This document compares the surgical outcomes of removing impacted mandibular third molars using either a conventional rotary handpiece or a piezoelectric device. A study was conducted on 20 patients where one impacted tooth was removed using a rotary bur and the other using piezosurgery. The piezoelectric surgery took longer on average but resulted in less post-operative pain, trismus, and higher patient satisfaction compared to the rotary technique. The document concludes that piezoelectric surgery is a precise technique that causes minimal soft tissue damage and reduced postoperative complications for removing impacted third molars.
Effect of Surgery Difficulty According to Impaction Level on the Incidence of...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
Effect of Surgery Difficulty According to Impaction Level on the Incidence of...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...Abu-Hussein Muhamad
Abstract: Severe atrophy of the inferior alveolar process and underlying basal bone often results in problems with a lower denture. These problems include insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. In this case report, patient with resorbed edentulous mandible was successfully rehabilitated using two dental implants placed in the interforaminal region with ball abutments opposing conventional maxillary complete denture. Key Words: dental implants; dental prosthesis, implant-supported; resorption,
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Periodontally Accelerated Osteogenic Orthodontics: A Surgical Technique and C...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Full body is the most of I don't have a lot more then I have been on my phone is a new one number and my heart is a new phone is it possible to be fine and I have a good day of the year and I am a good time with my family and I have to do not know what you do not know how to do with your family is a good day of
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
“Comparative Evaluation between Physics Forceps and Conventional Extraction F...inventionjournals
:Tooth extraction procedure, although known as a minimal traumatic procedure, some sort of trauma is subjected to underlying soft and hard tissues, resulting in immediate destruction and loss of alveolar bone. Conventional extraction forceps are designed on the principle of simple machine incorporating two first-class levers, connected with a hinge. The physics forceps are the newly invented forceps. The design of physics forceps which implements a first class lever, creep, and type of force that provides a mechanical advantage, which makes it more efficient. AIM: The aim of the present study to evaluate the efficacy between the conventional extraction forceps and physics forceps in orthodontic extraction of maxillary premolars. Patients & Methods:A total of 50 healthy patients with indicated for extraction of bilateral maxillary premolar for orthodontic reasons; split mouth design (control side, test side) in a randomized manner; were included in the present study. Results:Ease of technique, buccal cortical plate fracture, fracture of tooth or root, gingival laceration, soft tissue healing was not significant. The extraction time and bleeding associated with extraction socket were significant. Post operative days 1-4 are not significant and on day 5-7 the pain on VAS score is 0. Conclusion:The results of present study suggest that, extraction using any forceps can produce predictable results and it totally depends on surgeon’s expertise in a particular technique.
Periodontally Accelerated Osteogenic Orthodontics with Piezoelectric Surgery...Abu-Hussein Muhamad
Piezosurgery has been applied in dentistry for many years. This paper reviews specifically the treatment applications that have been used in surgically assisted orthodontic treatment since the last decade. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical technique which results in an increase in alveolar bone width, shorter treatment time, increase post-treatment stability, and decrease amount of apical root resorption. The aim of this case report is to compare the use of micro-motor and piezoelectric surgery unit during decortication in Periodontally Accelerated Osteogenic Orthodontics technique.
