Evolving Technologies for Tissue Cutting

Jundt, Jonathon S.; Marchena, Jose M.; Hanna, Issa; Dhanda, Jagtar; Breit, Matthew J.; Perry, Andrew P.

doi:10.1016/j.coms.2019.07.009

Cited by 8 publications

(7 citation statements)

References 37 publications

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“…This, in turn, can lead to worsened bone healing or necrosis of individual bone parts [ 7 , 8 ]. Although piezoelectric instruments could minimize this risk due to their low vibration induction in the tissue and overall, less local pressure application, they could not prevent it [ 9 , 10 , 11 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

First-Hand Experience and Result with New Robot-Assisted Laser LeFort-I Osteotomy in Orthognathic Surgery: A Case Report

Ebeling

Scheurer

Sakkas

et al. 2023

JPM

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Background: We report the world’s first developer-independent experience with robot-assisted laser Le Fort I osteotomy (LLFO) and drill-hole marking in orthognathic surgery. To overcome the geometric limitations of conventional rotating and piezosurgical instruments for performing osteotomies, we used the stand-alone robot-assisted laser system developed by Advanced Osteotomy Tools. The aim here was to evaluate the precision of this novel procedure in comparison to the standard procedure used in our clinic using a computer-aided design/computer-aided manufacturing (CAD/CAM) cutting guide and patient-specific implant. Methods: A linear Le-Fort-I osteotomy was digitally planned and transferred to the robot. The linear portion of the Le-Fort I osteotomy was performed autonomously by the robot under direct visual control. Accuracy was analyzed by superimposing preoperative and postoperative computed tomography images, and verified intraoperatively using prefabricated patient-specific implant. Results: The robot performed the linear osteotomy without any technical or safety issues. There was a maximum difference of 1.5 mm on average between the planned and the performed osteotomy. In the robot-assisted intraoperative drillhole marking of the maxilla, which was performed for the first time worldwide, were no measurable deviations between planning and actual positioning. Conclusion: Robotic-assisted orthognathic surgery could be a useful adjunct to conventional drills, burrs, and piezosurgical instruments for performing osteotomies. However, the time required for the actual osteotomy as well as isolated minor design aspects of the Dynamic Reference Frame (DRF), among other things, still need to be improved. Still further studies for final evaluation of safety and accuracy are also needed.

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Section: Discussionmentioning

confidence: 99%

First-Hand Experience and Result with New Robot-Assisted Laser LeFort-I Osteotomy in Orthognathic Surgery: A Case Report

Ebeling

Scheurer

Sakkas

et al. 2023

JPM

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“…There are many other advantages such as great healing potential, less postoperative inflammation and swelling 5 and the concomitant coagulation of small blood vessels allows for a dry operating field and better visibility 6 . In addition to the classical laser surgery, new technologies emerge which rely on local heating of the tissue such as monopolar coagulation or plasma beam coagulation 7 .…”

Section: Introductionmentioning

confidence: 99%

Development and evaluation of a scoring system for assessing incisions in laser surgery

Hohmann

Kuhn

Späth

et al. 2022

Sci Rep

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The idea of laser surgery is nearly as old as the laser itself. From the first trials to modern laser surgery systems, it was and is the aim to selectively cut the tissue in the focus spot without causing harm to surrounding structures. This is only possible when the correct parameters for the surgical laser are chosen. Usually, this is done by parameter studies. However, the concrete evaluation scheme often differs between groups and more precise approaches require staining and microscopic evaluation. To overcome these issues, a macroscopic scoring system is presented and evaluated. It can be shown that the scoring system works well and, thus, a laser cut can be evaluated within a few seconds. At the same time, the whole cutting front is taken into account. The presented scoring system is evaluated by the intra class correlation (ICC). The final agreement between different raters is more than 0.7. Therefore, the scoring system can be used to optimize and evaluate the cutting process and it should be suitable for comparing the results between different groups. Definitely, it can be applied for scoring within a group to enable e.g., a profound statistical analysis for a parameter study.

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“…Their cavitation effect reduces bleeding and provides better intraoperative visibility. The low vibration amplitude are thought to cut more precisely with less trauma to the surrounding tissues [8] cell proliferation and accelerate bone metabolism in a It was reported in a meta-analysis study of randomized controlled trials (RCTs), patients subjected to piezosurgery for impacted third molars were presented with longer operative times, less postoperative swelling, pain, and trismus than patients who operated with conventional rotary techniques. [ 9] Diode LASER is antibacterial in nature and can be uBecause of these benefits, piezoelectric devices were introduced in orthognathic surgery osteotomies to reduce operative complications and postoperative discomfort.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of using Piezoelectric device versus Conventional Saw for Osteotomy in Maxillary Orthognathic Surgery

hammer

Gad

2022

OMX

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Objectives: to evaluate the effect of piezoelectric surgery in comparison with the conventional surgical saw regarding clinical and histological parameters. Patients and Methods: 11 patients were included in a prospective comparative study to evaluate the effect of piezoelectric device in maxillary orthognathic surgery in comparison with the conventional regarding clinical and histological parameters. Assessment in this study included intraoperative bleeding, osteotomy time, postoperative facial edema, pain, and osteotomy site coagulative bone necrosis. Results: Coagulative bone necrosis comparison showed a statistically significant higher mean in the saw group compared to the peizotome group with p-value (p<0.001). There was a statistically significant increase of blood loss in saw group compared to peizotome group p-value (p=0.006). regarding osteotomy time there were a statistically significant increase in peizotome group compared to saw group p-value (p<0.001). There were no significant difference in facial swelling between both groups.A significant differences in postoperative pain between both groups at 1st , 2nd 3rd and 4th week postoperatively (P.value = 0.006), (P.value = 0.001), (P.value = 0.005) and (P.value= 0.002) in contrary to the 1st day postoperative follow up. Conclusion: Piezoelectric osteotomy device is effectively able to carry out osteotomy, more safe than surgical saw resulting in less blood loss in maxillary orthognathic surgery, less post-operative pain sensation, and obviously decrease marginal bone necrosis than saw. In spite, the saw is superior to piezo in osteotomy time, piezoelectric surgery provide the faster bone repair.

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Evolving Technologies for Tissue Cutting

Cited by 8 publications

References 37 publications

First-Hand Experience and Result with New Robot-Assisted Laser LeFort-I Osteotomy in Orthognathic Surgery: A Case Report

First-Hand Experience and Result with New Robot-Assisted Laser LeFort-I Osteotomy in Orthognathic Surgery: A Case Report

Development and evaluation of a scoring system for assessing incisions in laser surgery

Evaluation of using Piezoelectric device versus Conventional Saw for Osteotomy in Maxillary Orthognathic Surgery

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