Comparison of piezosurgery vs. conventional bone chisel for extraction of impacted mandibular third molars with root–canal intimacy: a retrospective cohort study with CBCT-based preoperative planning
- 1The Second Department, The Affiliated Stomatological Hospital of Nanjing Medical University , , ,
- 2State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing Medical University , , ,
- 3Department of Stomatology, The First Affiliated Hospital of Changsha Medical University , , ,
Abstract
Objective: To compare clinical outcomes of piezosurgery vs. conventional chisel for extracting impacted mandibular third molars (IMTMs) with roots adjacent to the inferior alveolar nerve canal (IANC) under identical CBCT-based planning, isolating the ultrasonic osteotome's incremental benefit beyond shared imaging.
Methods: A retrospective comparative cohort study was conducted using the clinical data of 126 patients with IMTMs whose tooth roots were closely adjacent to the IANC and who were treated in the Department of Oral and Maxillofacial Surgery at our hospital between September 2025 and May 2026. All patients underwent CBCT three-dimensional reconstruction before the operation to evaluate the anatomical structure and formulate the surgical plan. The patients were divided into the piezosurgery (n = 63) and conventional surgery (n = 63) groups. The conventional surgery group underwent traditional bone chiseling and crown splitting for extraction, while the piezosurgery group underwent extraction using the ultrasonic bone knife minimally invasive technique. The operation time, intraoperative blood loss, pain visual analogue scale (VAS) scores at different time points after surgery, degree of facial swelling, degree of mouth opening limitation, and complication occurrence rate were compared between the two groups.
Results: Compared with the conventional surgery group, the piezosurgery group exhibited a markedly shorter surgical procedure duration and a significantly reduced volume of intraoperative blood loss, with all between-group comparisons yielding statistically significant results (P < 0.05). There were interaction effects between the two groups and at different time points in the VAS scores, facial swelling differences, and mouth opening limitation differences (P < 0.05). The VAS scores, facial swelling differences, and mouth opening limitation differences in the piezosurgery group at 1 day, 3 days, and 7 days after surgery were all lower than those in the conventional surgery group (P < 0.05). Additionally, the incidence of adverse postoperative complications was markedly lower in the piezosurgery group than in the conventional surgery group, and this discrepancy was statistically significant (P < 0.05).
Conclusion: The CBCT-guided ultrasonic osteotome minimally invasive technique shortens operative time, reduces bleeding, alleviates postoperative pain, swelling, and trismus, and lowers complication rates in IMTM extraction with root-canal proximity.
Related
- Accelerated Preoperative Wound Bed Preparation Using Negative Pressure Wound Therapy With Instillation and Dwell Time: A Comparison With Conventional Negative Pressure Wound Therapy in Necrotic Wounds.
- Comparative outcomes of natural orifice specimen extraction surgery versus conventional minilaparotomy-assisted specimen extraction in colorectal cancer: A single-center retrospective study.
- Valorization of spent hops: a techno-economic analysis of bioactive extract production using conventional solvent and supercritical fluid extraction methods
- Comparison of Hockey-Stick and Conventional Linear Ultrasound Transducers for Detection of Non-Displaced Dentoalveolar Fractures: An Ex Vivo Paired Comparative Study
- Comparison of ‘quilting sutures’ with ‘conventional sutures and drain placement’ after mastectomy: protocol for the BE-Quilt – a multicentre, pragmatic randomised controlled trial
BibTeX
@article{hu2026comparison,
title = {{Comparison of piezosurgery vs. conventional bone chisel for extraction of impacted mandibular third molars with root–canal intimacy: a retrospective cohort study with CBCT-based preoperative planning}},
author = {Huijun Hu and Yuchao Zhang and Jian Tan and Yang Yu},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1950396},
url = {https://europepmc.org/article/PMC/PMC13719469},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparison of piezosurgery vs. conventional bone chisel for extraction of impacted mandibular third molars with root–canal intimacy: a retrospective cohort study with CBCT-based preoperative planning
AU - Huijun Hu
AU - Yuchao Zhang
AU - Jian Tan
AU - Yang Yu
PY - 2026
DA - 2026/10/16
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1950396
UR - https://europepmc.org/article/PMC/PMC13719469
AB - Objective: To compare clinical outcomes of piezosurgery vs. conventional chisel for extracting impacted mandibular third molars (IMTMs) with roots adjacent to the inferior alveolar nerve canal (IANC) under identical CBCT-based planning, isolating the ultrasonic osteotome's incremental benefit beyond shared imaging. Methods: A retrospective comparative cohort study was conducted using the clinical data of 126 patients with IMTMs whose tooth roots were closely adjacent to the IANC and who were treated in the Department of Oral and Maxillofacial Surgery at our hospital between September 2025 and May 2026. All patients underwent CBCT three-dimensional reconstruction before the operation to evaluate the anatomical structure and formulate the surgical plan. The patients were divided into the piezosurgery (n = 63) and conventional surgery (n = 63) groups. The conventional surgery group underwent traditional bone chiseling and crown splitting for extraction, while the piezosurgery group underwent extraction using the ultrasonic bone knife minimally invasive technique. The operation time, intraoperative blood loss, pain visual analogue scale (VAS) scores at different time points after surgery, degree of facial swelling, degree of mouth opening limitation, and complication occurrence rate were compared between the two groups. Results: Compared with the conventional surgery group, the piezosurgery group exhibited a markedly shorter surgical procedure duration and a significantly reduced volume of intraoperative blood loss, with all between-group comparisons yielding statistically significant results (P < 0.05). There were interaction effects between the two groups and at different time points in the VAS scores, facial swelling differences, and mouth opening limitation differences (P < 0.05). The VAS scores, facial swelling differences, and mouth opening limitation differences in the piezosurgery group at 1 day, 3 days, and 7 days after surgery were all lower than those in the conventional surgery group (P < 0.05). Additionally, the incidence of adverse postoperative complications was markedly lower in the piezosurgery group than in the conventional surgery group, and this discrepancy was statistically significant (P < 0.05). Conclusion: The CBCT-guided ultrasonic osteotome minimally invasive technique shortens operative time, reduces bleeding, alleviates postoperative pain, swelling, and trismus, and lowers complication rates in IMTM extraction with root-canal proximity.
SN - 2296-858X
ER -