Key words: Piezoelectric surgery, piezosurgery, Periodontal regeneration , accelerated tooth movement
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
An Evaluation of Short Term Success and Survival Rate of Implants Placed in F...DrHeena tiwari
An Evaluation of Short Term Success and Survival Rate of Implants Placed in Fresh Extraction Socket Post Prosthetic Rehabilitation- A Prospective Study
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...Abu-Hussein Muhamad
Abstract: Severe atrophy of the inferior alveolar process and underlying basal bone often results in problems with a lower denture. These problems include insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. In this case report, patient with resorbed edentulous mandible was successfully rehabilitated using two dental implants placed in the interforaminal region with ball abutments opposing conventional maxillary complete denture. Key Words: dental implants; dental prosthesis, implant-supported; resorption,
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Periodontally Accelerated Osteogenic Orthodontics: A Surgical Technique and C...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Full body is the most of I don't have a lot more then I have been on my phone is a new one number and my heart is a new phone is it possible to be fine and I have a good day of the year and I am a good time with my family and I have to do not know what you do not know how to do with your family is a good day of
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
“Comparative Evaluation between Physics Forceps and Conventional Extraction F...inventionjournals
:Tooth extraction procedure, although known as a minimal traumatic procedure, some sort of trauma is subjected to underlying soft and hard tissues, resulting in immediate destruction and loss of alveolar bone. Conventional extraction forceps are designed on the principle of simple machine incorporating two first-class levers, connected with a hinge. The physics forceps are the newly invented forceps. The design of physics forceps which implements a first class lever, creep, and type of force that provides a mechanical advantage, which makes it more efficient. AIM: The aim of the present study to evaluate the efficacy between the conventional extraction forceps and physics forceps in orthodontic extraction of maxillary premolars. Patients & Methods:A total of 50 healthy patients with indicated for extraction of bilateral maxillary premolar for orthodontic reasons; split mouth design (control side, test side) in a randomized manner; were included in the present study. Results:Ease of technique, buccal cortical plate fracture, fracture of tooth or root, gingival laceration, soft tissue healing was not significant. The extraction time and bleeding associated with extraction socket were significant. Post operative days 1-4 are not significant and on day 5-7 the pain on VAS score is 0. Conclusion:The results of present study suggest that, extraction using any forceps can produce predictable results and it totally depends on surgeon’s expertise in a particular technique.
Periodontally Accelerated Osteogenic Orthodontics with Piezoelectric Surgery...Abu-Hussein Muhamad
Piezosurgery has been applied in dentistry for many years. This paper reviews specifically the treatment applications that have been used in surgically assisted orthodontic treatment since the last decade. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical technique which results in an increase in alveolar bone width, shorter treatment time, increase post-treatment stability, and decrease amount of apical root resorption. The aim of this case report is to compare the use of micro-motor and piezoelectric surgery unit during decortication in Periodontally Accelerated Osteogenic Orthodontics technique.
Key words: Piezoelectric surgery, piezosurgery, Periodontal regeneration , accelerated tooth movement
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
An Evaluation of Short Term Success and Survival Rate of Implants Placed in F...DrHeena tiwari
An Evaluation of Short Term Success and Survival Rate of Implants Placed in Fresh Extraction Socket Post Prosthetic Rehabilitation- A Prospective Study
Similar to 84th Publication- IJECSE- 2ND Name.pdf (20)
60.Srinivasan S, Velusamy G, Munshi MAI, Radhakrishnan K, Tiwari RVC. Comparative Study of Antifungal Efficacy of Various Endodontic Irrigants with and without Clotrimazole in Extracted Teeth Inoculated with Candida albicans. J Contemp Dent Pract. 2020 Dec 1;21(12):1325-1330. PubMed PMID: 33893253.
Mathew P, Kattimani VS, Tiwari RV, Iqbal MS, Tabassum A, Syed KG. New Classification System for Cleft Alveolus: A Computed Tomography-based Appraisal. J Contemp Dent Pract. 2020 Aug 1;21(8):942-948. PubMed PMID: 33568619
Sahu S, Patley A, Kharsan V, Madan RS, Manjula V, Tiwari RVC. Comparative evaluation of efficacy and latency of twin mix vs 2% lignocaine HCL with 1:80000 epinephrine in surgical removal of impacted mandibular third molar. J Family Med Prim Care. 2020 Feb;9(2):904-908. doi: 10.4103/jfmpc.jfmpc_998_19. eCollection 2020 Feb. PubMed PMID: 32318443; PubMed Central PMCID: PMC7113948.
65.Izna, Sasank Kuntamukkula VK, Khanna SS, Salokhe O, Chandra Tiwari RV, Tiwari H. Knowledge and Apprehension of Dental Health Professionals Pertaining to COVID in Southern India: A Questionnaire Study. J Pharm Bioallied Sci. 2021 Jun;13(Suppl 1):S448-S451. doi: 10.4103/jpbs.JPBS_551_20. Epub 2021 Jun 5. PubMed PMID: 34447131; PubMed Central PMCID: PMC8375944.
