Effect of CBCT-guided minimally invasive tooth extraction with Piezosurgery on matrix metalloproteinases in gingival crevicular fluid,complications,and satisfaction of patients with impacted teeth

CAO Dong; BAO Shijin; JIANG Jiquan

doi:10.3969/j.issn.1002-3429.2025.20.016

Abstract：Objective To investigate the effect of oral cone-beam CT(CBCT)-guided minimally invasive tooth extraction with Piezosurgery on matrix metalloproteinases(MMPs)in gingival crevicular fluid,complications,and satisfaction of patients with impacted teeth.Methods A total of 103 patients with impacted teeth who were treated from January 2023 to January 2024 were selected as the research subjects.They were divided into the observation group(n=52)and the control group(n=51)according to random number table method.The observation group underwent CBCT-guided minimally invasive tooth extraction with Piezosurgery,while the control group underwent CBCT-guided traditional tooth extraction.The intraoperative and postoperative indicators,intraoperative and postoperative complications,and postoperative patient satisfaction were recorded in both groups.The MMPs in gingival crevicular fluid immediately after surgery and at 3 d after surgery,as well as the periodontal health indicators,chewing efficiency and indicators of alveolar bone before surgery and at 3 months after surgery were compared between the two groups.Results The integrity of the alveolar bone and facial swelling at 3 d after surgery,and visual analogue scale(VAS)pain scores at 1 and 3 d after surgery were all lower in the observation group than in the control group,while the mouth opening degree at 3 d after surgery was higher than that of the control group(P<0.01).The levels of matrix metalloproteinase(MMP)-3,MMP-1,and MMP-8 in the gingival crevicular fluid of the observation group were lower than those of the control group at 3 d after surgery(P<0.01).The plaque index(PLI),sulcus bleeding index(SBI),and gingival index(GI)in the observation group at 3 months after surgery were lower than those in the control group,while the masticatory efficiency,alveolar bone height,width and bone mineral density grayscale values were higher than those of the control group at 3 months after surgery(P<0.01).The total incidence of intraoperative and postoperative complications in the observation group was lower than that in the control group(P<0.05,P<0.01),while the satisfaction was higher in the observation group than in the control group at 3 months after surgery(P<0.05).Conclusion CBCT-guided minimally invasive tooth extraction with Piezosurgery for impacted teeth is safe and effective,and can reduce the release of MMPs,alleviate pain,and reduce the incidence of intraoperative and postoperative complications,which is beneficial for improving postoperative periodontal indicators and restoring alveolar bone and tooth function.