Thomas G Wiedemann*

Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, New York

*Corresponding Author: Thomas G Wiedemann, Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, New York.

Received: September 08, 2023; Published: September 26, 2023

Abstract

Piezosurgery is being applied increasingly in oral surgery and implantology. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible.

This clinical overview gives a summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in oral and implant surgery. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies

Keywords: OImplantology; Dental Implants; Piezoelectric Device; Piezosurgery; Bone Grafting; Osteotomy; Ridge Splitting; Osteotomy; Sinus Floor Augmentation

References

1. The Free Dictionary.
2. Chodos A., et al. “This month in physics history”. American Physical Society News 18.4 (2009): 5-7.
3. Catuna MC. “Sonic Energy; A possible dental application”. Annals of Dentistry 12 (1953): 100-101.
4. Mazorow HB. “Bone repair after experimentally produced defects”. Journal of Oral Surgery, Anesthesia, and Hospital Dental Service 18 (1960): 107-15.
5. Ta Mcfall., et al. “Comparison of the cutting effect on bone of an ultrasonic cutting device and rotary burs”. Journal of Oral Surgery, Anesthesia, and Hospital Dental Service 19 (1961): 200-209.
6. Horton JE., et al. “The healing of surgical defects in alveolar bone produced with ultrasonic instrumentation, chisel, and rotary bur”. Oral Surgery, Oral Medicine, Oral Pathology 39.4 (1975): 536-546.
7. Torrella F., et al. “Ultrasonic ostectomy for the surgical approach of the maxillary sinus: a technical note”. International Journal of Oral and Maxillofacial Implants 13.5 (1998).
8. Vercellotti T. “Piezoelectric surgery in implantology: a case report--a new piezoelectric ridge expansion technique”. International Journal of Periodontics and Restorative Dentistry 20.4 (2000).
9. Vercellotti T., et al. “The piezoelectric osteotomy in orthopedics: clinical and histological evaluations (pilot study in animals)”. The Mediterranean Journal of Surgery and Medicine 9 (2001): 89-96.
10. Bauer SE and Romanos GE. “Morphological characteristics of osteotomies using different piezosurgical devices. A scanning electron microscopic evaluation”. Implant Dentistry 23.3 (2014): 334-342.
11. Stübinger S., et al. “Ultrasonic bone cutting in oral surgery: a review of 60 cases”. Ultraschall in der Medizin (Stuttgart, Germany: 1980)29.1 (2008): 66-71.
12. Grötz KA. “Die entwicklung der piezosurgery in der oralchirurgie”. Oralchir Journal 2 (2010): 14-17.
13. Labanca M., et al. “Piezoelectric surgery: twenty years of use”. British Journal of Oral and Maxillofacial Surgery 46.4 (2008): 265-269.
14. Lamazza L., et al. “Identification of possible factors influencing temperatures elevation during implant site preparation with piezoelectric technique”. Annali di Stomatologia 5.4 (2014): 115.
15. Heinemann F., et al. “Experimental and histological investigations of the bone using two different oscillating osteotomy techniques compared with conventional rotary osteotomy”. Annals of Anatomy-Anatomischer Anzeiger 194.2 (2012): 165-170.
16. Esteves JC., et al. “Dynamics of bone healing after osteotomy with piezosurgery or conventional drilling–histomorphometrical, immunohistochemical, and molecular analysis”. Journal of Translational Medicine11.1 (2013): 1-13.
17. Chiriac G., et al. “Autogenous bone chips: influence of a new piezoelectric device (Piezosurgery^®) on chip morphology, cell viability and differentiation”. Journal of Clinical Periodontology32.9 (2005): 994-999.
18. Von See C., et al. “Comparison of different harvesting methods from the flat and long bones of rats”. British Journal of Oral and Maxillofacial Surgery 48.8 (2010): 607-612.
19. Ma L., et al. “Healing of osteotomy sites applying either piezosurgery or two conventional saw blades: a pilot study in rabbits”. International Orthopaedics 37 (2013): 1597-1603.
