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Martinho FC, Griffin IL, Tordik PA. Piezoelectric Device and Dynamic Navigation System Integration for Bone Window-Guided Surgery. J Endod 2023; 49:1698-1705. [PMID: 37804944 DOI: 10.1016/j.joen.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/06/2023] [Accepted: 09/26/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION This study investigates the feasibility of integrating a piezoelectric device (PIEZO) into a dynamic navigation system (DNS) for bone-window guided surgery. It compares the accuracy and efficiency of PIEZO + DNS to PIEZO + Freehand (FH) procedure for bone-window cutting and root-end resection (RER). METHODS Forty-eight mandibular molars of 3D-printed surgical jaw models were divided into two groups: PIEZO + DNS (n = 24) and PIEZO + FH (n = 24). Cone-beam computed tomography scans were taken before and after the procedure. The procedure was virtually planned on X-guide software. The bone-window cutting and RER were conducted with a PIEZO under dynamic navigation in the PIEZO + DNS group and using the dental operating microscope in the PIEZO + FH group. The 2D- and 3D-accuracy deviations and angular deflection were measured for the bone window cut. The root length resected and resection angle were calculated. The bone window cut, RER, total operating time, and number of mishaps were recorded. RESULTS PIEZO + DNS was more accurate than PIEZO + FH for bone-window cutting, showing fewer 2D and 3D deviations and less angular deflection (P < .05). The resection angle was lower in the PIEZO + DNS (P < .05). The bone-window cut and total operating time were significantly reduced using a DNS (P < .05). There was no difference in the number of mishaps (P > .05). CONCLUSIONS Within the limitations of this in vitro study, the integration of a PIEZO into a DNS is feasible for bone-window guided surgery. The DNS improved the accuracy and efficiency of bone-window cutting.
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Affiliation(s)
- Frederico C Martinho
- Clinical Professor, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| | - Ina L Griffin
- Clinical Assistant Professor, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Clinical Professor, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
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Yang C, Ji J, Lv Y, Li Z, Luo D. Application of Piezoelectric Material and Devices in Bone Regeneration. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:4386. [PMID: 36558239 PMCID: PMC9785304 DOI: 10.3390/nano12244386] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Bone injuries are common in clinical practice. Given the clear disadvantages of autologous bone grafting, more efficient and safer bone grafts need to be developed. Bone is a multidirectional and anisotropic piezoelectric material that exhibits an electrical microenvironment; therefore, electrical signals play a very important role in the process of bone repair, which can effectively promote osteoblast differentiation, migration, and bone regeneration. Piezoelectric materials can generate electricity under mechanical stress without requiring an external power supply; therefore, using it as a bone implant capable of harnessing the body's kinetic energy to generate the electrical signals needed for bone growth is very promising for bone regeneration. At the same time, devices composed of piezoelectric material using electromechanical conversion technology can effectively monitor the structural health of bone, which facilitates the adjustment of the treatment plan at any time. In this paper, the mechanism and classification of piezoelectric materials and their applications in the cell, tissue, sensing, and repair indicator monitoring aspects in the process of bone regeneration are systematically reviewed.
