Gömülü 20 yaş dişi cerrahisinde kemik dokusuna yapılan müdahalelerde kullanılan Er:Yag lazer, piezocerrahi ve konvansiyonel frez yöntemlerinin birbirleriyle klinik olarak karşılaştırılmalı incelenmesi
Özet
Impacted third molar surgery is the procedure most done in oral and maxillofacial surgery. In every field of surgery, the aim is to cause less complications by minimizing the tissue damage and to provide a less painful and more comfortable postoperatif recuperation period for the patients.In our study, 30 patients with bilateral impacted lower third molars in class 2, position B, vertical position according to the Pell and Gregory criteria were selected. Patient randomly divided into two group. In all patients one side the bony cover around the tooth were removed by the conventional bur technique on the other side half of patient treated with the Er:YAG laser and others treated with piezoelectrical surgery.The purpose of this study is to compare the postoperatif pain, edema, trismus and patient satisfaction between Er:YAG laser surgery, piezoelectric surgery device and conventional bur surgery that are used to extract impacted lower third molar.Postoperatif edema was evaluated by Amin-Laskin and Gallerdo method while pain were assessed using visual analog scale (VAS). Trismus, calculated between the interincisal distance measurement. Also a questionnaire was given to the patients to asses their subjective variables about the different techniques. The statistical analysis of the results were made by SPSS 15.0 software.The results of the study demonstrated that the pain observed at postoperatif 24th hour were statistically significant lower in the laser group than piezoelectrical surgery group. It was also lower than conventional bur group but is not significant.Only edemea statistically significant differences was seen in laser group between preoperative and postoperatif 48th hours. There was no significant differences between groups.Postoperatif 48th hours trismus value was seen the most high in laser group than in conventional bur surgery and least in piezosurgery group.Due to intraoperative and postoperatif comfort, the patients who were treated with impacted lower third molar procedure, were statistically most satisfied with laser technique. Piezoelectric surgery technique was also satisfied but it was not significant.In the conventional bur surgery, the operation time found shorter due to the relative cutting efficiency than laser group and piezosurgery group. Piezosurgery technique was faster when compared with laser technique.As a conclusion if the speed of hard tissue laser and piezoelectrical device were increase their capacity, they may be considered as an alternative to conventional surgical bur in routine use. Different indications for oral surgery instead of routine extraction of impacted third molars will be more successful for piezosurgery technique compared with laser surgery.