Vohra P, Belkhode V, Nimonkar S, Potdar S, Bhanot R, Izna, Tiwari RVC. Evaluation and diagnostic usefulness of saliva for detection of HIV antibodies: A cross-sectional study. J Family Med Prim Care. 2020 May;9(5):2437-2441. doi: 10.4103/jfmpc.jfmpc_138_20. eCollection 2020 May. PubMed PMID: 32754516; PubMed Central PMCID: PMC7380795
Mittal S, Hussain SA, Tiwari RVC, Poovathingal AB, Priya BP, Bhanot R, Tiwari H. Extensive pelvic and abdominal lymphadenopathy with hepatosplenomegaly treated with radiotherapy-A case report. J Family Med Prim Care. 2020 Feb;9(2):1215-1218. doi: 10.4103/jfmpc.jfmpc_1125_19. eCollection 2020 Feb. PubMed PMID: 32318498; PubMed Central PMCID: PMC7113973.
36.Kesharwani P, Hussain SA, Sharma N, Karpathak S, Bhanot R, Kothari S, Tiwari RVC. Massive radicular cyst involving multiple teeth in pediatric mandible- A case report. J Family Med Prim Care. 2020 Feb;9(2):1253-1256. doi: 10.4103/jfmpc.jfmpc_1059_19. eCollection 2020 Feb. PubMed PMID: 32318508; PubMed Central PMCID: PMC7113959.
More from CLOVE Dental OMNI Hospitals Andhra Hospital (20)
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ocular injury ppt Upendra pal optometrist upums saifai etawah
84th Publication- IJECSE- 2ND Name.pdf
1. International Journal of Early Childhood Special Education (INT-JECS)
ISSN: 1308-5581 Vol 14, Issue 03 2022
814
COMPARISON OF ROTARY AND PIEZO-SURGICAL UNIT IN THIRD
MOLAR IMPACTION: AN ORIGINAL RESEARCH
1. Dr. Kannan Venugopal, Department of Oral and Maxillofacial Surgery, PMS College of Dental
Science and Research, Golden Hills, Vattapara, Trivandrum, Kerala. kannan7072003@gmail.com
2. Dr. Rahul VC Tiwari, OMFS, FOGS, (MHA), PhD Scholar, Dept of OMFS, Narsinhbhai Patel
Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat,384315.
drrahulvctiwari@gmail.com
3. Dr Shilpa Sunil Khanna M.D.S, Department of Oral and Maxillofacial Surgery, Senior Lecturer,
Sri Ramakrishna Dental College and Hospital, Coimbatore , Tamil Nadu, 641006.
khannashilpa03@gmail.com
4. Dr. Heena Dixit Tiwari, BDS, PGDHHM, Final year Student, Master of Public Health,Parul
Univeristy, Limda, Waghodia, Vadodara, Gujrat, India.drheenatiwari@gmail.com
5. Dr. M L V SURYAMITHRA, Senior Lecturer, Department of Oral and Maxillofacial Surgery,
Mamata Institute of Dental Sciences, Hyderabad, Telangana. msuryamithra@gmail.com
6. Dr. MANOJ KUMAR KANTA, MDS, READER, DEPT OF MAXILLOFACIAL SURGERY,
GSL DENTAL COLLEGE AND HOSPITAL. kantamanojkumar@gmail.com
7. Dr Pritee Rajkumar Pandey, MDS, OMFS, DJ College of Dental Sciences & Research, Ajit
Mahal, Modinagar - Niwari Rd, Modinagar, Uttar Pradesh, India.Priteepandey1990@gmail.com
Corresponding Author: Dr. Kannan Venugopal, Department of Oral and Maxillofacial Surgery,
PMS College of Dental Science and Research, Golden Hills, Vattapara, Trivandrum, Kerala.
kannan7072003@gmail.com
ABSTRACT
Aim
The aim of this study was to compare the surgical outcome of third molar surgery using conventional rotary
handpiece and piezotome.