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Affiliation(s)
- Chunyu Yang
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
- State Key Laboratory of Heavy Oil Processing, College of New Energy and Materials, China University of Petroleum (Beijing), Beijing 102249, China
| | - Jianying Ji
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
- Center on Nanoenergy Research, School of Physical Science and Technology, Guangxi University, Nanning 530004, China
| | - Yujia Lv
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
| | - Zhou Li
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
| | - Dan Luo
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
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Dean A, Heredero‐Jung S, Solivera J, Sanjuan A, Alamillos‐Granados FJ. Computer-assisted and navigated piezoelectric surgery: A new technology to improve precision and surgical safety in craniomaxillofacial surgery. Laryngoscope Investig Otolaryngol 2022; 7:684-691. [PMID: 35734050 PMCID: PMC9195016 DOI: 10.1002/lio2.786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/05/2022] [Accepted: 03/14/2022] [Indexed: 11/12/2022] Open
Abstract
Background Computer-assisted navigated piezoelectric surgery (CANPS) is a surgical technique that combines the surgical navigation with a piezoelectric device. This association multiplies the advantages of both technologies, taking the best of each one providing a synergistic association. Objective To describe and assess the indications, advantages, disadvantages, and complications of this association of surgical techniques. Methods CANPS was used in 32 patients. The clinical diagnosis was facial trauma, tumors, orthognathic surgeries, temporomandibular joint ankylosis, pathology of the frontal sinus, and alveolar distraction. Nineteen patients were men and 13 were women. Planning software iPlan 3.05 of Brainlab, and Elements of Brainlab were used for planning and the Kolibri and Kurve of Brainlab for surgical navigation. The piezoelectric device used was a "Vercelotti" type in all patients. Results CAPNS could be performed successfully in all cases without complications and reduced the surgeon's uncertainty during the osteotomies. There is continuous control of the position of the surgical instrument. The use of the navigated piezoelectric device allowed the surgeon's uncertainty to be reduced during the performance of the osteotomies in depth, in poorly visible areas, with little access or reduced visibility. It also increases the safety of bone resections near important anatomical structures. Conclusions CANPS combines the advantages of piezoelectric surgery and navigation. CANPS affords real-time control of the position of the cutting tip and allows semiburied approaches. CANPS allows surgery to be precise, safer, and minimally invasive.
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Affiliation(s)
- Alicia Dean
- Department of Oral and Maxillofacial SurgeryReina Sofía University HospitalCórdobaSpain
| | - Susana Heredero‐Jung
- Department of Oral and Maxillofacial SurgeryReina Sofía University HospitalCórdobaSpain
| | - Juan Solivera
- Department of Oral and Maxillofacial SurgeryReina Sofía University HospitalCórdobaSpain
- Department of NeurosurgeryReina Sofía University HospitalCórdobaSpain
| | - Alba Sanjuan
- Head and Neck Oncology/Microvascular SurgeryAscension‐St John HospitalDetroitUSA
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Niemczyk SP, Barnett F, Johnson JD, Ordinola-Zapata R, Glinianska A. PRESS and Piezo MicroSurgery (Bony Lid): A Seven Year Evolution in a Residency Program Part 2: PRESS- defined site location. J Endod 2022; 48:797-806.e2. [PMID: 35181454 DOI: 10.1016/j.joen.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/09/2022] [Accepted: 02/07/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Treatment of a failing endodontic procedure via microsurgical revision presents better outcomes due, in part, to the integration of the Surgical Operating Microscope (SOM) and CBCT into clinical practice. But challenges still remain with respect to the operational locations and the techniques required to address them. Posterior sites, with substantial cortical plate thicknesses and sensitive anatomy, present the dichotomy of visualization versus post-surgical regeneration of bone. The bony lid technique bridges the gap between these two concepts, and the application of Piezosurgery renders a precise and biocompatible osseous incision. The purpose of this paper is to outline, through Case reports, the progression of Piezo-Guided surgery in a resident setting. METHODS The first two evolutions of the technique utilized a surgeon-defined method for site location. This third and final evolution utilizes a digital workflow to virtually plan the surgical procedure, integrating STL and DICOM files to create 3-dimensional guides with exacting resection locations, levels, and angles. Export of the virtually planned guide in post-production generates the Precision Endodontic Surgical Stent (PRESS) to accurately define the site location and parameters of the procedure. All surgeries were executed using the Piezosurgical method with increasing levels of guidance and precision throughout the evolution process. RESULTS Each step in the technique implementation enabled the resident to assimilate a new technique and skill set while maintaining bone architecture and minimizing volume loss post-operatively. The patient benefits were an increase in intra-operative safety and post-operative comfort. The resident benefits were accelerated regeneration timetables, increase in the confidence level of the resident and number of scheduled posterior surgical procedures. CONCLUSIONS The progression from crude on-site measurements to elegant and precise surgical guides enabled the access and manipulations of difficult surgical sites without compromising visibility, post-operative osseous regeneration, or patient comfort.
