Basheer 2017.

Study characteristics
Methods	Study design: parallel RCT Conducted in: India
Participants	Inclusion criteria: healthy patients above 20 years of age. Individuals having vertical, mesioangular, horizontal mandibular third molar impactions based on radiographic interpretation Exclusion criteria: patients with systemic disease that could influence healing, patients who do not provide consent, patients on antibiotics in the past 6 weeks or who require antibiotic prophylaxis before extraction, and patients who had acute local infection involving the impacted teeth Age: above 20 years old Number evaluated: 30 participants/30 teeth
Interventions	Piezoelectric versus rotary osteotomy technique for bone removal Group I: piezoelectric osteotomy technique (frequency of 25 to 29 kHz with a microvibration of 60 to 200 mm/s was used with a boosted working mode) Group II: rotary osteotomy technique (35,000 rpm) All participants underwent surgical removal of impacted mandibular third molars under 2% lidocaine with 1:200,000 adrenaline, with inferior alveolar, lingual, and long buccal nerve blocks administered. Postoperatively, all participants received amoxicillin 500 mg 3 times a day and diclofenac sodium 50 mg 3 times a day for 3 days. Postoperative instructions were given, and the sutures were removed on the seventh day.
Outcomes	Pain VAS (no pain to severe pain) Trismus (interincisal distance) Swelling Other outcomes: time taken for the procedure; patient satisfaction
Notes	Descriptive analysis was done. Results are explained as mean ± standard deviation (min to max) and also as number (%): 5% was considered as level of significance with 95% confidence interval. Quantitative data were analysed using unpaired t‐test, and qualitative data were analysed using Fisher’s exact test. Sample size calculation: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "individuals were randomly allocated to study groups" Comment: method of randomisation was not described
Allocation concealment (selection bias)	Unclear risk	Comment: methods of concealment were not discussed
Blinding (performance bias and detection bias) patient	Unclear risk	Comment: it is unclear if the participants were blinded as they consented to the procedure
Blinding (performance bias and detection bias) assessor	Unclear risk	Comment: blinding is not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	There were no reported dropouts.
Selective reporting (reporting bias)	Low risk	All of the outcomes were reported.
Other bias	High risk	Quote "to standardize our results, it was conducted on 30 male individuals having their age ranging from 25 to 33 years, in order to remove the gender factor that may play a role in postoperative complications due to hormonal changes that may occur in females" Comment: this study only included males, therefore the results are limited to this study population