Objective: This study compared magnetodynamic surgery, traditional drill-based surgery, and piezoelectric surgery for the preparation of the implant site, focusing on operative time and intra/postoperative discomfort. Methods: A total of 86 patients (69.8% female, 30.2% male) treated at the Oral Surgery Clinic, University of Trieste, were included: 43 underwent implant placement with the Magnetic Mallet (MM); the remaining 43 received preparations with the Piezodevice (IP) on one side and drills (Ds) on the other. All surgeries were performed by the same operator. Data included bone quality, operative time, and postoper- ative questionnaire responses for pain (VAS) and analgesic use. A statistical analysis was conducted using Mann–Whitney U and Kruskal–Wallis tests. Results: Significant differ- ences emerged in operative times and pain perception, influenced by bone quality. The MM and D had comparable times in D1–D2 and D3–D4 bone, but the D produced higher VAS scores. The MM vs. IP showed significant differences in absolute times (p = 0.00018) and relative times for both D1–D2 (p = 0.01875) and D3–D4 (p = 0.00584), with qualitative VAS differences. The IP vs. D also showed significant absolute (p = 0.000005) and relative time differences for D1–D2 (p = 0.00718) and D3–D4 (p = 0.000145), with VAS variations. In the MM group, higher bone density significantly prolonged times (p = 0.04136). Conclusions: Within the limits of this study, the traditional drill-based technique remains valid and widely used, but the Magnetic Mallet can offer advantages in terms of patient comfort and postoperative recovery. The Piezodevice, while excelling in tissue preservation, is limited by longer operative times.