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Affiliation(s)
- Stephen P Niemczyk
- Assistant Program Director and Director of Microsurgery, IB Bender Postdoctoral Endodontic Program, Albert Einstein Medical Center, Philadelphia, PA
| | - Frederick Barnett
- Chairman and Program Director, IB Bender Postdoctoral Endodontic Program, Albert Einstein Medical Center, Philadelphia, PA
| | - James D Johnson
- Chairman and Program Director, Advanced Specialty Education Program in Endodontics , Seattle, WA
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Treatment of Refractory Medicine Related Osteonecrosis of Jaw With Piezosurgical Debridement and Autologous Platelet Rich Fibrin: Feasibility Study. J Craniofac Surg 2021; 33:e226-e230. [PMID: 34310422 DOI: 10.1097/scs.0000000000007981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Medicine related osteonecrosis of jaw (MRONJ) is incidental in patients receiving certain bone modifying agents in oncology. These lesions may not respond to conservative management and aggravate. Autologous platelet derivatives contain bone growth factors, which help in bone regeneration. The aim of this pilot study is to develop protocol for treatment of refractory MRONJ with pizosurgical debridement and advanced platelet rich fibrin.In this feasibility study, refractory MRONJ lesions were treated by piezosurgical debridement and insertion of autologous advanced platelet rich fibrin in 15 patients. One patient had 2 lesion sites, so in all 16 MRONJ sites were treated. These patients were evaluated at the end of 1 month and 4 months for healing of MRONJ lesion. Statistical analysis was done by using Fisher test for response assessment in relation to variable. Eight lesions (50%) showed complete healing at the end of 1 month. At the end of 4 months 13 lesions (81.50%) were completely healed, 2 lesions (12.5%) were downgrades, and 1 lesion (6.25%) did not respond to treatment. Number of doses of bone modifying agent was only factor found associated with nonhealing of MRONJ when treated with this protocol.In this pilot study, feasibility of use of piezosurgical debridement and platelet rich fibrin was evaluated. The results of the study suggest complete healing can be achieved with this treatment protocol. Further research with increased sample size is warranted to determine optimum use of autologous platelet concentrates in treatment of MRONJ.
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Massimi L, Rapisarda A, Bianchi F, Frassanito P, Tamburrini G, Pelo S, Caldarelli M. Piezosurgery in Pediatric Neurosurgery. World Neurosurg 2019; 126:e625-e633. [DOI: 10.1016/j.wneu.2019.02.103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/09/2019] [Accepted: 02/10/2019] [Indexed: 02/04/2023]
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Ultrasonic versus conventional gap arthroplasty for the release of ankylosis of temporomandibular joint: a prospective cohort study. Sci Rep 2019; 9:385. [PMID: 30674962 PMCID: PMC6344476 DOI: 10.1038/s41598-018-36955-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 11/23/2018] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study was to compare the clinical outcomes of ultrasonic surgery to the conventional bone cutting technique using bur and saw for the release of ankylosis of temporomandibular joint. We conducted a prospective cohort study on 25 patients with 38 ankylotic joints at Chinese PLA General Hospital from March 01, 2012 to March 01, 2016. Patients were followed up at least 2 years postoperatively. The primary outcome was the intraoperative blood loss per joint. The secondary outcome was the long-term (≥2 years) improvement of maximum mouth opening. The blood loss was significantly reduced in the ultrasonic group compared to the conventional group (107.3 ± 62.3 ml vs. 186.3 ± 92.6 ml, P = 0.019). The long-term improvements of maximum mouth opening were substantial and stable in both groups (33.5 ± 4.8 mm in the ultrasonic group vs. 29.2 ± 6 mm in the conventional group, P = 0.06). Multivariate linear regression analysis showed a significant association between blood loss and technique used (coefficient: 66.3, 95% confidence interval: 22.1,110.4, P = 0.006). The ultrasonic surgery was associated with less intraoperative blood loss when compared to the conventional method for the release of ankylosis of temporomandibular joint while providing a stable and comparable long-term improvement of maximum mouth opening.
