higher patient satisfaction. Regression analyses showed a direct association between swelling and PoSSe scale in both groups. No permanent neurological complications were observed; alveolitis occurred in 3 CG and 2 TG sites.

Conclusions

This split-mouth randomized controlled trial suggests that piezosurgery for MA-HM3M extraction effectively reduces early postoperative inflammatory sequelae, improving patient-centered outcomes and quality of life, despite longer operative times.

Clinical relevance

The proposed piezoelectric protocol could represent a minimally invasive alternative to conventional rotary techniques, particularly in complex MA-HM3M extractions, enhancing patient comfort and quality of life during the most critical postoperative period while supporting a more controlled and refined surgical approach.

Registry: ClinicalTrials.gov, TRN: NCT06212232, Registration date: 25 January 2024.