{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T05:41:23Z","timestamp":1777268483896,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T00:00:00Z","timestamp":1696809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There are few research works with in\u2010depth studies and direct simultaneous comparisons of the effects on tissue reactions and patients'\u00a0recovery following in vivo conventional drilling, ultrasound\u2010 and laser\u2010assisted osteotomy in humans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The current study aims to compare bone cutting duration, pain, swelling, and trismus in patients following surgical mandible third molar extraction by bone removal using three different osteotomes\u2014a conventional rotary device, an ultrasonic unit, and an Er:YAG laser.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, randomized three\u2010group comparative clinical trial was performed. As an experimental setting for the study, \u0430n open mandible third molar surgery was chosen because osteotomy is included in its protocol. Patients were divided into three groups according to the used device for bone removal. Bone cutting time intraoperatively, facial swelling, trismus, and pain on the first, second, and third postoperative days were assessed. The statistical analyses were performed using the SPSS v. 17.0\u2014Kolmogorov\u2013Smirnov test, one\u2010way ANOVA, Student's <jats:italic>t<\/jats:italic>\u2010test, Mann\u2013Whitney test, and <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0test. Statistical results were considered significant at <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 (confidence interval of difference, 95% CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty patients (34 males and 46 females with an average age of 25.18 years) were included in the study. The average time for bone removal by the conventional low\u2010speed device (4.95\u2009min), by the ultrasonic unit (5.13\u2009min), and by the Er:YAG laser (9.00\u2009min) differed significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). The mean postoperative facial swelling showed a marked difference between the groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), in favor of the laser and piezo groups. The osteotome proved to influence pain intensity not only immediately after surgery (<jats:italic>p<\/jats:italic>\u2009=\u20090.002), but also during the followed\u2010up period (<jats:italic>p<\/jats:italic>\u2009=\u20090.001), again in favor of the two above\u2010mentioned groups. No association was found between trismus and the osteotome used by the followed\u2010up patients (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bone\u2010cutting mechanism and the biological influence of the laser beam and ultrasound on living tissues proved to be favorable factors for patients'\u00a0pain levels and tissue swelling postoperatively independent of the longer osteotomy duration compared to conventional drilling.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23730","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T18:07:28Z","timestamp":1696874848000},"page":"862-870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Conventional drilling <i>versus<\/i> ultrasound and laser osteotomy in mandibular third molar surgery:\u00a0A comparative 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