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Effects of a Pasty Bone Cement Containing Brain-Derived Neurotrophic Factor-Functionalized Mesoporous Bioactive Glass Particles on Metaphyseal Healing in a New Murine Osteoporotic Fracture Model. Int J Mol Sci 2018; 19:ijms19113531. [PMID: 30423942 PMCID: PMC6274902 DOI: 10.3390/ijms19113531] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 10/29/2018] [Accepted: 11/05/2018] [Indexed: 12/30/2022] Open
Abstract
The development of new and better implant materials adapted to osteoporotic bone is still urgently required. Therefore, osteoporotic muscarinic acetylcholine receptor M3 (M3 mAChR) knockout (KO) and corresponding wild type (WT) mice underwent osteotomy in the distal femoral metaphysis. Fracture gaps were filled with a pasty α-tricalcium phosphate (α-TCP)-based hydroxyapatite (HA)-forming bone cement containing mesoporous bioactive CaP-SiO₂ glass particles (cement/MBG composite) with or without Brain-Derived Neurotrophic Factor (BDNF) and healing analyzed after 35 days. Histologically, bone formation was significantly increased in WT mice that received the BDNF-functionalized cement/MBG composite compared to control WT mice without BDNF. Cement/MBG composite without BDNF increased bone formation in M3 mAChR KO mice compared to equally treated WT mice. Mass spectrometric imaging showed that the BDNF-functionalized cement/MBG composite implanted in M3 mAChR KO mice was infiltrated by newly formed tissue. Leukocyte numbers were significantly lower in M3 mAChR KO mice treated with BDNF-functionalized cement/MBG composite compared to controls without BDNF. C-reactive protein (CRP) concentrations were significantly lower in M3 mAChR KO mice that received the cement/MBG composite without BDNF when compared to WT mice treated the same. Whereas alkaline phosphatase (ALP) concentrations in callus were significantly increased in M3 mAChR KO mice, ALP activity was significantly higher in WT mice. Due to a stronger effect of BDNF in non osteoporotic mice, higher BDNF concentrations might be needed for osteoporotic fracture healing. Nevertheless, the BDNF-functionalized cement/MBG composite promoted fracture healing in non osteoporotic bone.
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Troedhan A, Mahmoud ZT, Wainwright M, Khamis MM. Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician. ACTA ACUST UNITED AC 2017. [DOI: 10.17352/2455-4634.000028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Effects of Piezoelectric Surgery on Bone Regeneration Following Distraction Osteogenesis of Mandible. J Craniofac Surg 2017; 28:74-78. [PMID: 27906844 DOI: 10.1097/scs.0000000000003213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study is to compare the bone healing in the distraction gap following the osteotomy performed with piezoelectric and conventional devices for the distraction osteogenesis in the rabbit mandibles. Twelve rabbits were randomly divided into 2 groups; 6 for piezoelectric device and 6 for rotary instruments. After 3 days of latency period, distraction was started at a rate of 1 mm per day for 10 days. All the animals were sacrificed after 4 weeks of consolidation phase for histological and histomorphological evaluation. Histological evaluation revealed thick trabecular bone formation in all of the specimens. Inflammation scores were chronic minimal. The mean percentages of the bone area in distraction gap are 62% in group P and 57% in group R. However, the difference between 2 groups was not statistically significant (P > 0.05). Our results revealed a slight increase in bone formation in the distraction gap in piezo-osteotomy groups histologically though not statistically supported. However, there is still a need for more histological studies with larger sample sizes evaluating the bone structure following piezo-osteotomies.
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Wang L, Aghvami M, Brunski J, Helms J. Biophysical regulation of osteotomy healing: An animal study. Clin Implant Dent Relat Res 2017; 19:590-599. [PMID: 28608504 DOI: 10.1111/cid.12499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/01/2017] [Accepted: 05/02/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Osteotomies have been performed for centuries yet there remains a remarkable lack of consensus on optimal methods for cutting bone. There is universal agreement, however, that preserving cell viability is critical. PURPOSE To identify mechanobiological parameters influencing bone formation after osteotomy site preparation. MATERIALS AND METHODS A murine maxillary osteotomy model was used to evaluate healing. Computational modeling characterized stress and strain distributions in the osteotomy, as well as the magnitude and distribution of heat generated by drilling. The impact of osteocyte death and bone composition were assessed using molecular and cellular assays. RESULTS The phases of osteotomy healing in mice align closely with results in large animals; in addition, molecular analyses extended our understanding of osteoprogenitor cell proliferation, differentiation, and mineralization. Computational analyses provided insights into temperature changes caused by drilling and the mechanobiological state in the healing osteotomies, while concomitant cellular assays correlate drill speed with osteocyte apoptosis and bone resorption. Even when drilling was controlled, trabeculated, spongy (Type III) bone healed faster than densely lamellar (Type I) bone because of the abundance of Wnt responsive osteoprogenitor cells in the former. CONCLUSIONS These data provide a mechanobiological framework for evaluating tools and technologies designed to improve osteotomy site preparation.
