Antetokounmpo had missed five games due to a sore left knee but scored 20 of his 29 points in the first quarter of his comeback at Little Caesars Arena on Monday.
Khris Middleton was also back in the line-up for the first time since last month following a knee injury of his own as the third-placed Bucks moved to 30-17 in the Eastern Conference.
Greek superstar Antetokounmpo said: "The band is back together" and added: "'I was trying to be aggressive and some shots fell."
Milwaukee scored an incredible 49 points in the first quarter, only two short of the NBA record, with Antetokounmpo taking centre stage.
Bucks head coach Bucks coach Mike Budenholzer was impressed with the way Antetokounmpo was able to hit the ground running.
"It was impressive to come out and play the way he did," Budenholzer said. "He did a little bit of everything, just like the whole group that in that [first] quarter."
Pistons head coach Dwane Casey feared the Bucks could come out firing.
"The first quarter is what I was afraid would happen," Casey said. "A championship-calibre team came in and put their stamp on the game at the beginning.
"We didn't respond, and that's how you give up a 49-point first quarter. I liked our fight after that, but this is a 48-minute game."