Postoperative evaluation of Er:YAG laser, piezosurgery, and rotary systems used for osteotomy in mandibular third-molar extractions


CIVAK T., Ustun T., YILMAZ H. N., Gursoy B.

Journal of Cranio-Maxillofacial Surgery, cilt.49, sa.1, ss.64-69, 2021 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 49 Sayı: 1
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1016/j.jcms.2020.11.010
  • Dergi Adı: Journal of Cranio-Maxillofacial Surgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.64-69
  • Anahtar Kelimeler: Er:YAG laser, Piezosurgery, Stereophotogrammetry
  • İstanbul Yeni Yüzyıl Üniversitesi Adresli: Evet

Özet

Objective: This study compared patient postoperative pain, swelling, and trismus after usage of rotary instruments, piezosurgery, and Er:YAG lasers in mandibular third-molar extraction. Materials and methods: This prospective study was executed with class II and position B vertically impacted mandibular third molars. Patients were divided into three groups according to the osteotomy system used to remove retentive bone: rotary instruments, piezosurgery, and Er:YAG laser. Postoperative pain was evaluated using VAS questionnaires at 12 h, 24 h, 48 h, and 7 days after procedures. Trismus was evaluated by measuring the distance between the maxillary and mandibular incisors at maximum mouth opening, and comparing preoperative measurements with those for postoperative days 2 and 7. Analyses of swelling were carried out via a stereophotogrammetry system. Operation times were measured using a digital stopwatch from the initial incision to the final suture. Results: There were no statistically significant differences between the groups in terms of pain, trismus, or swelling (p > 0.05). Pain persisted more in the rotary instrument group 24 h later (0 ± 1.3; p = 0.001). The pain scores obtained after 48 h for the piezosurgery (1.81 ± 2.29) and rotary (2.2 ± 2.12) groups were observed at 24 h in the laser group (2.19 ± 1.52). The mean operation time was highest using the laser (19.1 ± 3.85 min; p = 0.001) and lowest using rotary instruments (9.88 ± 2.97 min; p = 0.001). Conclusion: Piezosurgery and Er:YAG laser are good alternatives to rotary instrument systems in third-molar extraction, but both systems are slower than traditional rotary instruments.