20. Stoetzer M., et al. “Effects of a new piezoelectric device on periosteal microcirculation after subperiosteal preparation”. Microvascular Research 94 (2014): 114-118.
21. Adell R., et al. “A long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws”. International Journal of Oral and Maxillofacial Implants5.4 (1990).
22. Blanes RJ., et al. “A 10‐year prospective study of ITI dental implants placed in the posterior region. I: Clinical and radiographic results”. Clinical Oral Implants Research 18.6 (2007): 699-706.
23. Piemonte CPO. “Ultrasonic implant site preparation using piezosurgery: a multicenter case series study analyzing 3,579 implants with a 1-to 3-year follow-up”. International Journal of Periodontics and Restorative Dentistry 34 (2014): 11-18.
24. Preti G., et al. “Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus a drill technique: a pilot study in minipigs”. Journal of Periodontology 78.4 (2007): 716-722.
25. Stübinger S., et al. “Comparison of Er: YAG laser, piezoelectric, and drill osteotomy for dental implant site preparation: a biomechanical and histological analysis in sheep”. Lasers in Surgery and Medicine 42.7 (2010): 652-661.
26. da Silva Neto UT., et al. “Clinical analysis of the stability of dental implants after preparation of the site by conventional drilling or piezosurgery”. British Journal of Oral and Maxillofacial Surgery52.2 (2014): 149-153.
27. Al‐Dajani M. “Recent trends in sinus lift surgery and their clinical implications”. Clinical Implant Dentistry and Related Research18.1 (2016): 204-212.
28. Seoane J., et al. “Membrane perforation in sinus floor elevation–piezoelectric device versus conventional rotary instruments for osteotomy: an experimental study”. Clinical Implant Dentistry and Related Research 15.6 (2013): 867-873.
29. Vercellotti T., et al. “The piezoelectric bony window osteotomy and sinus membrane elevation: introduction of a new technique for simplification of the sinus augmentation procedure”. International Journal of Periodontics and Restorative Dentistry 21.6 (2009): 561-568.
30. van den Bergh JP., et al. “Sinus floor elevation and grafting with autogenous iliac crest bone”. Clinical Oral Implants Research 9.6 (1998): 429-435.
31. Kasabah S., et al. “Can we predict maxillary sinus mucosa perforation?” Acta Medica-Hradec Kralove 46.1 (2003): 19-24.
32. Sohn DS., et al. “Comparison of two piezoelectric cutting inserts for lateral bony window osteotomy: a retrospective study of 127 consecutive sites”. International Journal of Oral and Maxillofacial Implants 25.3 (2010).
33. Peñarrocha-Diago M., et al. “Osteotomy in direct sinus lift. A comparative study of the rotary technique and ultrasound”. Medicina Oral, Patologia Oral Y Cirugia Buccal 17.3 (2012): e457.
34. Delilbasi C and Gurler G. “Comparison of piezosurgery and conventional rotative instruments in direct sinus lifting”. Implant Dentistry6 (2013): 662-665.
35. Stübinger S., et al. “Palatal versus vestibular piezoelectric window osteotomy for maxillary sinus elevation: a comparative clinical study of two surgical techniques”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 107.5 (2009): 648-655.
36. Baldi D., et al. “Sinus floor elevation using osteotomes or piezoelectric surgery”. International Journal of Oral and Maxillofacial Surgery 40.5 (2011): 497-503.
37. Cassetta M., et al. “Use of piezosurgery during maxillary sinus elevation: clinical results of 40 consecutive cases”. International Journal of Periodontics and Restorative Dentistry 32.6 (2012).
38. Kühl S., et al. “Transcrestal maxillary sinus augmentation: Summers' versus a piezoelectric technique--an experimental cadaver study”. Clinical Oral Implants Research (2016).
39. Rickert D., et al. “Comparison between conventional and piezoelectric surgical tools for maxillary sinus floor elevation. A randomized controlled clinical trial”. Clinical Implant Dentistry and Related Research 15.2 (2013): 297-302.
40. Stacchi C., et al. “Intraoperative complications during sinus floor elevation using two different ultrasonic approaches: a two‐center, randomized, controlled clinical trial”. Clinical Implant Dentistry and Related Research 17 (2015): e117-e125.
