Date: January 2021.
Source: Journal of Cranio-Maxillofacial Surgery, Volume 49, Issue 1, Pages 64-69.
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 3dMD 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).
Conclusions: 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.

Article: Postoperative evaluation of Er:YAG laser, piezosurgery, and rotary systems used for osteotomy in mandibular third-molar extractions.
Authors: Tayfun Civak, Tugba Ustun, Hanife Nuray Yilmaz, Bahar Gursoy. Department of Orthodontics, Marmara University, Faculty of Dentistry, Istanbul, Turkey.