Introduction
swelling, lockjaw, paresthesia, pain, trismus, oedema
TRISMUS, POSTOPERATIVE COMPLICATIONS, PARESTHESIA, BONE NECROSIS, OEDEMA, SEQUELAE, COMPLICATIONS
Included wisdom teeth surgery is one of the most common procedures performed by oral surgeons, usually associated with intraoperative and postoperative complications [The most significant post-surgical complications are pain, swelling, lockjaw, and even paresthesia of the lower lip or tongue, which can have both social and biological impact and can compromise patients' quality of life [Conventional surgery using rotary instruments is the most common technique in extraction procedures.The conventional technique has disadvantages, such as the excessively high temperature produced during osteotomy that can cause marginal bone necrosis and compromise hard and soft tissue healing [In the last decades, technological innovations have been introduced in oral surgery to allow less invasive approaches, ranging from use of piezoelectric instruments to dynamic navigated surgery [In particular, the advent of ultrasound, in surgery, has improved several oral surgical procedures, such as the extraction of impacted third molars.According to a systematic review with meta-analysis by AL-Moraissi et all. in 2016, the piezo electric surgical technique used in third molar extractions shows a significant reduction in post-operative sequelae (oedema, pain, trismus). The low incidence of post-operative sequelae seems to be related to the atraumatic and micrometric cutting action of the instrument [Piezo surgery is effective in osteotomy because it works selectively, being inert against soft tissue, nerves and blood vessels. This represents a significant advantage over a bur [When used appropriately, piezo surgery causes less structural and cellular damage than conventional surgery. In addition, the formation of new bone is faster than with rotary burs [Several studies have shown that the micrometric cutting action of piezo surgery requires a longer intervention time than the use of a bur, potentially causing more discomfort in the postoperative period [The aim of this study is to evaluate, in an innovative way, the facial swelling following the osteotomy performed with rotary instrument (R group) versus piezo electric instrument (P group) in the mandibular impacted third molar extraction, using a facial reconstruction software.