Postoperative evaluation of Er:YAG laser, piezosurgery, and rotary systems used for osteotomy in mandibular third-molar extractions.

OBJECTIVE: This study compared patient postoperative pain, swelling, and trismus after usage of rotary instruments, piezosurgery, and Er:YAG lasers in mandibular third-molar extraction. MATERIALS AND METHODS: This prospective study was executed with class II and position B vertically impacted mandibular third molars. Patients were divided into three groups according to the osteotomy system used to remove retentive bone: rotary instruments, piezosurgery, and Er:YAG laser. Postoperative pain was evaluated using VAS questionnaires at 12 h, 24 h, 48 h, and 7 days after procedures. Trismus was evaluated by measuring the distance between the maxillary and mandibular incisors at maximum mouth opening, and comparing preoperative measurements with those for postoperative days 2 and 7. Analyses of swelling were carried out via a stereophotogrammetry system. Operation times were measured using a digital stopwatch from the initial incision to the final suture. RESULTS: There were no statistically significant differences between the groups in terms of pain, trismus, or swelling (p > 0.05). Pain persisted more in the rotary instrument group 24 h later (0 ± 1.3; p = 0.001). The pain scores obtained after 48 h for the piezosurgery (1.81 ± 2.29) and rotary (2.2 ± 2.12) groups were observed at 24 h in the laser group (2.19 ± 1.52). The mean operation time was highest using the laser (19.1 ± 3.85 min; p = 0.001) and lowest using rotary instruments (9.88 ± 2.97 min; p = 0.001). CONCLUSION: Piezosurgery and Er:YAG laser are good alternatives to rotary instrument systems in third-molar extraction, but both systems are slower than traditional rotary instruments.

The Prevalence of Cleft Lip and Palate Patients: A Single-Center Experience for 17 Years.

OBJECTIVE: The aim of the present study was to report the prevalence of cleft lip and palate (CLP), isolated cleft palate (CP), isolated cleft lip (CL), and median cleft (MC) applied in Marmara University School of Dentistry, Department of Orthodontics. METHODS: There were 1058 patients who applied to the center between 2000 and 2017. A total of 1026 patients were included in the study. Files, models, and photographs were evaluated. The patients were divided into six groups: unilateral right or left CLP, bilateral CLP, isolated CP, isolated CL, and MC. The prevalence was identified according to cleft type, side, gender, age, and application year. RESULTS: The most common type was unilateral CLP (44.3%), which was observed more on the left side (28.9%), followed by CP (28.7%). MC had a minimum ratio (0.3%) between cleft types. Males were more prone to have unilateral CLP (right side, 64.6%) and bilateral CLP (64.1%), whereas females were more prone to have CP (59.9%). The greatest number of applications was recorded in 2004, and the patients mostly applied in the neonatal period (64.9%). The ratios of complete cleft cases in all types of clefts were statistically significantly higher. CONCLUSION: Unilateral CLP was the most common cleft type and seen more on the left side. While males were affected more by CLP, isolated CP was seen more in females than in males.