Orthognathic surgery is a successful surgical method for correcting facial deformities, and the piezoelectric system can be used in place of or in addition to traditional tools like the reciprocating saw to perform osteotomies. This study assesses how using a reciprocating saw or a piezoelectric device exclusively affects neurosensory impairment. A review was performed following the PRISMA-ScR recommendations. A search was conducted until December 2024 in PubMed, Embase, and Web of Science. Clinical trials and quasi-experimental studies in English and Spanish were included. A total of nine articles were obtained for full-text review using inclusion and exclusion criteria. The selected articles included a total of 731 subjects. The age range of the studies included was between 18 and 49 years. Three of the six analyzed state that piezoelectric surgery positively correlates with neurosensory recovery, showing less surgical time and a less painful and faster postoperative recovery than the use of a saw. However, only two reported no significant statistical difference in sensitivity recovery between the saw and piezoelectric instruments. Despite the methodological heterogeneity among the studies included, the sample size, and the variability of factors, using a piezoelectric system typically shows a better postoperative recovery of sensitivity compared to using a saw.