***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE The aim of this prospect i ve study was to objective ly evaluate inferior alveolar nerve ( IAN ) sensory disturbances in patients who underwent sagittal split ramus osteotomy ( SSRO )  by comparing 1 side treated with a reciprocating saw with the other side treated with a piezosurgery device . MATERIAL S AND METHODS Clinical evaluation of IAN sensory disturbance was undertaken preoperatively and at 1 week , 4 weeks , 2 months , and 6 months postoperatively in 20 patients who underwent SSRO at the Division of Oral and Maxillofacial Surgery , Araraquara Dental School , São Paulo State University . The 20 patients were examined at all periods for IAN functionality by Semmes-Weinstein testing ; neither the patients nor the examiner knew which side was treated using piezosurgery or a reciprocating saw . RESULTS The mean age of the patients was 28.4 years ( range , 20 to 48 yr ) . Before surgery , no patient had impaired function of the IAN  in any of the 8 zones in the mental and inferior lip areas . All patients reported feeling the first monofilament at the time of the preoperative test . Seven days postoperatively , all patients reported some kind of altered sensitivity in at least 1 zone evaluated . CONCLUSIONS The results of this study suggest there was no statistically significant difference in the sensitivity of the labiomental area regarding the instrument used to perform the osteotomy . Future studies will focus on enlarging the sample and evaluating the results PURPOSE The surgical removal of m and ibular third molars is frequently accompanied by significant postsurgical sequelae , and different protocol s have been described to decrease such adverse events . The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during m and ibular third molar removal . PATIENTS AND METHODS A single-center , r and omized , split-mouth study was performed using a consecutive series of unrelated healthy patients attending the Oral Surgery Unit of the University of Turin for surgical removal of bilateral m and ibular third molar teeth . Each patient was treated , at the same appointment , using bur removal on 1 side of the m and ible and a piezoelectric device on the contralateral side . The primary outcomes reported were postoperative pain , objective orofacial swelling , and surgical duration ; secondary outcomes were gender , age , and possible adverse events . Analysis of variance or paired t test was used as appropriate to test any significant differences at baseline according to each treatment subgroup , and categorical variables were analyzed by χ(2 ) test . RESULTS The study sample consisted of 100 otherwise healthy patients . The mean pain evaluation reported by patients who underwent surgery with piezosurgery was significantly lower than that reported after bur ( conventional ) removal , reaching statistical difference after 4 days ( P = .043 ) . The clinical value of orofacial swelling at day 7 , normalized to baseline , was lower in the piezosurgery group ( P < .005 ) . The average surgical duration was significantly shorter in the bur group than in the piezosurgery group ( P < .05 ) . Three patients having bur removal developed short-term complications ( 2 dry sockets and 1 temporary paraesthesia ) , which totally resolved by 4 weeks . CONCLUSIONS To date , this prospect i ve investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal . This study also compared surgeons with different degrees of experience . It is evident that using a piezoelectric device can enhance the patient experience and decrease postoperative pain and swelling PURPOSE The purpose of this study was to compare the discomfort and surgical outcomes of a piezosurgery device with those of rotatory instruments in lower third molar extraction . MATERIAL S AND METHODS A split-mouth , r and omized , unblinded clinical study was design ed ; the 2 molars had to have the same extraction difficulty score . The test side was extracted using a piezosurgery technique and the control side was extracted using a conventional h and piece . The primary endpoint was patient discomfort evaluated with the Postoperative Symptom Severity ( PoSSe ) scale , which was administered to each patient ; secondary endpoints were pain , trismus , swelling , and surgical time evaluation . Paired- sample s t test and repeated- measures analysis of variance were used to compare outcomes within patients . RESULTS Ten consecutive patients ( 6 female , 4 male ; mean age , 22.4 ± 2.3 yr ) were recruited .  