Evaluation Of Clinical Effect Of Piezosurgery Combined With High-speed Turbine Drill In The Extraction Of Complicated Mandibular Impacted Third Molar

Objective:To evaluate the efficacy and application of piezosurgery in the extraction of complicated mandibular impacted third molar using piezosurgery combined with high-speed turbine drill and turbine drill alone,the clinical indexes of two different minimally invasive operations were compared during and after the operation.Methods:A total of 80 patients(80 affected teeth)who underwent extraction of mandibular impacted third molars in the department of oral surgery of the First Hospital of Shanxi Medical University from February 2018 to August 2019 were selected as the study subjects,and they all met the criteria of hard or difficult according to the score method of difficulty coefficient of extraction of mandibular impacted third molar by Hu Kaijin et al.The subjects were randomly divided into the experimental group(n=40)and the control group(n=40).Experimental group:22males and 18 females,with an average age of 23.63±2.76 years.Control group: 20 males and 20 females,with an average age of 24.15±5.23 years.Flap was opened under local anesthesia and the operative area was exposed.In the experimental group,using piezosurgery to remove bone and increase clearance,and combined with 45 degree angle turbine drill to alternatively separate teeth.The control group directly used a 45 degree angle turbine drill to remove bone,increase clearance and separate teeth.Tooth dislocation,suture,note.Record the operation time(gingival incision to complete suture);Assess the patient's intraoperative psychological status;On the 1st,3rd and 7th day after surgery,use VAS scale to evaluate the pain degree,and use Alcantara direct measurement to evaluate the swelling degree,and the vertical distance between the central incisor of the upper and lower mandibular was used to evaluate the openings.Record the incidence of nerve injury,infection and dry socket disease.Results:1.The average operation time of the experimental group(17.20±1.84)min,the average operation time of the control group(18.50±2.22)min,the difference was statistically significant(P<0.05).2.Intraoperative psychological state evaluation: Good experience(experimental group: 28 cases;Control group: 15 cases);General experience(11 cases in the experimental group and 20 cases in the control group);Poor experience(1 case in the experimental group and 5 cases in the control group),and the difference between the two groups was statistically significant(P<0.05).3.On the 1st and 3rd day after the operation,the experimental group was significantly better than the control group in terms of pain,swelling degree and limited opening,with statistically significant differences(P<0.05).On the 7th day after the operation,there was no significant difference in the degree of pain,swelling and limited opening between the experimental group and the control group(P>0.05).4.There was no infection,dry socket disease or tongue numbness in the two groups after surgery.In the control group,1 case of temporary lower lip numbness was found,which was recovered after 3 months.The difference between the two groups was not statistically significant(P>0.05).Conclusion:1.The application of piezosurgery combined with turbine drill to remove the complicated mandibular impacted third molar can save more operation time.2.The application of piezosurgery combined with turbine drill to remove the complicated mandibular impacted third molar can effectively relieve intraoperative anxiety and tension.3.The application of piezosurgery combined with turbine drill to remove the complicated mandibular impacted third molar can significantly reduced postoperative pain,swelling,and limited openings.