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

**Authors:** Izzet Acikan, Aykut Can Balkanlioglu

PMC · DOI: 10.1186/s40902-026-00502-2 · 2026-01-30

## TL;DR

This study compares piezosurgery and conventional methods for removing impacted molars, finding similar outcomes in pain and quality of life but faster initial swelling reduction with piezosurgery.

## Contribution

The study provides empirical evidence comparing piezosurgery and conventional techniques for impacted molar surgery in terms of postoperative recovery and quality of life.

## Key findings

- Piezosurgery showed faster reduction of postoperative swelling on day two compared to conventional methods.
- No significant differences were found in pain, mouth opening, or quality of life between the two techniques.
- The study suggests piezosurgery may not offer significant overall advantages beyond initial swelling reduction.

## Abstract

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.

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.

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.

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.

## Full-text entities

- **Diseases:** dyspepsia (MESH:D004415), infection (MESH:D007239), postoperative swelling (MESH:D008269), thermal injury (MESH:D020886), pericoronitis (MESH:D010497), cysts (MESH:D003560), peptic ulcer (MESH:D010437), oral disorders (MESH:D009056), bleeding (MESH:D006470), trismus (MESH:D014313), bone damage (MESH:D001847), diabetes (MESH:D003920), Swelling (MESH:D004487), postoperative pain (MESH:D010149), trauma (MESH:D014947), inferior alveolar nerve block (MESH:D000080902), Pain (MESH:D010146), inflammation (MESH:D007249), osteitis (MESH:D010000), anxiety (MESH:D001007), immunodeficiency (MESH:D007153)
- **Chemicals:** lidocaine (MESH:D008012), epinephrine (MESH:D004837)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12858685/full.md

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Source: https://tomesphere.com/paper/PMC12858685