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Introduction Piezoelectric device or piezosurgery device was originally developed for the atraumatic cutting of bone by way of ultrasonic vibrations and as an alternative to the mechanical and electrical instruments that are used in conventional oral surgery. Over the past two decades, an increasing amount of literature has shown that piezoelectric devices are innovative tools and that there is extensive indication of their use in dental implantology and oral and maxillofacial surgery. Recent publications have also shown the benefits of their use in craniofacial surgery, plastic and reconstructive surgery, head and neck surgery, neurosurgery, ophthalmology, traumatology, and orthopaedics. Key features of piezosurgery include the selective cutting of bone without damaging the adjacent soft tissue (e.g. vessels, nerves or mucosa), providing a clear visibility in the operating field, and cutting with micron sensitivity without the generation of heat. The cutting characteristics of piezosurgery are mainly depending upon the degree of bone mineralization, the design of the insert being used, the pressure being applied on the handpiece and the speed of movement during usage. Therefore, a novice user must know these factors and adapt their operating technique in order to utilize the advantages of piezosurgery. This critical review summarizes the basic operating principles of piezoelectric devices and outlines the application areas in oral and maxillofacial surgery that piezosurgery can be utilized supported by clinical examples. Conclusion Piezosurgery can create clear vision of the surgical area from pressurized irrigation and cavitation effect. Disadvantages can include large initial costs. The number of studies covering this topic is insufficient; thus, further research needs to be conducted to enable us to learn more and clarify any misconceptions.

Maxillofacial neurosensory deficiencies may be caused by various surgical procedures such as tooth extraction, osteotomies, preprosthetic procedures, excision of tumors or cysts, surgery of the TMJ and surgical treatment of fractures and cleft lip/palate. These deficiencies may be intolerable for the patient, mainly because of the elective nature of the procedures such as osteotomies. In this study, a retrospective evaluation of incidence of neurosensory deficiencies (NSD) in 227 patients who underwent different kinds of surgeries in the maxillofacial region is presented. Clinical neurosensory testing such as two-point discrimination, static light touch, brush directional stroke, pin-prick, thermal discrimination and dental vitality tests were used for evaluation. All the patients were grouped according to the surgical procedures and all of them were evaluated at least one year post operation. It was concluded that osteotomies, especially sagittal split ramus osteotomies, have the highest incidence of postoperative NSD.

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