Efficacy of Periotome Versus Conventional Forceps Extraction in Socket Preservation and Reduction of Postoperative Pain: A Randomised Clinical Trial

Abstract

Introduction: Atraumatic extraction is necessary when a patient undergoes dental implant rehabilitation. Various tooth extraction systems are used and regularly upgraded. The periotome is a tool that severes the Periodontal Ligaments (PDL) and aids in atraumatic extraction while preserving the socket. Aim: To evaluate the efficacy of conventional forceps versus periotome extractions of single-rooted maxillary teeth in terms of socket preservation, procedure duration, and postoperative pain. Materials and Methods: This was a single-blinded randomised clinical trial conducted at Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharastra, India from December 2020 to March 2021 involved 42 patients aged 18-60 years who required extraction of maxillary single-rooted teeth that had failed endodontic treatment. The patients were randomly divided into two groups: a periotome group and a conventional forceps group. Clinical assessment was conducted to evaluate socket preservation, extraction time, postoperative pain, and any complications related to the extraction procedure. Statistical analysis was performed using the Mann-Whitney U test, Chi-square test, and unpaired t-test. Results: The majority of patients were within the age group of 51-60 years, with 13 males and 29 females. The difference in extraction time between the two groups was not statistically significant (p=0.368). The periotome group exhibited a significantly lower incidence of buccal cortical plate fractures compared to the conventional forceps group (p=0.048). Regarding the severity of postoperative pain, the periotome group demonstrated a significantly lower value than the conventional forceps group (p=0.028). Conclusions: The periotome proved to be a more efficient choice for preserving the socket in endodontically non treatable teeth requiring extraction, as compared to conventional forceps.