The total score on the PoSSe scale was significantly lower for piezosurgery compared with the conventional rotating h and piece ( 24.7 ± 10.3 vs 36.0 ± 7.6 ; t = -4.27 ; P = .002 ) . Moreover , postoperative swelling 1 week after surgery was significantly lower for piezosurgery than for the conventional rotating h and piece ( 2.75 ± 0.23 vs 3.1 ± 0.39 cm ; t = -2.63 ; P = .027 ) . CONCLUSIONS Piezosurgery was associated with less postoperative discomfort and yielded better results for swelling . Piezosurgery seems to be a good technique in daily surgical practice , especially if applied in the critical steps in which safety and respect for soft tissue , bone , and nerves are necessary PURPOSE This study was design ed to assess the impact of " pain and swelling " associated with third molars on patients ' quality of life before surgery . PATIENTS AND METHODS The data for these analyses were obtained from a larger ongoing study design ed to examine the surgical and medical management of problems associated with third molars . Data from 480 patients with 4 third molars scheduled for removal were used in the analysis . Question naires administered presurgery assessed patients ' medical and dental history , their reasons for seeking third molar removal , and sociodemographic characteristics . Adverse impacts on oral health-related quality of life were measured using the 14-item Oral Health Impact Profile ( OHIP ) question naire . The primary outcome variable was the percentage of people reporting 1 or more of the 12 non-pain-specific OHIP items " fairly often " or " very often " during the 3 months before enrollment . RESULTS One third ( 178 of 480 ) of patients said they were seeking third molar surgery because of current or previous symptoms of pain/swelling , and 17 % reported 1 or more of the 12 non-pain-specific OHIP items . In the multivariate logistic regression model , the odds of one or more impacts was greater for people who presented because of symptoms ( odds ratio [ OR ] , 2.9 ; 95 % confidence interval [ CI ] , 1.7 to 4.8 ) , who were aged 25 years or more ( OR , 1.9 ; 95 % CI , 1.1 - 3.3 ) , and who had a self-reported history of tooth loss due to pathology or trauma ( OR , 2.9 ; 95 % CI , 1.9 to 5.5 ) . CONCLUSIONS Adverse impacts on quality of life occurred for 1 in 8 patients seeking third molar surgery , and the odds increased 3-fold for patients who had experienced pain/swelling compared with those who were asymptomatic Our aim was to compare the use of a conventional rotary h and piece and a Piezosurgical unit for extraction of lower third molars . We studied 40 patients , who were allocated alternately to have the third molar removed with either the h and piece or the Piezosurgical unit .  Pain , trismus , and oedema were evaluated at baseline and then postoperatively , together with paraesthesiae , on postoperative days 1 , 3 , 5 , 7 , and 15 . Damage to surrounding tissue was checked on the same day whereas dry socket was evaluated from postoperative day 3 onwards . More patients complained of pain in the conventional group , they also required more analgesics , and they developed trismus more often than in the Piezosurgery group . There was also significantly more postoperative swelling in the conventional group . Patients were also evaluated using the subjective Postoperative Symptom Severity ( PoSSe ) scale . Our results suggest that apart from some inherent limitations with the Piezotome , it is a valuable alternative for extraction of third molars PURPOSE The purpose of this study was to investigate and compare , in a r and omized and controlled clinical trial , the use of ultrasound bone surgery devices and the use of rotary instruments in lower third molar extraction s. MATERIAL S AND METHODS We selected 26 patients ( 12 women and 14 men ) for this study ; the mean age was 31.2 years ( range , 24 - 45 years ) . A r and omized clinical trial was planned . Patients in the control group received treatment with the conventional rotary instruments ; patients in the test group received treatment with the ultrasound bone surgery tools . Twenty-six third molars were allocated to the test and control groups according to a computer-generated r and omization list . All the surgical procedures were performed by the same surgeon . Pain , trismus , cheek swelling , and number of analgesics taken were evaluated at baseline ( before surgery ) and at the first- , third- , fifth- , and seventh-day visits . RESULTS Pain levels ( evaluated on a visual analog scale ) were higher in the control group when compared with the ultrasonic group ; however , no statistically significant differences were found . On the contrary , the number of analgesics taken in the test group was significantly lower when compared with the control group . The occurrence of trismus was significantly