Methodology
This prospective study consisted of 20 medically fit patients between 18–40 years of age with bilateral impacted
mandibular third molars from both the genders. On one side surgical extraction was done using conventional
rotary technique and contra lateral side was treated using piezosurgery (split mouth study design). Statistical
analysis was done between these two techniques for patient satisfaction, duration of surgery, pain perception and
trismus.
Results
Piezoelectric surgery took more time than rotary, but patient satisfaction, pain, mouth opening was statistically
poor with conventional rotary technique.
Conclusion
Piezoelectric device is a promising, meticulous, innovative ultrasonic technique for safe and effective bone
removal when compared with rotary technique.
Keywords: Piezoelectric surgery, Rotary surgical technique, Surgical removal, Mandibular impacted third
molar.
INTRODUCTION
Third molar surgery is the most common procedure performed in oral and maxillofacial surgery practice.1
Some
of the most frequent complaints following third molar surgery, according to the work of Oikarinen 2
and Kim 3
,
are pain and trismus. Fisher showed that trismus and swelling are closely associated with acute inflammation
following third molar surgery. Inferior alveolar nerve injury is a well documented.4
complication of maxillofacial procedures such as third molar surgery.5
Susarla and Dodson stated that the
incidence of nerve damageranges from 1% to 22% and has become a common cause of litigation.6
Severaltherapeutic protocols have thus been evaluated to support improvements in thepostoperative period.7-9
Approximately 20% of the population has impacted teeth, where mandibular and maxillary third molars are the
most common.10
The highest incidence of impaction has been shown in mandibular wisdom teeth which may
2. International Journal of Early Childhood Special Education (INT-JECS)
ISSN: 1308-5581 Vol 14, Issue 03 2022
815
lead to pathologies like pericoronitis, periodontitis, second molars tooth-crown resorption, pain, cysts or
odontogenic tumors, and primary or secondary crowding of the dentition. Early removal of these teeth to
prevent the abovementioned problems is widely approved.11
Hard tissue cutting is a common procedure in the dental fields, especially during maxillofacial, oral, and
periodontal surgeries. Traditionally, rotating instruments like burs have been used for osseous surgery.
However, bone overheating and damage to adjacent tissues are disadvantages that are related to the use of
thesemethods.12
Piezoelectric surgery techniques have opened up a new age for osteotomy, osteoplasty and exodontia in
maxillofacial and oral surgery. As well as being selective, the micrometric cuts possible via these techniques
maximize surgical precision, resulting in minimal damage to soft tissue. In addition, the cavitation effect
provides maximum intraoperative visibility and a blood-free surgical site.
Its mechanism of action is based on the ability of certain ceramics and crystals to deform when an electric
current is passed across them, resulting in microvibration at ultrasonic frequency.13
A frequency of 25–30KHz,
from a nitride hardened or diamond-coated insert, allows for selective cut of bone tissue.14
Since its approval for
commercial use in 2002, it has been successfully utilized for many surgical procedures, such as maxillary sinus
lifting, autologous bone graft harvesting, bone splitting, lateralization of the inferior alveolar nerve, and
orthognathic and neurologic surgeries.15
Goyal et al. compared piezosurgery with the conventional rotary surgical technique and found that pain,
swelling, trismus, and healing were significantly decreased in the piezosurgery site.16
Moreover, a systematic
review and meta-analysis done by Jiang et al. compared piezosurgery and conventional rotary osteotomy
techniques in third molar extraction. They concluded that although the patients undergoing piezosurgery
experienced longer surgery time, they developed less swelling, less pain, and less postoperative trismus.17
Also, similar findings were concluded in the metaanalysis conducted by Al-Moraissi et al. in which there was a
significant reduction in postoperative sequelae (facial swelling, pain, and trismus) with the piezoelectric surgical
technique in third molar extraction, whereas their results showed that the duration of surgery and operating time
for third molar extraction were significantly shorter with conventional rotary instruments compared to the
piezoelectric surgical technique.18
AIM OF THE PRESENT STUDY
This study compares the two different instruments i.e. piezoelectric and rotary bur for removal of impacted
mandibular third molars for evaluating the time required, patient satisfaction of the procedure intra-operatively,
the severity of pain and mouth opening postoperatively.
