Clinical applications of ultrasonic instrumentation in the surgical removal of bone

Horton, John E.; Tarpley, Thomas M.; Jacoway, John R.

doi:10.1016/0030-4220(81)90051-7

Cited by 107 publications

(51 citation statements)

References 12 publications

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“…[4][5][6] Protocols evaluated to improve such adverse postoperative sequelae have included different medications, 4,7 different flap designs, 9,10 and the use of rotary rather than hand instruments for bone removal (osteotomy). [11][12][13] Piezosurgery is an osteotomy technique utilizing micro-vibrations at ultrasonic frequency to perform efficient bone cutting. 14 The piezoelectric device has been useful for application in complex surgical sites, such as the posterior mandible, where the osteotomy lines are of necessity close to vulnerable structures such as nerves and blood vessels; ultrasonic vibrations allow a selective and defined cutting action, leading to a higher level of precision, safety and less tissue damage than using common rotating instruments (burs).…”

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confidence: 99%

A Split-Mouth Randomized Clinical Trial to Evaluate the Performance of Piezosurgery Compared With Traditional Technique in Lower Wisdom Tooth Removal

Mantovani

Arduino

Schierano

et al. 2014

Journal of Oral and Maxillofacial Surgery

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This is an author version of the contribution published on:Questa è la versione dell 'autore dell'opera: J Oral Maxillofac Surg. 2014 Oct;72(10):1890-7. doi: 10.1016/j.joms.2014 AbstractPurpose: The surgical removal of mandibular third molars is frequently accompanied by significant post-surgical sequelae, and different protocols have been described to improve such adverse events. The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. Methods:A single-centre, randomized, split-mouth study was performed using a consecutive series of unrelated healthy Caucasian patients, attending the Oral Surgery Unit of the University of Turin, for surgical removal of bilateral mandibular third molar teeth. Each patient was treated, at the same appointment, using bur removal on one side of the mandible and a piezoelectric device on the contralateral side. The primary outcomes reported were postoperative pain, objective orofacial swelling and the duration of surgical time; secondary outcomes were sex, age and possible adverse events. Anova or paired t-test were used as appropriate to test any significant differences at baseline according to each treatment subgroups and categorical variables were analysed by χ2 test.Results: The study sample consisted of 100 otherwise healthy patients. The mean pain evaluation reported by patients who underwent surgery with the piezosurgery was significantly lower than that experienced after bur (conventional) removal, reaching a statistical difference after 4 days (P=0.043). The clinical value of orofacial swelling at 7th day, normalized to baseline, was lower in the piezosurgery group (P<0.005).The average time of surgery was significantly lower in the bur than piezosurgery group (P<0.05).Three patients having bur removal experienced short-term complications (two dry sockets and one temporary paraesthesia): both totally resolved by 4 weeks. Conclusions:To date, this prospective investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal, also comparing surgeons with different 3 degrees of experience. It is evident that using a piezoelectric device can enhance the patient experience and reduce post-operative pain and swelling.

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confidence: 99%

A Split-Mouth Randomized Clinical Trial to Evaluate the Performance of Piezosurgery Compared With Traditional Technique in Lower Wisdom Tooth Removal

Mantovani

Arduino

Schierano

et al. 2014

Journal of Oral and Maxillofacial Surgery

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“…In 1975, Horton et al (10) compared alveolar bone healing in surgical defects produced by ultrasound with defects produced using a chisel or rotary instrumentsgood results being obtained with all three techniques. In 1981 these same authors published another study on the clinical applications of ultrasound in bone surgery (11). Posteriorly, an experimental study in dogs was published, comparing bone healing using the Piezosurgery® device, conventional tungsten carbide drills or diamond drills to create 4-mm bone defects around the posterior mandibular teeth.…”

Section: Discussionmentioning

confidence: 99%

Application of ultrasound in bone surgery: Two case reports

Escoda-Francolí¹,

Rodríguez-Rodríguez²,

Berini-Aytés³

et al. 2010

Med Oral

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The present study describes some of the applications of ultrasound in bone surgery, based on the presentation of two clinical cases. The Piezosurgery® ultrasound device was used (Tecnología Mectron Medical, Carasco, Italy). In one case the instrument was used to harvest a chin bone graft for placement in a bone defect at level 1.2, while in the other case a bony window osteotomy was made in the external wall of the maxillary sinus, in the context of a sinus membrane lift procedure. The Piezosurgery® device produces specific ultrasound frequency modulation (25-29 kHz), and has been designed to secure increased precision in application to bone surgery. This instrument produces selective sectioning of the mineralized bone structures, and causes less intra-and postoperative bleeding. One of the advantages of the Piezosurgery® device is that it can be used for maxillary sinus lift procedures in dental implant placement. In this context it considerably lessens the risk of sinus mucosa laceration by preparing the bony window in the external wall of the upper maxilla, and can be used to complete the lifting maneuver. The use of ultrasound in application to hard tissues can be regarded as a slow technique compared with the conventional rotary instruments, since it requires special surgical skill and involves a certain learning curve.

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“…Catuna in 1953, Volkov and Shepeleva [8] in 1974 described cutting of hard tissue with ultransonic vibrations as piezoelectric effect. In 1981, its application was described by Aro et al, [9] in orthopaedic surgery, and Horton et al, [10] in oral and maxillofacial surgery.…”

Section: Historical Backgroundmentioning

confidence: 99%