Evaluation of cone beam computed tomography and piezosurgery for the diagnosis and treatment of impacted teeth

Hala Mokhtar Abdel-Alim


Surgical extraction impacted third molar requires precise anatomical localization.  CBCT is superior to plain films and CT in accurate identification of the area.  Surgical complications of osteotomy performed with conventional rotary instruments are compared with outcomes while using Piezoelectric surgery..

Materials and methods: 30 patients with bilateral impacted mandibular third molars were allocated to 2 groups according to the osteotomy device used, Group 1 conventional rotary while Group 2 a piezoelectric device. Postoperative evaluation of nerve injury, pain, edema and trismus was carried out.  Results: CBCT proved to be an important tool for precise estimation of the amount of bone to be removed and the relation to the neighboring soft tissue.  Piezosurgery was superior to conventional cutting devices since decreased bleeding ensured a clear field; and  with better quality of life including no symptoms of nerve injuries, and less pain, edema and trismus. However, time of surgery was longer with piezosurgery than with conventional surgery. Conclusion:  Accurate assessment using CBCT and the use of piezosurgery in removing impacted teeth specially in anatomical areas with approximation to vital soft tissue structures are important tools in decreasing morbidity while removing impacted teeth.


Key words: CBCT Impaction, edema, piezosurgery, pain, trismus



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