Periotome versus piezotome as an aid for atraumatic extraction: a randomized controlled trial

Abstract

Objectives: A single-blinded randomized controlled trial was designed to compare and evaluate the effectiveness of the periotome and piezotome as aids for atraumatic extraction and its sequalae. Materials and Methods:The study sample comprised 48 teeth, equally allotted to the piezotome or periotome groups by random allocation, in participants aged 19-62 years. All samples in both groups had either complete tooth structure or intact roots without crowns and had mobility ≤grade II. Clinical parameters of operative duration, presence or absence of gingival laceration, reported operative and postoperative pain, and intake of analgesics following extraction were recorded. IBM SPSS software package version 22 was used for data entry and analysis. Results: The mean operation time was significantly (P≤0.05) longer in the piezotome group than in the periotome group. However, fewer gingival lacerations were observed with use of a piezotome than with a periotome, although no significant difference was observed. The piezotome group reported significantly (P≤0.05) higher visual analog scale (VAS) pain scores during the procedure and non-significantly higher scores thereafter until the third postoperative day. In the piezotome group, the dosage of analgesic was higher, although the periotome group had a higher percentage of participants who used analgesics postoperatively; however, these differences were not statistically significant. Conclusion:The present clinical trial favors the use of periotome over piezotome for atraumatic extraction due to shorter operating time, lower postoperative VAS pain scores, and lower dosage of analgesics despite the superior ability of the piezotome to prevent gingival laceration.

Manzaneda’s Tool: Adaptation of the Piezotome for Rib Remodeling Surgery without Incisions

“… 1 Within the review, a search was made for piezotome tips that most closely resemble the straight shape and finish necessary for use in RibXcar; however, such a tool was not found. 3 , 10 The straightness of the tip allows for a noninvasive, fast, and unmarked entry for patients.…”

“…2 The piezotome is a piezoelectric device that allows for a selective and delicate manipulation of the bone, which, thanks to the micro-vibrations, allows for precise and soft cuts, without pressure and with minimum bleeding, regardless of the bone density. 3 The RibXcar technique is the pioneer in the inclusion of the piezotome for costal surgery. 1 For the inclusion of this surgical tool, an original adaptation of the piezotome has been made to perform the surgery in a safe and practical way.…”

“…2 The piezotome is a piezoelectric device that allows for a selective and delicate manipulation of the bone, which, thanks to the micro-vibrations, allows for precise and soft cuts, without pressure and with minimum bleeding, regardless of the bone density. 3 …”

The Socket-Plug Technique and Materials Comparison in Atraumatic Extractions - A Multiple-Case Study

“…12 Other instrumental methods including using physics forceps and piezotome for the extraction are also reported. 9,13 Interradicular septum is presented in the tooth with multiple roots especially posterior dentitions and is suggested to preserve for better wound healing and immediate implant placement. [21][22][23] As the interradicular septum remains, the post-extraction site is divided into two smaller sockets and the morphologic shape favors the wound healing process.…”

“…The use of instruments such as desmotome and periotome could lower the risk of pain, analgesic consumption, gingival laceration, and damaging the periodontal tissue during the procedure. 4,9,12 The residual inflammatory tissue should be curetted without any remains, preventing plug materials resorption and chances of delayed healing due to the low pH environment inside the socket. 4 The technique benefits the healing of the wound and maintains alveolar bone for future implant insertion.…”