Postoperative Pain, Swelling, and Trismus After Piezosurgery-Assisted Minor Oral Surgery in Patients with Coronary Artery Disease and Diabetes Mellitus: A Retrospective Cohort Study.

Background/Objectives: This retrospective cohort study aimed to evaluate postoperative pain, swelling, and trismus following piezosurgery-assisted minor oral surgical procedures in patients with coronary artery disease and diabetes mellitus (CAD+DM) and to compare the outcomes with those of systemically healthy individuals. Methods: Medical records of 60 patients who underwent piezosurgery-assisted minor oral surgery between 2018 and 2021 were retrospectively reviewed. Patients were allocated into two groups: CAD+DM (n = 30) and healthy controls (n = 30). Postoperative pain was assessed using a visual analog scale (VAS) at 6 h, 12 h, postoperative day 1, day 2, day 3, and day 7. Swelling and trismus were evaluated preoperatively and on postoperative days 2 and 7. Swelling and trismus data were analyzed using repeated-measures ANOVA and two-way repeated-measures ANOVA, whereas VAS scores were analyzed using the Friedman test, Dunn's post hoc test, and Mann-Whitney U test. Results: Both groups demonstrated significant time-dependent changes in swelling and trismus (all p < 0.001). Swelling increased on postoperative day 2 and decreased by day 7 in both groups; however, swelling values were significantly higher in the CAD+DM group at all evaluation time points (all p < 0.0001). Trismus was greatest on postoperative day 2 and improved significantly by day 7 in both groups (all p < 0.0001). A significant time × group interaction was observed for trismus (p < 0.0001), whereas no significant between-group difference was detected on postoperative day 7 (p = 0.7729). VAS scores decreased significantly over time in both groups (Friedman test, p < 0.0001). Pain scores were significantly lower in the CAD+DM group at 6 h, day 1, day 2, day 3, and day 7 (all p < 0.001), while no difference was observed at 12 h (p = 0.633). Conclusions: Piezosurgery-assisted minor oral surgery was associated with favorable postoperative recovery in both CAD+DM and healthy patients. Although CAD+DM patients exhibited greater postoperative swelling, trismus recovery was comparable between groups, and postoperative pain remained low throughout follow-up. Piezosurgery appears to be a safe and effective surgical approach for medically compromised patients undergoing minor oral surgical procedures.