Does Piezosurgery Decrease Patient Morbidity in Surgically Assisted Rapid Palatal Expansion Compared With Saw and Burrs?

PURPOSE

The present study compared the postoperative pain, edema, patient satisfaction, and operating time with the use of piezosurgery, a reciprocal microsaw, and conventional burrs in the surgically assisted rapid palatal expansion (SARPE) technique for the correction of transversal maxillary deficiency. The results of the present study may help clinicians minimize the postoperative complaints of patients after SARPE.

PATIENTS AND METHODS

The present randomized single-blind study included patients who had undergone SARPE with piezosurgery, a reciprocating microsaw, or conventional burrs. To determine the facial norms and postoperative facial edema, 4 anatomic distances were measured on the patients' face using the modified flexible ruler method. The mean facial edema score was determined to evaluate and compare the overall edema among the groups. Two separate visual analog scales were used to assess patients' postoperative pain and intraoperative satisfaction. The duration of the osteotomies was recorded. Intragroup data were statistically analyzed via a t test, and intergroup data were analyzed via a nonparametric Kruskal-Wallis test. Spearman's correlation was used to evaluate the relationships among the variables.

RESULTS

For the 80 patients, edema (second day: piezosurgery, 0.53 ± 0.34; microsaw, 0.61 ± 0.30; burrs, 0.94 ± 0.33; P < .001) and pain (piezosurgery, 2.3 ± 0.3; microsaw, 3.6 ± 0.4; burrs, 3.9 ± 0.6; P < .001) were greater for conventional burrs and microsaws, with statistically significant differences. Patient satisfaction (piezosurgery, 8.3 ± 0.3; microsaw, 5.5 ± 0.5; burrs, 5.1 ± 0.9; P < .001) was greater with piezosurgery. However, in the piezosurgery group, the duration of osteotomies was 50% greater (piezosurgery, 16.10 ± 3.30; microsaw, 11.05 ± 2.09; burrs, 11.2 ± 2.14; P < .001).

CONCLUSIONS

The results from the present study have shown that piezosurgery is an effective method for minimizing facial edema and patient morbidity and increasing patient satisfaction during SARPE. Moreover, the use of conventional burrs and microsaws prolonged the duration of facial edema.