Effects of impacted mandibular third molar surgery performed with piezosurgery and conventional systems on postoperative sequelae and quality of life: a randomized controlled trial

BACKGROUND: Although piezosurgery has become a common technique in maxillofacial procedures—including third molar extractions—its advantages over conventional rotary instruments regarding postoperative recovery are still debated. Therefore, this randomized clinical trial aimed to evaluate and compare postoperative complications following the removal of impacted mandibular third molars using either piezosurgery or conventional rotary instruments. METHODS: This randomized controlled clinical trial included a total of 50 participants who were randomly allocated into two groups: the piezosurgery group and the conventional surgery group. Postoperative outcomes were assessed in patients who underwent surgical extraction of impacted mandibular third molars using one of these two methods. Pain levels were recorded daily using a Visual Analog Scale (VAS), whereas swelling, mouth opening, and oral health–related quality of life were evaluated before surgery and again on postoperative days two and seven. RESULTS: The piezosurgery technique resulted in a faster reduction of postoperative swelling on the second day; however, by the seventh day, no statistically significant differences were found between the two surgical techniques with respect to postoperative swelling. Similarly, there were no significant variations between the piezosurgery and conventional methods in terms of postoperative pain, mouth opening, or oral health–related quality of life throughout the observation period. CONCLUSION: Piezosurgery appears to offer a potential advantage; however, apart from reducing swelling, it does not demonstrate any significant superiority in terms of mouth opening, pain, or quality of life. Further standardized, large-scale randomized controlled studies are needed to obtain stronger evidence regarding the efficacy of both techniques.