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Affiliation(s)
- Liao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, 94305
| | - Maziar Aghvami
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, 94305
| | - John Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, 94305
| | - Jill Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, 94305
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Comparison between piezosurgery and conventional osteotomy in cranioplasty with fronto-orbital advancement. J Craniomaxillofac Surg 2017; 45:395-400. [DOI: 10.1016/j.jcms.2016.12.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 10/25/2016] [Accepted: 12/15/2016] [Indexed: 11/23/2022] Open
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Magesty RA, Galvão EL, de Castro Martins C, Dos Santos CRR, Falci SGM. Rotary Instrument or Piezoelectric for the Removal of Third Molars: a Meta-Analysis. J Maxillofac Oral Surg 2016; 16:13-21. [PMID: 28286381 DOI: 10.1007/s12663-016-0938-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 06/18/2016] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of this systematic review and meta-analysis was to compare, in the lower third molar surgery, the osteotomy techniques with rotary instruments and piezoelectric motors. METHODS An electronic search was conducted using the following databases: Pubmed, Web of Science, and the Cochrane Oral Health Group Trials Register. Inclusion criteria were: studies in humans, randomized or nonrandomized, comparing the extraction of third molars that required osteotomy and/or odontosection with rotary instrument and osteotomy and/or odontosection with piezoelectric motor assistance. The analysis and inclusion of articles was performed by two reviewers independently. An evaluation of the quality of articles and data extraction was carried out. RESULTS From a total of nine hundred seventy four (974) trials, eleven articles were included in the qualitative analysis, and seven were included in the quantitative analysis. Rotary instruments were faster than the piezoelectric surgery (95 % CI 0.34 to 1.16). The piezoelectric surgery showed better results when compared with roatry instruments when trismus was assessed in 2 (95 % CI 0.65 to 1.69), 3 (95 % CI 0.63 to 1.67) and 5 (95 % CI 0.03 to 2.26) days after surgery. Seven days after surgery, there were no differences between the techniques (95 % CI (-0.022) to (-1.49)). CONCLUSION The piezoelectric surgery was effective in reducing pain, swelling and trismus in third molar surgery, but the same requires greater surgical time than the rotary instruments.
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Affiliation(s)
- Rafael Alvim Magesty
- Departamento de Odontologia, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais Brazil
| | - Endi Lanza Galvão
- Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Carolina de Castro Martins
- Pediatric Dentistry, Faculdade de Odontologia, Universidade Federal de Minas Gerias, Belo Horizonte, Brazil
| | - Cássio Roberto Rocha Dos Santos
- Oral and Maxillofacial Surgery, Departamento de Odontologia, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais Brazil
| | - Saulo Gabriel Moreira Falci
- Oral and Maxillofacial Surgery, Departamento de Odontologia, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais Brazil
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Abstract
Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies.
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Affiliation(s)
- Stefan Stübinger
- Hightech Research Center of Cranio-maxillofacial Surgery, University of Basel, Allschwil, Switzerland
| | | | - Britt-Isabelle Berg
- Department of Cranio-maxillofacial Surgery, University Hospital Basel, Basel, Switzerland ; Division of Oral and Maxillofacial Radiology, Columbia University Medical Center, New York, NY, USA
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Biomechanical Stability of Dental Implants in Augmented Maxillary Sites: Results of a Randomized Clinical Study with Four Different Biomaterials and PRF and a Biological View on Guided Bone Regeneration. BIOMED RESEARCH INTERNATIONAL 2015; 2015:850340. [PMID: 25954758 PMCID: PMC4410536 DOI: 10.1155/2015/850340] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 02/22/2015] [Accepted: 02/27/2015] [Indexed: 12/28/2022]
Abstract
Introduction. Bone regenerates mainly by periosteal and endosteal humoral and cellular activity, which is given only little concern in surgical techniques and choice of bone grafts for guided bone regeneration. This study investigates on a clinical level the biomechanical stability of augmented sites in maxillary bone when a new class of moldable, self-hardening calcium-phosphate biomaterials (SHB) is used with and without the addition of Platelet Rich Fibrin (aPRF) in the Piezotome-enhanced subperiosteal tunnel-technique (PeSPTT). Material and Methods. 82 patients with horizontal atrophy of anterior maxillary crest were treated with PeSPTT and randomly assigned biphasic (60% HA/40% bTCP) or monophasic (100% bTCP) SHB without or with addition of aPRF. 109 implants were inserted into the augmented sites after 8.3 months and the insertion-torque-value (ITV) measured as clinical expression of the (bio)mechanical stability of the augmented bone and compared to ITVs of a prior study in sinus lifting. Results. Significant better results of (bio)mechanical stability almost by two-fold, expressed by higher ITVs compared to native bone, were achieved with the used biomaterials and more constant results with the addition of aPRF. Conclusion. The use of SHB alone or combined with aPRF seems to be favourable to achieve a superior (bio)mechanical stable restored alveolar bone.
