Discussion
postoperative pain, bleeding, intraoperative bleeding, swelling, pain, tooth, phobia of psycho-emotional reaction
BLEEDING, POSTOPERATIVE BLEEDING, INTRAOPERATIVE BLEEDING, BONE NECROSIS, HAND SWELLING, HEAT, SUPERNUMERARY TEETH
In this clinical study, we collected 60 patients who needed to have their embedded supernumerary teeth extracted. In this study, we classified the embedded supernumerary teeth by the impacted data of the patients according to the type of obstruction (inverted, horizontal, oblique, orthodontic) and the position about the long axis of the adjacent teeth (root tip, middle, and crown segments). Three extraction methods were performed on different locations and types of buried multiple teeth, and their surgical results were evaluated. The piezosurgery group required the longest operative time for the extraction of inverted, horizontal, oblique, and root tip, middle embedded supernumerary teeth, but had the least postoperative bleeding, was effective in reducing postoperative pain and swelling, and significantly reduced patient fear compared to the HSCAH and combined piezosurgery. When extracting inverted, horizontal, oblique, and root tip, and middle embedded supernumerary teeth, the HSCAH, and combined piezosurgery groups can significantly reduce the operative time; however, in the HSCAH group, the bleeding is higher and the postoperative pain and swelling are significant.In this study, we evaluated the surgical outcomes of different locations and types of embedded supernumerary teeth with piezosurgery, HSCAH, and combined piezosurgery, and assessed the operative time, intraoperative bleeding, and two postoperative variables, namely pain, and facial swelling, and a fourth variable, phobia of psycho-emotional reaction.In terms of operative time, in a study by Jiang [In terms of the amount of surgical bleeding, Stbinger et al. [The piezosurgery operates at 24.0 to 29.5 kHz and can selectively perform cutting functions, using different operating frequencies for soft and hard tissues, cutting only mineralized structures-bone, but stopping when it encounters nerve, blood vessels, or other soft tissues. Less invasive damage during cutting, less damage to surrounding tissues, and promotes tissue repair. The release of oxygen ions during cutting provides a certain antiseptic effect and does not cause bone necrosis near the cutting area. When ultrasound works it stimulates cells and promotes tissue metabolism and bone regeneration. When an HSCAH performs osteotomy, a smooth surface is formed around the bone. When an piezosurgery performs osteotomy, an irregular rough surface is formed around the bone, and more osteoclasts and osteoblasts on this rough bone edge work simultaneously to promote bone regeneration. When an HSCAH cuts bone, the working head heats up, which causes thermal damage to bone tissue; however, the piezosurgery cutter head generates less heat, so it can prevent thermal damage to bone tissue during osteotomy [In terms of the level of pain being assessed by VAS, in a study by Topcu [In terms of facial swelling, Mistry [For postoperative fears, there have been many studies on the extraction of obstructed wisdom teeth [Strengths of the present study include the high-quality study design, the randomization, the similarities of the baseline characteristics across the three groups, and the use of a well-validated instrument, We found that in past studies, both piezosurgery and HSCAHs alone were used for tooth extraction, but the two were not used in combination, and in addition, only the two methods were used to compare and contrast the clinical outcomes after extraction. In this study, we divided the study population into three groups and applied both a piezosurgery and an HSCAH to one group of patients for clinical observation and treatment. And the piezosurgery combined with the HSCAH was used on one group of patients to observe the results of the procedure. Furthermore, In this study, we used CBCT data to classify embedded supernumerary teeth according to the type of obstruction (inverted, horizontal, oblique, orthodontic) and the position about the long axis of adjacent teeth (root tip, middle, and coronal segments). In previous investigations, either imaging data were used to classify the embedded supernumerary teeth or extraction measures were used to compare the clinical outcome after extraction without any classification. The limitation of this study is the relatively small sample size. In this study, only short-term follow-up was used to observe the healing of the extraction sockets when comparing the healing of the three methods of extracting supernumerary teeth, while longer follow-up is needed to determine the healing of the extraction sockets and surrounding hard tissues.