Effects of piezoelectric versus rotary handpiece on postoperative sequelae following surgical removal of impacted mandibular third molars; A comparative study

Bone removal is a key step in surgically extracting the impacted mandibular third molar and is chiefly responsible for the postoperative sequelae. The piezoelectric drill was introduced to help lessen the severity of these sequelae. This study aimed to compare the effects of using either a piezoelectric drill or a conventional rotary instrument on postoperative sequelae and complications following impacted mandibular third molar surgery. The study was a prospective randomised clinical trial. Impacted mandibular third molars were surgically removed using either a piezoelectric drill or a conventional drill. The primary outcome measured included postoperative sequelae (pain, swelling, and trismus) over one week postoperatively, while the secondary outcome involved postoperative complications. One hundred and twenty subjects completed the study, with 60 subjects in each group. The median postoperative pain scores were lower in the piezo group, and this difference was statistically significant on the 6th and 7th days (p = 0.004 and 0.011, respectively). Postoperative swelling was also less in the piezo group compared to the rotary group on days 1 and 3 (p < 0.001). No statistically significant difference was observed in the postoperative interincisal distance between the two groups. Nine subjects experienced complications in the rotary group, whereas none did in the piezo group. This difference was statistically significant (p = 0.002). The Piezoelectric drill resulted in faster recovery of postoperative sequelae and a lower incidence of postoperative complications following the removal of the impacted mandibular third molar.