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Matsuda H, Furuya Y, Sasaki H, Takanashi T, Morioka T, Miura T, Yoshinari M, Yajima Y. Comparison of Surface Morphology and Healing in Rat Calvaria Bone Defects between Ultrasonic Surgical Method and Rotary Cutting Method. J HARD TISSUE BIOL 2015. [DOI: 10.2485/jhtb.24.267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Hiroya Matsuda
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Yoshitaka Furuya
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Hodaka Sasaki
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Takuya Takanashi
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Toshiyuki Morioka
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Tadashi Miura
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
| | - Masao Yoshinari
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
| | - Yasutomo Yajima
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
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Troedhan A, Schlichting I, Kurrek A, Wainwright M. Primary implant stability in augmented sinuslift-sites after completed bone regeneration: a randomized controlled clinical study comparing four subantrally inserted biomaterials. Sci Rep 2014; 4:5877. [PMID: 25073446 PMCID: PMC5376201 DOI: 10.1038/srep05877] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/01/2014] [Indexed: 02/07/2023] Open
Abstract
Implant-Insertion-Torque-Value (ITV) proved to be a significant clinical parameter to predict long term implant success-rates and to decide upon immediate loading. The study evaluated ITVs, when four different and commonly used biomaterials were used in sinuslift-procedures compared to natural subantral bone in two-stage-implant-procedures. The tHUCSL-INTRALIFT-method was chosen for sinuslifting in 155 sinuslift-sites for its minimal invasive transcrestal approach and scalable augmentation volume. Four different biomaterials were inserted randomly (easy-graft CRYSTAL n = 38, easy-graft CLASSIC n = 41, NanoBone n = 42, BioOss n = 34), 2 ccm in each case. After a mean healing period of 8,92 months uniform tapered screw Q2-implants were inserted and Drill-Torque-Values (DTV) and ITV were recorded and compared to a group of 36 subantral sites without need of sinuslifting. DTV/ITV were processed for statistics by ANOVA-tests. Mean DTV/ITV obtained in Ncm were: Control Group 10,2/22,2, Bio-Oss 12,7/26,2, NanoBone 17,5/33,3, easy-graft CLASSIC 20,3/45,9, easy-graft CRYSTAL 23,8/56,6 Ncm, significance-level of differences throughout p < 0,05. Within the limits of this study the results suggest self-hardening solid-block-like bone-graft-materials to achieve significantly better DTV/ITV than loose granulate biomaterials for its suspected improvement of vascularization and mineralization of the subantral scaffold by full immobilization of the augmentation site towards pressure changes in the human sinus at normal breathing.
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Affiliation(s)
- Angelo Troedhan
- Head of Maxillofacial Surgery Dep., Center for Facial Esthetics Vienna, Brauhausgasse 12, 1050 Vienna, Austria
| | - Izabela Schlichting
- Head of Oral Surgery &Implantology Dep., Center for Facial Esthetics Vienna, Brauhausgasse 12, 1050 Vienna, Austria
| | - Andreas Kurrek
- Head of Oral Surgery &Implantology Dep., Implantology Clinic Oberkassel, Dominikanerstrasse 10, 40545 Dusseldorf
| | - Marcel Wainwright
- Head of Oral Surgery &Implantology Dep., Implantology Clinic Kaiserswerth, Kaiserswerther Markt 25, 40489 Dusseldorf
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