METHODOLOGY
Sample size was determined to be 20 patients. All patients were informed about the study and consent was taken
for the same. Preoperative orthopantomogram and intraoral periapical radio figures were taken. The patients
were subjected to removal of impacted mandibular third molars using piezoelectric and rotary bur. The study
was conducted to compare surgical and post-surgical outcome of impacted third molar removal using
piezoelectric on one side and rotary bur on contralateral side. Internal ethics committee for human studies, of the
institution has approved this study. Intra-operatively, the time taken and patient satisfaction of the procedure
was evaluated. Post operatively, patients were evaluated for pain using a feedback form of visual analog scale
for a period of 7 days, mouth opening examined clinically on day 3, day 5 and day 7.
All the patients underwent surgical removal of impacted mandibular third molars. Full thickness mucoperiosteal
flap was raised and retracted using Austin’s retractor. On one side, bone was removed using rotary device with
#702 or #703 bur and constant irrigation was done using sterile isotonic saline solution to reduce the heat
generated during bone removal. After around 10 to 15 days, using SL 1, SL 2, & SL 3 burs, bone was removed
using piezoelectric device on contralateral side. Guttering technique was adapted on both the sides. The teeth
were removed in toto. The irregular bone and gingival margins were parried; the wound was irrigated with
sterile saline solution. Flaps were repositioned and sutured using 3-0 black braided silk. Post operatively, all
patients received amoxicillin 500 mg tid and diclofenac sodium 50 mg tid for 3 days. Postoperative instructions
were given and the sutures were removed on the 7th day.
Patient satisfaction of the individual procedure was evaluated intra-operatively and graded using a scale. Post-
operative pain was evaluated according to subjective analysis like VAS (visual analog scale).For mouth
opening, Inter-incisal distance is measured preoperatively, and postoperatively on day 3, day 5 and day 7.
RESULTS
Patients belong to age group 19 to 34 years, out of which 11 were males and 9 were females. Intra-operatively,
the time taken and patient satisfaction of the procedure was evaluated and post operatively, clinical assessment
3. International Journal of Early Childhood Special Education (INT-JECS)
ISSN: 1308-5581 Vol 14, Issue 03 2022
816
of mouth opening was done on day 3, day 5 and day 7, correlating with that of preoperative value. Pain was
evaluated subjectively using feedback form of visual analog scale for a period of 7 days.
The time taken for removal of impacted tooth using rotary bur was much less (25.15+ 6.74 min) compared to
that of piezoelectric device (50.30+ 20.51 min). (Table 1) Student t test (paired) was used for statistical analysis.
Patient satisfaction was evaluated using a grading scale and mixed results were obtained in terms of satisfaction
of the procedure. The mean of mouth opening on day 3, day 5 & day 7 was significantly better in the
piezoelectric group (p<0.01) as compared to rotary bur. (Table 2) On day 1 the pain was much less in
piezoelectric group as compared with rotary bur group with a p value of 0.03. From day 2 to day 6, there was
significant difference among the two groups at the level of p<0.01. On day 7 no significant difference was found
among the two groups. (Table 3)
Table 1- Comparison of time taken in minutes between piezoelectric and Rotary Surgery
Time taken Piezoelectric Rotary
Min-Max 15-88 15-41
Mean ± SD 50.30±20.51 25.15±6.74
95%CI 15.0-88.0 15.0-41.0
Table 2- Comparison of mean score mouth opening for procedure in two groups
Mouth opening score Piezoelectric Rotary P value
Pre-op 34.45±2.54 34.40±2.46 0.330
Day 3 31.75±3.11 27.75±2.92 <0.001
Day 5 32.95±3.09 30.75±3.18 <0.001
Day 7 33.70±2.94 33.00±2.82 <0.001
Table 3- Patient satisfaction using grading scale between Piezoelectric and Rotary bur
Patient satisfaction
grade
Piezoelectric
(n=20)
Rotary
(n=20)
P value
1: Very satisfied 6(30.0%) 8(40.0%) 0.298
2: Fairly satisfied 8(40.0%) 5(25.0%) 0.204
3: Fairly unsatisfied 6(30.0%) 7(35.0%) 0.392
4: very unsatisfied 0 0 -
DISCUSSION
In oral and maxillofacial surgery, impacted third molars are routinely extracted and invariably cause certain
degree of postoperative pain, swelling, and trismus. The severity of postoperative responses is correlated to the
“aggressiveness” of the procedure.[7] In 1975, Horton et al.[15] studied the effects of chisel, ultrasonic
instrument, and rotary bur used for osteotomy and compared their effect on postoperative wound healing and
reported that rotary burst was more
traumatizing to the bone. A favorable healing outcome was observed in chisel, followed by ultrasonic
instruments. In 1999, Prof. Tomaso Vercellotti, in collaboration with Mectron Spa, invented a new innovative
piezoelectric bone surgery technique.[16] The postoperative pain was evaluated based on VAS.
