Escalating Role of Piezosurgery in Dental Therapeutics

Agarwal, Esha; Masamatti, Sujata Surendra; Kumar, Ashish

doi:10.7860/jcdr/2014/9161.4988

Cited by 17 publications

(28 citation statements)

References 17 publications

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“…Any rigid physical body oscillating at ultrasonic speed in liquids creates the physical phenomenon of the pressure-induced cavitation effect, which is very similar to the photoacoustic effect caused by infrared laser beams in liquids, but at signifi cant lower temperatures [9]. Thus, the physical mechanism of cutting bone with Piezotomes is based on precise disruption of mineralized bone-components by harmonic acoustic shockwaves and cavitation -similar to ultrasonic kidney stone crushers -but completely preserves soft tissues from damage due to the ultrasonic frequency of the devices [10,11]. The pressure-induced cavitation effect -as demonstrated by the author´s investigations of various piezotome-surgical tips ( Figure 6) -enhances the clean separation of mineralized tissue formations, enables a signifi cant improved bone healing [10,11], and -at lower power-settings -an improved and non-destructive dissection of soft-tissues [12] with improved postsurgical hemodynamic microcirculation [13].…”

Section: Piezotomesmentioning

confidence: 99%

Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician

Troedhan¹,

Mahmoud²,

Wainwright³

et al. 2017

Int J Oral Craniofac Sci

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Background: New tools for bone-cutting were introduced to oral and maxillofacial surgery in the last decade, such as lasers and piezotomes. Purpose: to evaluate most recent evidence, when surgical procedures performed with drills or burs are compared with laser-and/or piezotome-surgical procedures in experimental and clinical studies and to assess possible advantages of their use in daily practice. Methods: a systematic search of various medical databases with specifi c keywords was performed, excluding studies published before 2006 for their possible invalidity by technological progress. Systematic reviews were assigned to Group 1, experimental studies ex vivo to Group 2, in vivo to Group 3 and clinical studies to Group 4. All studies in each of the groups 2-4 were appraised regarding their evidence, starting with a value of 0 for no evidence of advantages of lasers and/or piezotomes compared to rotary instruments, 1 for moderate evidence with verifi ed clinical impact and 2 for strong evidence and signifi cant clinical impact and statistically processed for their Evidence Value (EV) in each group and their Overall mean Evidence Value (OmEV). Results: 129 studies were fi nally included for evaluation. Two systematic reviews concluded lack of evidence for lasers to be advantageous over burs/drills. Nine reviews for piezotomes reveal strong evidence piezotome-surgery to signifi cantly reduce morbidity and to enhance soft-tissue preservation. Comparative experimental and clinical studies of burs/drills vs lasers revealed a low EV in Group 2 (EV:0,8), Group 3 (EV:0,5) and Group 4 (EV:0,5) with an OmEV of 0,6. Comparative studies burs/drills vs piezotomes resulted in a signifi cant EV in all groups (

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Section: Piezotomesmentioning

confidence: 99%

Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician

Troedhan¹,

Mahmoud²,

Wainwright³

et al. 2017

Int J Oral Craniofac Sci

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“…Piezoelectric osteotomy differs itself from other techniques mainly for its micrometric and selective cut on the mineralized tissues, but also for allowing a heat-free and blood-free operating site. Piezoelectric cut is realized by mechanical vibrations in a range between 60 and 210 μm with a frequency of 29.000 times per second, thus obtaining an efficacy that, although slightly inferior to that of bone saws or burs, has been reported to not increase the overall duration of surgery [ 18 , 40 , 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series

Crovace

Luzzi

Lacitignola

et al. 2020

Veterinary Sciences

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Objective: To report the physical and technical principles, clinical applications, and outcomes of the minimal invasive piezoelectric osteotomy in a consecutive veterinary neurosurgical series. Methods: A series of 292 dogs and 32 cats underwent an osteotomy because a neurosurgical pathology performed with a Mectron Piezosurgery® bone scalpel (Mectron Medical Technology, Genoa, Italy) was retrospectively reviewed. Efficacy, precision, safety, and blood loss were evaluated intraoperatively by two different surgeons, on a case-by-case basis. Postoperative Rx and CT scans were used to assess the selectivity and precision of the osteotomy. A histological study on bony specimens at the osteotomized surface was carried out to evaluate the effects of piezoelectric cutting on the osteocytes and osteoblasts. All the patients underwent a six-months follow-up. A series of illustrative cases was reported. Results: All the osteotomies were clear-cut and precise. A complete sparing of soft and nervous tissues and vasculature was observed. The operative field was blood- and heat-free in all cases. A range of inserts, largely different in shape and length, were allowed to treat deep and difficult-to-reach sites. Two mechanical complications occurred. Average blood loss in dogs’ group was 52, 47, and 56 mL for traumatic, degenerative, and neoplastic lesions, respectively, whereas it was 25 mL for traumatized cats. A fast recovery of functions was observed in most of the treated cases, early on, at the first sixth-month evaluation. Histology on bone flaps showed the presence of live osteocytes and osteoblasts at the osteotomized surface in 92% of cases. Conclusions: Piezosurgery is based on the physical principle of the indirect piezo effect. Piezoelectric osteotomy is selective, effective, and safe in bone cutting during neurosurgical veterinary procedures. It can be considered a minimal invasive technique, as it is able to spare the neighboring soft tissues and neurovascular structures.

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“…For the Bucomaxillofacial surgery branch, the piezosurgery may be used in maxillary and mandibular osteotomies in orthognathic surgeries, as well as in alveolar corticotomies, cysts and tumors, surgeries of facial traumas, osteogenic distractions and procedures of pre-implant insertion (Fig. 5) (Agarwal et al;Eggers et al;Landes et al;Labanca et al;Robiony et al, 2004).…”

Section: Literature Reviewmentioning

confidence: 99%

“…The process consists of crystals or ceramics which get deformations when exposed to electric flows, resulting in an oscillating movement with ultrasound frequency that has the power to precisely cut bone structures without causing injuries in the soft tissues. This article has as its as to look over its effectiveness and efficiency in oral surgery procedures (Landes et al, 2008;Agarwal et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Using Piezoelectric System in Oral and Maxillofacial Surgery

Azevedo¹,

Costa²,

Przysiezny³

et al. 2018

Int J Med Surg Sci

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Motors and handpieces with the piezoelectric system have recently been used in several surgeries, following the current minimally invasive trend surgery. The system consists of crystals or ceramics undergoing deformation when exposed to electrical current, resulting in an oscillating movement with ultrasound frequency. In the Oral and Maxillofacial Surgery field activity, the piezosurgery may be used in maxillary and mandibular osteotomies in the orthognathic surgery, alveolar corticotomies, cysts tumors, facial trauma surgery, among others. This study aims to present a literary review on the piezoelectric system, which allows discussion to their use and effectiveness in oral surgery procedures.

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Escalating Role of Piezosurgery in Dental Therapeutics

Cited by 17 publications

References 17 publications

Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician

Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician

Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series

Using Piezoelectric System in Oral and Maxillofacial Surgery

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