Objective: To systematically review the efficacy and complications of impacted mandibular third molar extraction with combined application of piezosurgery and rotary instrument. Methods: CNKI, WanFang Data, VIP, SinoMed, PubMed and Web of Science databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and complications of combined application of piezosurgery and rotary instrument (experimental group) versus rotary instrument alone (control group) in extracting impacted mandibular third molar from inception to December 24th, 2024. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Then, a meta-analysis was performed by using Revman 5.3 software and Stata 11.0 software. Results: A total of 11 RCTs involving 454 cases in experimental group and 454 cases in control group were included. The results of meta-analysis showed that the operation duration was shorter in experimental group based on Chinese RCTs and longer based on English RCTs, the pain Visual Analog Scale (VAS) was lower in post-operative 1st and 2nd day and the MIO (maximal interincisal opening) was larger in experimental group in post-operative 1st and 3rd day. Within 1 week, the incidences of trismus and facial swelling were lower in experimental group, but there were no significant differences between two groups in facial swelling degree in post-operative 1st, 3rd day. Conclusions: Current evidence shows that combined application of piezosurgery and rotary instrument may not consistently shorten the operation duration and reduce postoperative facial swelling, but it can reduce the degree of postoperative pain reaction and restriction of mouth opening.

Incompetent lip seal (ILS) can significantly affect craniofacial development and function, resulting in abnormal tooth eruption and alignment, as well as swallowing dysfunction. This article systematically reviews the research progress on labial incompetence, including the influencing factors of lip muscle closure force (physiological and pathological factors), measurement methods for lip muscle closure force, the impact of lip muscle closure force on dental and jaw development, and treatment strategies for labial incompetence, aiming to provide clinical diagnostic and therapeutic references.

Loss of alveolar bone in the oral cavity is one of the common complications during and after alveolar surgery. Traditional alveolar surgery techniques often destroy the buccolingual alveolar bone and accelerate the resorption of alveolar bone during the operation. The bone window technique preserves the vascular supply of the periosteum through its specific design and surgical execution, thereby creating a favorable biological environment for bone tissue survival and regeneration. This mechanism enables maximal preservation of alveolar bone. this paper summarized the development and application of bone window technology in alveolar surgery in recent years and provided a basis for the clinical application of bone window technology.

Tooth extraction is a common procedure in oral surgery, and the selection of surgical instruments directly impacts operative efficiency and patient outcomes. As the primary dental cutting instruments, pneumatic handpieces and electric handpieces exhibit distinct performance characteristics, yet their differences have not been systematically summarized. This study aims to conduct a comparative analysis of their technical principles, clinical efficacy, and infection control protocols through literature review and clinical evaluation, thereby providing evidence-based recommendations for optimal instrument selection in clinical practice.

Objective: To investigate the effect of concentrated growth factor (CGF) on the relief of complications and the healing and repair of soft and hard tissue after extraction of lower mandibular impacted third molar. Methods: Fifty patients with lower impacted third molars were randomly divided into experimental group and control group. Postoperative complications pain, swelling and soft tissue healing were compared at 1, 3 and 7 days after surgery, and the second molar pocket and alveolar bone tissue healing were compared 3 months later. Results: The wound healing index of experimental group was better than that of control group 7 days after operation (P<0.01). CGF alleviated local swelling 1 and 3 days after operation (P<0.001), and there was no significant difference between CGF and CGF on day 7. There was no statistical significance in visual simulation scores on the first day after surgery (P=0.250), and experimental group were lower than those on the control group on the 3rd and 7th day after surgery (P=0.001). There were significant differences in alveolar ridge width and buccal-lingual wall height between experimental group and control group (P<0.001). Bone density in experimental group was significantly higher than that in control group. The improvement of periodontal pocket in experimental group was significantly different (P<0.001). Conclusions: Local application of CGF can effectively promote wound healing, relieve local swelling and pain, and promote tissue regeneration after the extraction of lower mandibular third molar.

Objective: This article reports a case of staged extraction of impacted mandibular third molars adjacent to the inferior alveolar nerve canal (IANC) using coronectomy, providing additional therapeutic options for minimally invasive management of high-risk impacted teeth. Diagnosis and treatment: A 27-year-old male patient presented with bilateral mesioangular low-position impacted mandibular third molars, with roots closely adjacent to the IANC. After discussing postoperative risks of conventional extraction, the patient exhibited severe anxiety. A staged coronectomy protocol was therefore implemented as an adaptive treatment strategy. Results: Following staged extraction, the patient exhibited no postoperative sensory abnormalities, infections, or other complications, with significantly reduced anxiety levels. Conclusions: The procedure of segmental extraction of impacted molars can serve as an alternative treatment option for the removal of mandibular third molars adjacent to the inferior alveolar nerve.

Objective: This article discusses a case of surgical extraction of a buccolingually embedded obstructed mandibular first molar and analyzes the key intraoperative operations and their impact on postoperative recovery. Diagnosis and treatment: Preoperative cone-beam computed tomography (CBCT) was used to assess the location of the obstructed tooth and its relationship with adjacent anatomical structures, and a personalized surgical plan was formulated. During the operation, the main lingual window was opened, combined with buccal auxiliary opening window technique, to gradually debride and split and remove the tooth. Postoperative close follow-up was performed to observe the healing of the extraction socket. Results: No residual dental tissue was seen in the immediate postoperative X-ray examination. On review 3 months after surgery, the patient’s bone in the extraction area was in a remodeled state, indicating that the surgery had achieved a good result. Conclusions: Proper selection of the surgical incision and bone removal technique is crucial for improving the success rate of impacted mandibular first molar extraction in the buccolingual direction, minimizing trauma, and protecting adjacent structures.

Objective: To evaluate the clinical outcomes of two different rotational space preparation techniques for the extraction of bilateral impacted mandibular supernumerary teeth with curved root in a single patient. Diagnosis and treatment: The patient was a 23-year-old female. Initial eruption of supernumerary cusps was observed on the lingual side of teeth . On the lingual side of , the mucosa appeared pale, and bony bulging caused by the right supernumerary tooth was palpable. Preoperative cone beam computed tomography(CBCT) revealed that the bilateral mandibular supernumerary teeth resembled premolars in morphology and exhibited pronounced root curvature. The left supernumerary tooth was located near the alveolar crest, whereas the right one was positioned below the alveolar crest. Based on the different impaction conditions, odontotomy and ostectomy were employed respectively to prepare rotational space for the extraction of the curved-root supernumerary teeth. Results: Both impacted curved-root supernumerary teeth were successfully and easily extracted. Postoperative healing was uneventful, with no abnormalities in adjacent teeth and no evidence of lower lip numbness. CBCT performed six months postoperatively demonstrated satisfactory bone regeneration at the extraction sockets. Conclusions: Both rotational space preparation techniques provide efficient resistance elimination during the extraction of impacted curved-root supernumerary teeth and ensure a low incidence of complications, including inferior alveolar nerve injury and adjacent tooth trauma.