41. Wallace SS., et al. “Schneiderian membrane perforation rate during sinus elevation using piezosurgery: clinical results of 100 consecutive cases”. International Journal of Periodontics and Restorative Dentistry 27.5 (2007).
42. Cortes ARG., et al. “Effectiveness of piezoelectric surgery in preparing the lateral window for maxillary sinus augmentation in patients with sinus anatomical variations: a case series”. International Journal of Oral and Maxillofacial Implants27.5 (2012).
43. Wallace SS., et al. “Maxillary sinus elevation by lateral window approach: evolution of technology and technique”. Journal of Evidence Based Dental Practice 12.3 (2012): 161-171.
44. Mouraret S., et al. “Cell viability after osteotomy and bone harvesting: comparison of piezoelectric surgery and conventional bur”. International Journal of Oral and Maxillofacial Surgery 43.8 (2014): 966-971.
45. Miron RJ., et al. “Impact of bone harvesting techniques on cell viability and the release of growth factors of autografts”. Clinical Implant Dentistry and Related Research15.4 (2013): 481-489.
46. Lakshmiganthan M., et al. “Piezosurgical osteotomy for harvesting intraoral block bone graft”. Journal of Pharmacy and Bioallied Sciences4.2 (2012): S165.
47. Majewski P. “Autogenous bone grafts in the esthetic zone: optimizing the procedure using piezosurgery”. International Journal of Periodontics and Restorative Dentistry 32.6 (2012).
48. Stübinger S., et al. “Piezoelectric harvesting of an autogenous bone graft from the zygomaticomaxillary region: case report”. International Journal of Periodontics and Restorative Dentistry 26.5 (2006).
49. Anitua E., et al. “Surgical correction of horizontal bone defect using the lateral maxillary wall: Outcomes of a retrospective study”. Journal of Oral and Maxillofacial Surgery72.4 (2014): 683-693.
50. Altiparmak N., et al. “The effect of conventional surgery and piezoelectric surgery bone harvesting techniques on the donor site morbidity of the mandibular ramus and symphysis”. International Journal of Oral and Maxillofacial Surgery44.9 (2015): 1131-1137.
51. Amato F., et al. “Rapid Orthodontic Treatment After the Ridge-Splitting Technique-A Combined Surgical-Orthodontic Approach for Implant Site Development: Case Report”. International Journal of Periodontics and Restorative Dentistry 32.4 (2012).
52. Simion M., et al. “Jawbone enlargement using immediate implant placement associated with a split-crest technique and guided tissue regeneration”. International Journal of Periodontics and Restorative Dentistry12.6 (1992).
53. Scipioni A., et al. “Bone regeneration in the edentulous ridge expansion technique: histologic and ultrastructural study of 20 clinical cases”. International Journal of Periodontics and Restorative Dentistry 19.3 (1999).
54. Rahnama M., et al. “The use of piezosurgery as an alternative method of minimally invasive surgery in the authors’ experience”. Videosurgery and Other Miniinvasive Techniques 8.4 (2013): 321-326.
55. Brugnami F., et al. “Piezosurgery-assisted, flapless split crest surgery for implant site preparation”. Journal of Maxillofacial and Oral Surgery13 (2014): 67-72.
56. Rodriguez JG and Eldibany RM. “Vertical splitting of the mandibular body as an alternative to inferior alveolar nerve lateralization”. International Journal of Oral and Maxillofacial Surgery 42.9 (2013): 1060-1066.
57. Eldibany R and Rodriguez JG. “Immediate loading of one-piece implants in conjunction with a modified technique of inferior alveolar nerve lateralization: 10 years follow-up”. Craniomaxillofacial Trauma and Reconstruction 7.1 (2014): 55-61.
58. Gowgiel JM. “The position and course of the mandibular canal”. The Journal of Oral Implantology 18.4 (1992): 383-385.
59. Hur MS., et al. “Topography and spatial fascicular arrangement of the human inferior alveolar”. Clinical Implant Dentistry and Related Research1 (2013): 88-95.
