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Piezosurgery

Piezosurgery is a relatively new technique for osteotomy and osteoplasty that utilizes ultrasonic vibration. The piezosurgery device is essentially an ultrasound machine with modulated frequency and a controlled tip vibration range. The ultrasonic frequency is modulated from 10, 30, and 60 cycles/s (Hz) to 29 kHz. The low frequency enables cutting of mineralized structures, not soft tissue. Power can be adjusted from 2.8 to 16 W, with preset power settings for various types of bone density. The piezosurgery tip vibrates within a range of 60-200 mm, which allows clean cutting with precise incisions.

Application In Dentistry

Piezo Surgical equipment can be used for retrograde preparation of root canal; it performs bone cutting with great precision facilitating ridge augmentation and ridge expansion, tooth extraction, ankylotic tooth extraction and surgical orthodontic surgeries.

Application In Periodontology And Implantology

The removal of supra and subgingival calculus deposits and stains from teeth, periodontal pocket lavage with simultaneous ultrasonic tip movement, scaling, root planning and crown lengthening, periodontal ostectomy and osteoplasty procedures requires careful removal of small quantities of bone adjacent to exposed root surfaces to avoid damaging the tooth surface. The piezosurgery device is used to develop positive, physiologic architecture of bone support of the involved teeth.

The piezosurgery device can be used for soft-tissue debridement to remove the secondary flap after incision through retained periosteum. By changing to a thin, tapered tip and altering the power setting, the piezosurgery device can be used to debride the field of residual soft tissue and for root surface scaling to ensure thorough removal of calculus.

Osteoplasty and ostectomy is performed using the piezosurgery device to create positive architecture for pocket elimination surgery. The device allows for precise removal of bone, with minimal risk of injury to underlying root surfaces. Final smoothing of root surfaces and bony margins using a specific ultrasonic insert, PP1, creates a clean field, with ideal bony architecture ready for flap closure. The piezosurgery device is used in bone grafting of an infrabony periodontal defect. Autogenous bone can be readily harvested from adjacent sites with minimal trauma and therefore minimal postoperative effects. Implant site preparation, implant removal and bone harvesting, bone grafting and sinus lifts can be done with much ease and less soft tissue trauma.

Advantages Of Piezosurgery Device Over Conventional Surgical Equipments

Compared with traditional rotary instrumentation, piezosurgery requires much less hand pressure. This results in enhanced operator sensitivity and control, indicating that the clinician can develop a better ‘feel’ and precision for the cutting action because of micro vibration of cutting tip. The cut is safe because the ultrasonic frequency used does not cut soft tissue. The cutting action is less invasive, producing less collateral tissue damage, which results in better healing. Owing to its cavitation effect on physiological solutions (for example, blood), piezosurgery creates a virtually bloodless surgical site that makes visibility in the working area much clearer than with conventional bone cutting instruments. Unlike conventional burs and micro saws, piezosurgery inserts do not become hot, which again reduces the risk of postoperative necrosis.