Other factors affecting pain and swelling are individual pain threshold, body response and type of wound. The
severity of pain might vary among individuals. The severity of trismus and swelling correlates with the degree
of trauma during the surgery. Thus, a risk of error is present when the case and control are different
individuals.12 The present study is a split-mouth study design in which the subjects are served as their own
controls.
Over a period of time surgical procedures have been modified to reduce intraoperative and postoperative
complications. The surgical method should be one with minimum complication.13 Initially bone removal was
done by using chisel and mallet. Later rotary instruments were introduced for cutting bone in maxillofacial
operations. Rotating instruments are potentially injurious due to excessive increase in the temperature during
osseeus drilling, which can produce marginal osteonecrosis and impair bony regeneration. Piezoelectric
techniques were developed in response to the need for greater precision and safety in bone surgery as compared
to that of manual and motorized instruments.
4. International Journal of Early Childhood Special Education (INT-JECS)
ISSN: 1308-5581 Vol 14, Issue 03 2022
817
The present study is done to compare two different instruments i.e., piezoelectric and rotary bur in surgical
removal of impacted molar tooth. Intraoperatively, time required and patient satisfaction was evaluated.
Postoperatively, mouth opening was measured clinically on day 3, day 5 and day 7 correlating with preoperative
values. Pain was evaluated using a feedback form of VAS for a period of 7 days.
Francesco Sortino et al. (2008) did a clinical study to compare postoperative outcome in surgical removal of
third molars treated by piezoelectric and by rotatory osteotomy technique. The study was concluded by saying
that piezoelectric osteotomy produced a reduced amount of trismus 24hrs after surgery, but a longer surgery
time was required when compared with the rotatory osteotomy technique.13
In piezoelectric group, 30% were very satisfied, 40% were fairly satisfied and 30% were fairly unsatisfied as
compared to rotary bur in which 40% were very satisfied, 25% were fairly satisfied and 35% were fairly
unsatisfied and amount of pain experienced by piezoelectric group was less as compared to rotary bur technique
over a period of 7 days and the mouth opening was much better in piezoelectric group as compared to rotary bur
group at the level of P<0.001.
CONCLUSION
We conclude piezoelectric instrument is better alternative for removal of impacted tooth than rotary instruments.
Extensive studies are required to be conducted for its different uses in osseous surgeries, so that its range of
applications can be widened.
REFERENCES
1. Tetsch, p., wagner, w., 1982. Operative extraction of wisdom teeth. Munich: Wolfe medical publications
ltd.
2. Oikarinen, k., rasanen, a., 1991. Complications of third molar surgery Among university students. J am coll
health, 39(6), 281-285.
3. Kim, j., choi, s., wang, s., kim, s., 2005. Minor complications after Mandibular third molar surgery: type,
incidence and possible prevention. Oral surg Oral med oral pathol oral radiol endod, 102.
4. Fisher, s.e., frame, j.w., rout, p.g.j., mcentegart, d.j., 1988. Factors affecting the onset and severity of pain
following the surgical removal of Unilateral impacted mandibular third molar teeth. Br dent j, 164, 351-
353.
5. Genu, p.r., vasconcelos, c.e., 2008. Influence of the tooth section Technique in alveolar nerve damage after
surgery of impacted lower third molars. Int j oral maxillofac surg, 37, 933-928.
