Clinical perspectives of Prof José Carlos Rosas Díaz
Which diagnostic steps are necessary before extraction?
Dr Rosas Díaz: Before extraction, a comprehensive clinical and tomographic assessment is essential to accurately evaluate the bony structures surrounding the third molars and to plan an appropriate surgical approach.
Which complications occur most frequently during the extraction of impacted molars, and how can they be avoided?
Dr Rosas Díaz: Pain, swelling, haematoma and infection are among the most common complications. In my experience, these can be reduced by keeping mucoperiosteal flaps as small and atraumatic as possible. This is facilitated by the use of piezosurgical osteotomy instruments, which cut using high-frequency microvibrations rather than rotational movement. This allows precise work on bony and dental structures while protecting the surrounding soft tissue.
In your clinical experience, how does the type of osteotomy performed with piezo technology affect postoperative complications such as swelling, pain or nerve injuries?
Dr Rosas Díaz: The precision of the osteotomy and the overall surgical approach play an important role in postoperative healing. When I work with more controlled, tissue-preserving cuts, procedures are often more efficient and flap design can usually be kept more conservative.
In selected cases, this has been associated with reduced postoperative swelling and discomfort. From a clinical perspective, minimising flap size and avoiding unnecessary trauma are key factors, regardless of the specific instrument used.
Which clinical factors influence your decision between conventional techniques and a piezosurgical approach with potentially improved postoperative tolerance?
Dr Rosas Díaz: The main consideration is the potential to reduce pain, swelling and infection by performing smaller, more tissue-preserving flap preparations — something that is often more achievable with piezo technology.
All images courtesy of W&H.
