• Ana Gigovska Arsova University Clinic for Oral Surgery and Implantology St. Pantelejmon, Skopje, North Macedonia
  • Bruno Nikolovski Faculty of Medical Sciences, Goce Delcev University in Stip, North Macedonia
  • Stavre Trajculeski University Clinic for Oral Surgery and Implantology St. Pantelejmon, Skopje, North Macedonia
  • Aneta Terzievska University Clinic for Oral Surgery and Implantology St. Pantelejmon, Skopje, North Macedonia
  • Boris Velickovski Faculty of Dentistry, Ss. Cyril and Methodius University in Skopje, North Macedonia


Removal of impacted permanent third molars is considered to be one of the most common and routine oral surgical procedures. This intervention is usually performed in the classical way with the use of rotatory  instruments and burs. As an alternative to this classical approach, piezosurgery can be used, which is an osteotomy technique based on ultrasonic vibrations. The crucial advantage of piezosurgery is that it is inert to soft tissues. The aim of this study was to compare piezosurgery with the rotatory osteotomy technique, with particular reference to the time required to perform the intervention and the intensity of postoperative sequelae: pain, swelling, and trismus. This paper summarizes published experiences and knowledge of piezosurgery, with special regard to the extraction of mandibular third molars. For the purposes of this research, an automatic detailed search was performed on the electronic database PubMed for the period 2012-2022. Keywords used in the search were: piezosurgery, impacted third molars. The initial filtration resulted in 47 scientific papers, 17 of which met the selection criteria. Of particular interest were papers such as Meta-analyzes and systematic reviews. A review of the literature indicates that although patients undergoing piezosurgery required longer operating times, they had less postoperative pain, swelling, and trismus.

Keywords: impacted molar, piezosurgery.



1.Pavlikova G, Foltan R, Horka M, Hanzelka T, Borunska H, Šedy J.. Piezosurgery in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2011;40:451–7.
2.Aly LAA. Piezoelectric Surgery: Applications in oral & Maxillofacial Surgery. Future Dental Journal 2018;4:105–11.
3.Vercellotti T, Nevins ML, Kim DM, Nevins M, Wada K, Schenk RK, Fiorellini JP. Osseous response following resective therapy with piezosurgery. Int J Periodontics Restorative Dent 2005: 25: 543–549.
4.Walsh LJ. Piezosurgery: an increasing role in dental hard tissue surgery. Austral Dent Pract 2007: 9: 52–56.
5.Eggers G, Klein J, Blank J, Hassfeld S. Piezosurgery: an ultrasound device for cutting bone and its use and limitations in maxillofacial surgery. British Journal of Oral and Maxillofacial Surgery. 2004 Oct; 42(5):451–3.
6.Kirpalani T, Dym H. Role of piezosurgery and lasers in the oral surgery office. Dent Clin North Am. 2020;64(2):351-363.
7.Bui CH, Seldin EB, Dodson TB. Types frequencies and risk factors for complications after third molar removal. J Oral Maxillofac Surg. 2003;61(12):1379-89.
8.De Azevedo ET, Costa DL, Pryzysiezny PE et al. Using piezoelectric system in oral and maxillofacial sugery. Int J Oral Maxillofac Surg. 2011;40:451-7.
9.Sohn DS, Ahn MR, Lee VH, Yeo DS, Lim SU. Piezoelectric osteotomy for intraoral harvesting of bone blocks. Int J Periodontics Retorative Dent. 2007;27:127-131.
10.Beziat JL, Vercellotti T, Gleizal A. What is Piezosurgery? Two-years experience in craniomaxillofacial surgery. Rev Stomatol Chir Maxillofac 2007; 108: 101–107.
11.Blus C, Szmukler-Moncler S. Atraumatic tooth extraction and immediate implant placement with piezosurgery: evaluation of 40 sites after at least 1 year of loading. Int J Periodontics Restorative Dent 2010: 30: 355–363.
12.Valente N, Cosma L, Nocca G, D`Addona A Piezoelectric Device Versus Conventional Osteotomy Instruments in the Comparison of Three Different Bone Harvesting Methods: An Istomorphometric, Phonometric, and Chronometric Evaluation The International journal of oral & maxillofacial implants 2019;34(5):1070–1077.
13.Abella F, de Ribot J, Doria G, Duran- Sindreu F, Roig M. Applications of piezoelectric surgery in endodontic surgery: a literature review. Journal of endodontics. 2014 Mar 1; 40(3):325-32.
14.Chang HH, Lee MS, Hsu YC, Tsai SJ, Lin CP. Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars. J Formos Med Assoc. 2015 Oct;114(10):929-35.
15. Jiang Q, Qiu Y, Yang C, Yang J, Chen M, Zhang Z Piezoelectric Versus Conventional Rotary Techniques for Impacted Third Molar Extraction: A Meta-analysis of Randomized Controlled Trials. Medicine (Baltimore). 2015 Oct;94(41):e1685.
16.Liu J, Hua C, Pan J, Han B, Tang X. Piezosurgery vs conventional rotary instrument in the third molar surgery: A systematic review and meta-analysis of randomized controlled trials. J Dent Sci. 2018 Dec;13(4):342-349.
17.Badenoch-Jones E.K., David M., Lincoln T., Piezoelectric compared with conventional rotary osteotomy for the prevention of postoperative sequelae and complications after surgical extraction of mandibular third molars: a systematic review and meta-analysis British Journal of Oral and Maxilofacial Surgery, 2016 Dec;54(10):1066-1079.
18.Al-Moraissi E.A., Elmansi Y.A., Al-Sharaee Y.A., Alrmali A.E., Alkhutari A.S. Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower thirdmolar surgery than conventional rotary instruments? A systematic review and meta analysis. Int J Oral Maxillofac Surg 2016; 45:383–391.
19.Cicciù M, Stacchi C, Fiorillo L, Cervino G, Troiano G, Vercellotti T, Herford AS, Galindo-Moreno P, Di Lenarda R. Piezoelectric bone surgery for impacted lower third molar extraction compared with conventional rotary instruments: a systematic review, meta-analysis, and trial sequential analysis. Int J Oral Maxillofac Surg. 2021 Jan;50(1):121-131.
How to Cite
GIGOVSKA ARSOVA, Ana et al. APPLICATION OF PIEZOSURGERY IN EXTRACTION OF IMPACTED THIRD MOLARS. Journal of Morphological Sciences, [S.l.], v. 5, n. 2, p. 104-108, aug. 2022. ISSN 2545-4706. Available at: <>. Date accessed: 25 sep. 2022.