60. Bovi M. “Mobilization of the inferior alveolar nerve with simultaneous implant insertion: a new technique. Case report”. International Journal of Periodontics and Restorative Dentistry 25.4 (2005).
61. Metzger MC., et al. “Inferior alveolar nerve transposition-an in vitro comparison between piezosurgery and conventional bur use”. Journal of Oral Implantology 32.1 (2006): 19-25.
62. Salami A., et al. “Novel approach to facial nerve decompression: use of piezosurgery”. Acta Oto-Laryngologica5 (2009): 530-533.
63. Ma Z., et al. “Efficacy of the technique of piezoelectric corticotomy for orthodontic traction of impacted mandibular third molars”. British Journal of Oral and Maxillofacial Surgery 53.4 (2015): 326-331.
64. Ozer M., et al. “Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region”. The Korean Journal of Orthodontics 43.6 (2013): 302-310.
65. Cassetta M., et al. “Minimally invasive corticotomy in orthodontics: a new technique using a CAD/CAM surgical template”. International Journal of Oral and Maxillofacial Surgery 44.7 (2015): 830-833.
66. Guijarro-Martínez R and HERNANDEZ ALFARO F. “Endoscopically Assisted Tunnel Approach for Minimally Invasive Corticotomies: A Preliminary Report” (2012).
67. Hu YK., et al. “Retrieval of root fragment in maxillary sinus via anterolateral wall of the sinus to preserve alveolar bone”. Journal of Craniofacial Surgery 26.2 (2015): e81-e84.
68. Mantovani E., et al. “A split-mouth randomized clinical trial to evaluate the performance of piezosurgery compared with traditional technique in lower wisdom tooth removal”. Journal of Oral and Maxillofacial Surgery 72.10 (2014): 1890-1897.
69. Mozzati M., et al. “Third-molar extraction with ultrasound bone surgery: a case-control study”. Journal of Craniofacial Surgery 25.3 (2014): 856-859.
70. Pippi R and Alvaro R. “Piezosurgery for the lingual split technique in mandibular third molar removal: a suggestion”. Journal of Craniofacial Surgery 24.2 (2013): 531-533.
71. Rullo R., et al. “Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery: relationships between surgical difficulty and postoperative pain with histological evaluations”. Journal of Cranio-Maxillofacial Surgery 41.2 (2013): e33-e38.
72. Itro A., et al. “The piezoelectric osteotomy technique compared to the one with rotary instruments in the surgery of included third molars. A clinical study”. Minerva Stomatologica 61.6 (2012): 247-53.
73. D’Amato S., et al. “Piezoelectric bone surgery in the treatment of an osteoma associated with an impacted inferior third molar: a case report”. Clinical Cases in Mineral and Bone Metabolism 11.1 (2014): 73.
74. Sivolella S., et al. “Osteotomy for lower third molar germectomy: randomized prospective crossover clinical study comparing piezosurgery and conventional rotatory osteotomy”. Journal of Oral and Maxillofacial Surgery 69.6 (2011): e15e23.
75. Berg BI., et al. “Der Zahn im Auge--Die erste in der Schweiz eingebrachte Osteo-Odonto-Keratoprothese”. Praxis (16618157) 102.9 (2013).
76. Brockmeyer P., et al. “Reduced somatosensory impairment by piezosurgery during orthognathic surgery of the mandible”. Oral and Maxillofacial Surgery19 (2015): 301-307.
77. Olate S., et al. “LeFort I segmented osteotomy experience with piezosurgery in orthognathic surgery”. International Journal of Clinical and Experimental Medicine 7.8 (2014): 2092.
78. Spinelli G., et al. “Comparison of piezosurgery and traditional saw in bimaxillary orthognathic surgery”. Journal of Cranio-Maxillofacial Surgery 42.7 (2014): 1211-1220.
79. Bertossi D., et al. “Piezosurgery versus conventional osteotomy in orthognathic surgery: a paradigm shift in treatment”. Journal of Craniofacial Surgery 24.5 (2013): 1763-1766.
80. Geha HJ., et al. “Sensitivity of the inferior lip and chin following mandibular bilateral sagittal split osteotomy using Piezosurgery”. Plastic and Reconstructive Surgery 118.7 (2006): 1598-1607.
81. Bertossi D., et al. “Piezosurgery versus conventional osteotomy in orthognathic surgery: a paradigm shift in treatment”. Journal of Craniofacial Surgery 24.5 (2013): 1763-1766.
