Alveolar Repair After The Use Of Piezosurgery In The Removal Of

Lower Third Molars : A Prospective Clinical, Randomised, Double-

Blind, Split-Mouth Study

L. de Freitas Silva, E.N. Ribeiro de Carvalho Reis, B.C. Oliveira Souza, L.S. Egas, A.M. Aranega, D.
Ponzoni

The Department of Surgery and Integrated Clinic, São Paulo State University (UNESP), School of
Dentistry, Ara¸catuba, São Paulo, Brazil
Introduction
• The extraction of third molars is one of the most common procedures
done by oral and maxillofacial surgeons.

• After exodontia, the healing process of the remaining alveolus can be

divided into three phases:
A. Inflammatory
B. Proliferative
C. Modelling or Remodelling
Inflammatory Consists of the
Two to Three formation of clots
Phase days and the migration of
inflammatory cells
 Related to Identified
Proliferative Fibroplasia and radiographically
Phase The formation two weeks after
of bone extraction
 Reduction in
Modelling &
the size of the
Remodelling
alveolar ridge
Rotating Instruments have been used for
operating on bones

Overheating or fragmentation of bone

Formation of a smear layer during

osteotomy

Damage to adjacen tissues.

Piezosurgery is a selective
micrometric technique that
uses a defined ultrasound
frequency (ranging from 24 to
32 kHz) to cut the bone

Lower risks of post

operative pain,
trismus,oedema, and
neurological complications,
less stress on the bones
 Evaluate the density of the healing bone

Panoramic radiographs of patients who had had lower

third molars extracted using rotary instruments and
piezosurgical ultrasound.
Material and Methods
15 patients : 18 and 30 years

Impacted or semi-impacted right and left mandibular third molars

( Panoramic Radiographs)

The teeth were removed during two operations for each patient,
with an interval of at least 15 days between

Evaluated four months after operation

Operation

Anaesthetised : 2%
mepivacaine and
Control Group Avellanal incision
1:100.000
adrenaline

Odontectomy with a surgical burr 702 Detachment with a

at high speed under constant irrigation Molt periosteal
with saline solution elevator No. 9
 The osteotomy was
Surgical ultrasound
done in a rectangular
Piezo Group (Piezosonic Driller®,
shape using the ES007R
Carapicuíba)
and ES007L tips

The teeth were removed with The other steps of the

the aid of dental extractors extraction were similar
and the wound sutured with to those in the control
4/0 interrupted silk group
 Nimesulide 100 mg &
Amoxicillin 500 mg 0.12 % Chlorhexidine
Sodium Dipiron 500
orally digluconate
mg

Four months
The suture was
postoperatively each
removed seven days
patient had a digital
postoperatively
panoramic radiograph.
Results
Discussion