ABSTRACT
This pilot split-mouth study aimed to evaluate and compare early postoperative discomfort and wound healing outcomes in post-extraction sockets after dental extraction performed with a Magnetic Mallet (MM), piezosurgery, and conventional instruments (EudraCT 2022-003135-25). Twenty-two patients requiring the extraction of three non-adjacent teeth were included. Each tooth was randomly assigned to a specific treatment (control, MM, or piezosurgery). Outcome measures were the severity of symptoms after surgery, wound healing assessed at the 10-days follow-up visit, and the time taken to complete each procedure (excluding suturing). Two-way ANOVA and Tukey's multiple comparisons tests were performed to evaluate eventual differences between groups. There were no statistically significant differences between the compared methods in postoperative pain and healing, and no additional complications were reported. MM required significantly less time to perform a tooth extraction, followed by conventional instruments and piezosurgery, in increasing order (p < 0.05). Overall, the present findings suggest the use of MM and piezosurgery as valid options for dental extractions. Further randomized controlled studies are needed to confirm and extend this study's results, facilitating the selection of the optimal method for an individual patient depending on the patient's needs and preferences.
ABSTRACT
OBJECTIVE: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. METHODS: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. RESULTS: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. CONCLUSIONS: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..
