Beginning of Revolutionary Surgical Technique - Piezosurgery

Bone cutting has been performed by either manual or motor-driven instruments. Manual instruments are mostly used to remove small amounts of bone but they are difficult to control in cortical bone. When the bone is dense, motor driven instruments are often used. Motor driven instruments transform electric energy into mechanical cutting action so there will be overheating of the surrounding tissue that may delay the healing response. So the role of peizosurgery comes to action. Most dental implants are positioned using a drilling surgery technique. However, dentistry recently experienced the implementation of piezoelectric surgery. This technique was introduced to overcome some of the limitations involving rotating instrument in bone surgery. This technique was created and developed in response to the need to reach major levels of precision and safety in bone injury, as compared to that available by the usual manual and motorized instruments.

Piezosurgery is a new technique for osteotomy and osteoplasty that utilizes ultrasonic vibrations. The device is characterized by piezoelectric ultrasonic vibrations of frequency of 29kHz and a range between 60/200 Hz. Due to their characteristics the microvibrations allow a selective cut of only mineralized structure without damaging soft tissues, which remain undamaged even in the case of accidental contact. It also maintains a clear surgical site which is the result of the cavitation effect created by an irrigation/cooling instrument and an oscillating tip. The micrometric vibration ensures precise cutting action. The micrometric vibration makes the instrument manageable and permits major interoperative control with a consequent increase in safety especially in anatomically difficult areas. Piezosurgery inserts does not become hot which prevents the risk of postoperative necrosis and promotes rapid healing. The cooling liquid flows laminar along the tip. Thereby, a more effective cooling also in deeper regions is achieved.

Applications of piezosurgery is quite vast in dentistry which includes retrograde preparation in root canal, bone cutting with great precision facilitating ridge augmentation and ridge expansion. In periodontal procedures, there is need for careful removal of small quantities of bone adjacent to exposed root surfaces to avoid damaging the tooth surface. The piezosurgery plays a positive role in developing physiologic architecture of bony support of the involved teeth. The main use of piezosurgery device is in implantology which includes implant site preparation, implant removal and bone harvesting, bone grafting and sinus lifts can be done with much ease and less soft tissue trauma. Methods like crest expansion, sinus lift elevation, harvesting of bone chips and bone blocks are becoming much more secure and easier.

Given its innovative nature, peizosurgery distinguishes itself as being different from the conventional techniques utilised in bone surgery. Consequently, it requires different surgical skill. To master the right surgical skill it is essential to demonstrate an adequate learning curve.