82. Chiarini L., et al. “Surgical treatment of unilateral condylar hyperplasia with piezosurgery”. Journal of Craniofacial Surgery 25.3 (2014): 808-810.
83. Nocini PF., et al. “Microvascular free bone flap harvest with piezosurgery”. Journal of Oral and Maxillofacial Surgery 69.5 (2011): 1485-1492.
84. De Castro DK., et al. “Self-irrigating piezoelectric device in orbital surgery”. Ophthalmic Plastic and Reconstructive Surgery 29.2 (2013): 118-122.
85. Kalwerisky K., et al. “Piezoelectric-assisted removal of the lateral orbital rim in lateral orbital rim advancement”. Orbit31.1 (2012): 63-63.
86. Ponto KA., et al. “Piezosurgery for orbital decompression surgery in thyroid associated orbitopathy”. Journal of Cranio-Maxillofacial Surgery 42.8 (2014): 1813-1820.
87. Iacoangeli M., et al. “Piezosurgery as a further technical adjunct in minimally invasive supraorbital keyhole approach and lateral orbitotomy”. Journal of Neurological Surgery Part A: Central European Neurosurgery (2014): 112-118.
88. Jung SH., et al. “Spheno-orbital meningioma resection and reconstruction: the role of piezosurgery and premolded titanium mesh”. Craniomaxillofacial Trauma and Reconstruction 4.4 (2011): 193-200.
89. Salami A., et al. “Piezosurgery^® for removal of symptomatic ear osteoma”. European Archives of Oto-Rhino-Laryngology267 (2010): 1527-1530.
90. Salami A., et al. “surgery in the exeresis of glomus tympanicum tumours”. European Archives of Oto-Rhino-Laryngology (2009).
91. Salami A., et al. “Piezosurgery in the exeresis of glomus tympanicum tumours”. European Archives of Oto-Rhino-Laryngology 265 (2008): 1035-1038.
92. Crippa B., et al. “Comparison of postoperative pain: piezoelectric device versus microdrill”. European Archives of Oto-Rhino-Laryngology 268 (2011): 1279-1282.
93. Salami A., et al. “Learning curve for Piezosurgery in well-trained otological surgeons”. Otolaryngology--Head and Neck Surgery 142.1 (2010): 120-125.
94. Salami A., et al. “Piezosurgery in otologic surgery: four years of experience”. Otolaryngology-Head and Neck Surgery140.3 (2009): 412-418.
95. Hoigne D., et al. “Piezoelectric osteotomy in hand surgery: the autologous osteocartilage transplantation for joint reconstruction”. Handchirurgie, Mikrochirurgie, Plastische Chirurgie: Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie: Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse: Organ der V...,43.5 (2011): 319-320.
96. Hoigne DJ., et al. “Piezoelectric osteotomy in hand surgery: first experiences with a new technique”. BMC Musculoskeletal Disorders7 (2006): 1-4.
97. Santini M., et al. “Resection of costal exostosis using piezosurgery associated with uniportal video-assisted thoracoscopy”. The Annals of Thoracic Surgery99.3 (2015): 1080-1082.
98. Ramieri V., et al. “The use of piezosurgery in cranial surgery in children”. Journal of Craniofacial Surgery26.3 (2015): 840-842.
99. Robiony M and Polini F. “Piezosurgery: a safe method to perform osteotomies in young children affected by hemifacial microsomia”. Journal of Craniofacial Surgery21.6 (2010): 1813-1815.
100. e Silva LMDC., et al. “Tracheostomy-dependent child with temporomandibular ankylosis and severe micrognathia treated by piezosurgery and distraction osteogenesis: case report”. British Journal of Oral and Maxillofacial Surgery 49.7 (2011): e47-e49.
101. Jose A., et al. “Piezoelectric osteoarthrectomy for management of ankylosis of the temporomandibular joint”. British Journal of Oral and Maxillofacial Surgery 52 (7 (2014): 624-628.
102. González-García A., et al. “Piezoelectric and conventional osteotomy in alveolar distraction osteogenesis in a series of 17 patients”. The International Journal of Oral and Maxillofacial Implants 5 (2008): 891-896.

Citation

Citation: Thomas G Wiedemann. “Review of Contemporary Applications of Piezoelectric - Surgery in Modern Implant Dentistry"Acta Scientific Dental Sciences 7.10 (2023): 95-104.

Copyright

Copyright: © 2023 Thomas G Wiedemann. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.