Piezosurgery in Periodontology and Oral Implantology

WHAT IS PIEZOSURGERY?

Piezo surgery 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 W 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

Piezosurgery tip Vibration

 Piezosurgery tip Movement

 APPLICATION IN DENTISTRY

Piezosurgical 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, 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.

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.

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 microvibration 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. The Inbuilt Feedback Function constantly checks the performance parameters of the ultrasonic unit during operation. Simultaneously it controls the power output by Auto Tunning Function, which enables to supply the power suited for bone cutting procedure.

Unlike conventional burs and micro saws, piezosurgery inserts do not become hot, which again reduces the risk of postoperative necrosis.

 

 Auto Tunning Function

CONCLUSION

The piezo surgery device is an advanced instrument that can be used for bone surgery in a variety of dental surgical specialties.

The advantage of piezosurgery is that it can precisely cut hard tissue, while precluding injury to soft tissue. Minimal heat is generated during cutting, thus maintaining vitality of adjacent tissue. It provides substantial improvement in dental/implant surgery, benefiting the surgeon by ease of use and the patient by minimizing surgical trauma and promoting rapid healing.