Discussion
edema, pain, postoperative edema, tooth
EDEMA, COMPLICATION, HAND SWELLING, SEPARATION, COMPLICATIONS
Every attempt to reduce the associated morbidity when deciding on the donor site is essential in determining the frequency of clinical use of a method. One of the ways to reduce morbidity is to be gentle with the tissues and to keep the operation time short. In this study, conventional and piezosurgery methods were compared in autogenous graft harvesting from the ramus, which is one of the most preferred donor sites when there is sufficient bone. In this randomized controlled study, no significant difference was found in osteotomy times between the groups. Although there was a substantial increase in operation time compared to the conventional method in operations such as separation of dental hard tissue with bone that would be performed in wisdom tooth surgery, it was found that piezosurgery does not work slowly due to its other advantages, especially in bone-related operations involving factors other than just cutting the bone such as bone harvesting from the retromolar area.The disadvantages of the piezosurgery device have been widely discussed in the literature; slowing the osteotomy time by 20–35% and increased costs are the most debated disadvantages [Different tips have been developed for piezoelectric devices, which can provide significant advantages with safe and effective osteotomies [When comparing piezosurgery with the conventional method, it is difficult to reach a conclusion about edema and pain in oral and maxillofacial surgical procedures. Although many studies claim that there is no significant difference between piezosurgery devices and rotary instruments [Clinical and animal studies have shown that piezosurgery is gentler than the conventional method of bone and soft tissue during osteotomy [The strengths of this study lie in its design as a randomized control trial, which ensures uniformity in critical group characteristics as well as randomization and patient blinding. Its validity is further strengthened using a well-validated instrument and the fact that all surgeries were performed by a single highly skilled surgeon competent in piezosurgery. Furthermore, the consistent use of cooled saline solution for irrigation in both groups demonstrates methodologic rigor. However, limitations such as the impossibility of double-blinding and the surgeon’s knowledge of group assignments, although inherent in the study, are important considerations in the interpretation of the findings.The limitations of our study include the inability to implement double blinding and complete masking of the operator, which were inherent constraints of our methodology. Additionally, we did not conduct a statistical analysis to compare complications, treatment costs, and quality of life indicators between the groups. Our focus was primarily on the speed of the two methods, and we did not measure the graft volume, which could be a significant factor in assessing the efficacy of these techniques. The study also did not consistently match the donor and recipient sites ipsilaterally, which might have influenced morbidity-related outcomes. It is essential for future studies to consider the correlation between donor and recipient site locations in evaluating these surgical methods. While our findings align with those observed in other oral and maxillofacial surgery procedures, they should not be generalized across all maxillofacial surgeries. We intend to undertake further research to measure the maximum graft volume obtainable with each technique and to compare the efficiency and postoperative morbidity between them. Comprehensive future studies are necessary to establish equivalency and investigate factors influencing operation time and complication rates. Additionally, the exploration of advanced 3D measurement techniques for assessing postoperative edema and swelling could provide a more nuanced understanding of surgical outcomes [