higher in the control group when compared with the test group . The clinical values of cheek swelling were higher in the rotary group when compared with the ultrasound group at the fifth-day visit . CONCLUSION This study showed that the use of ultrasound bone surgery for third molar extraction significantly reduced the occurrence of postsurgical trismus , the occurrence of swelling , and the number of analgesics taken after surgery Abstract Introduction : Reducing post-interventional inflammation and pain in odontostomatological surgery procedures , such as tooth extraction s , implants or oral biopsies is a relevant clinical goal . Chlorhexidine oral rinse is commonly used with this aim . Recently a new product containing chlorhexidine , dexpanthenol , allantoin and chitosan ( Bexident Post [ BP ] ) in a gel formulation has been developed . We evaluated the efficacy of BP in controlling postsurgical inflammation and pain and in promoting cicatrization in subjects undergoing molar extraction s. Subjects and methods : We conducted a prospect i ve sequential cross-over , r and omized controlled study in patients undergoing surgical removal of at least two impacted m and ibular third molars ( teeth numbers 38 and 48 ) ( numbers 17 and 32 in the Universal Tooth Numbering System ) , in two separate sessions , to determine the effect of BP in comparison with bicarbonate ( BC ) oral rinse ( one spoonful in 200 ml of water ) , both used three times daily . Each subject utilized both products in a r and omized sequential manner after each tooth extraction . Primary outcomes of the study were post-procedure pain and inflammation . Secondary outcomes were  analgesic pill rescue use ( metamizole 1 cap every 8 hours if needed ) and an assessor-blinded evaluation of cicatrization with a semi-quantitative scale ( good , satisfactory and insufficient ) . Post-procedure pain was assessed 6 hours after tooth extraction and for seven consecutive days by means of a 10 cm visual analogue scale ( VAS ) ( from 0 : no pain to 10 : extreme pain ) . The extent of inflammation was evaluated through metric measurements of facial perimeter using st and ardized anatomical reference points . Results : A total of 47 patients ( 22 men and 25 women ; mean age 34 years ) were enrolled with a total of 94 molars extracted . Nineteen subjects applied BC as the first sequential treatment and 28 BP as the first . Before surgery no mean differences in the two treatments in inflammation measurements were observed . After surgery mean VAS pain score was similar between the two treatments in the first 6 hours ( VAS score = 6.5 ) . A marked progressive reduction in pain intensity with the use of BP was observed throughout the treatment period in comparison with BC ( 7 day mean scores 3.7 vs. 5.3 ; p = 0.0001 ) . BP was superior to BC in reducing inflammation with −50 % of the inflammation-related measurement ( 6 mm vs. 12 mm ; p = 0.0001 ) . Analgesic pill consumption was lower with BP in comparison with BC ( 13 pills vs. 24 ; p < 0.05 ) . Cicatrization was scored ‘ good ’ in a higher percentage of subjects during BP use ( 64 % ) in comparison with the BC group ( 13 % ) ( p = 0.0001 ) . No serious side effects were reported with either treatment regimen . Conclusion : In this trial BP performed better than BC in controlling pain and inflammation in subjects undergoing dental surgery , reducing the consumption of analgesics and favoring better cicatrization Fifty-two consecutive healthy patients with bilateral , similarly impacted m and ibular third molars were studied . For each patient , both third molars were removed at the same operation by the same experienced operator . On one side , the lingual split method by chisel was used ; on the other , the buccal approach with surgical bur . St and ard preoperative and postoperative drug regimens were used . Pain , facial swelling ( visual analogue scales ) , and lingual and labial sensory disturbance were recorded for each side by the patients at home 6 , 24 , and 48 h and 7 days after surgery . Wound healing was assessed at 4 weeks . There were no statistically significant differences between methods in relation to pain , facial swelling , sensory loss , infection , or periodontal pocket depth distal to the second molar , although 2 % of third molars removed by chisel had lingual sensory disturbance at 7 days , as compared with 8 % where burs had been used . There were no statistically significant differences between duration of 
    Output:
    
Conclusion The piezoelectric surgery was effective in reducing pain , swelling and trismus in third molar surgery , but the same requires greater surgical time than the rotary instruments