6. Susarla, s.m., dodson, t.b., 2007. Preoperative computed tomography Imaging in the management of
impacted mandibular third molars. J oral Maxillofac surg, 65, 83-88.
7. G. Juodzbalys and P. Daugela, “Mandibular third molar impaction: review of literature and a proposal of a
classification,” Journal of Oral & Maxillofacial Research, vol. 4, no. 2, article e1, 2013.
8. S. Mansuri, A. Mujeeb, S. A. Hussain, and M. A. Z. Hussain, “Mandibular third molar impactions in male
adults: relationship Of Operative time and Types of impaction on inflammatory complications,” Journal of
International Oral Health, vol. 6, no. 2, pp. 9–15, 2014.
9. T. de Santana-Santos, J.-A. de Souza-Santos, P.-R. Martins- Filho, L.-C. da Silva, E.-D. de Oliveira e Silva,
and A.-C. Gomes, “Prediction of postoperative facial swelling, pain and trismus following third molar
surgery based on preoperative variables,” Medicina Oral, Patolog´ıa Oral y Cirug´ıa Bucal, vol. 18, no. 1,
pp. e65–e70, 2013.
10. C. H. Bui, E. B. Seldin, and T. B. Dodson, “Types, frequencies, and risk factors for complications after
third molar extraction,” Journal of Oral and Maxillofacial Surgery, vol. 61, no. 12, pp. 1379–1389, 2003.
11. P. Leclercq, C. Zenati, and D. M. Dohan, “Ultrasonic bone cut part 2: state-of-the-art specific clinical
applications,” Journal of Oral and Maxillofacial Surgery, vol. 66, no. 1, pp. 183–188, 2008.
12. A. Barone, S. Marconcini, L. Giacomelli, L. Rispoli, J. L. Calvo, and U. Covani, “A randomized clinical
evaluation of ultrasound bone surgery versus traditional rotary instruments in lower third molar extraction,”
Journal of Oral and Maxillofacial Surgery, vol. 68, no. 2, pp. 330–336, 2010.
13. A. Happe, “Use of a piezoelectric surgical device to harvest bone grafts from the mandibular ramus: report
of 40 cases,” International Journal of Periodontics and Restorative Dentistry, vol. 27, no. 3, pp. 241–249,
2007.
14. M. Danza, R. Guidi, and F. Carinci, “Comparison between implants inserted into piezo split and unsplit
alveolar crests,” Journal of Oral and Maxillofacial Surgery, vol. 67, no. 11, pp. 2460–2465, 2009.
15. C. A. Landes, S. St¨ubinger, J. Rieger, B. Williger, T. K. L. Ha, and R. Sader, “Critical evaluation of
piezoelectric osteotomy in orthognathic surgery: operative technique, blood loss, time requirement, nerve
and vessel integrity,” Journal of Oral and Maxillofacial Surgery, vol. 66, no. 4, pp. 657–674, 2008.
5. International Journal of Early Childhood Special Education (INT-JECS)
ISSN: 1308-5581 Vol 14, Issue 03 2022
818
16. M. Goyal, K. Marya, A. Jhamb et al., “Comparative evaluation of surgical outcome after removal of
impacted mandibular third molars using a Piezotome or a conventional handpiece: A Prospective Study,”
British Journal of Oral and Maxillofacial Surgery, vol. 50, no. 6, pp. 556–561, 2012.
17. Q. Jiang, Y. Qiu, C. Yang, J. Yang, M. Chen, and Z. Zhang, “Piezoelectric versus conventional rotary
techniques for impacted thirdmolar extraction: a meta-analysis of randomized controlled trials,” Medicine,
vol. 94, no. 41, Article ID e1685, 2015.
18. E. A. Al-Moraissi, Y. A. Elmansi, Y. A. Al-Sharaee,A. E.Alrmali, and A. S. Alkhutari, “Does the
piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than
conventional rotary instruments? A systematic review and meta analysis,” International Journal of Oral and
Maxillofacial Surgery, vol. 45, no. 3, pp. 383–391, 2016.