1
|
Nandagopal N, John B. An overview on the art of piezosurgery in the maxillofacial practice. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2021029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Piezosurgery is an emerging boom in the field of maxillofacial surgery for precise, safe and effective osteotomies sparing the adjacent vital structures compared to conventional surgery. Corpus: It works on the principle of piezoelectric effect in which crystals in the piezoelectric substances get deformed on the application of an electric field. Various studies gave the evidence of improved wound healing and bone formation compared to conventional approaches. The soft tissue sparing capability with improved patient comfort and decreased blood loss gave the utmost importance for this surgical technique in the present as well as future world of surgery. Conclusion: Piezosurgery has emerging as a promising surgical modality with a wide range of clinical applications throughout the whole field of surgery.
Collapse
|
2
|
Julie CP, Pierre-Aurélien B, Mathieu D, Alexandru S, Carmine M, Christian P, Federico DR, Arnaud G. Is computer-assisted design and manufacturing technology useful in the surgical management of trigonocephaly? J Craniomaxillofac Surg 2021; 49:993-999. [PMID: 34187730 DOI: 10.1016/j.jcms.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 04/15/2021] [Accepted: 06/05/2021] [Indexed: 11/18/2022] Open
Abstract
The aim of this study is to assess the usefulness of CAD/CAM technology in the surgical treatment of trigonocephaly compared to conventional surgical treatment. Children operated from trigonocephaly between 2017 and 2019 at the French Referral Center for craniosynostosis of Femme-Mère-Enfant Hospital of Lyon, France, were included and separated in two groups. Group 1 included children operated on trigonocephaly using CAD-CAM technology; Group 2 included children operated on trigonocephaly without CAD-CAM technology. Age, gender, duration of surgery, complications, blood transfusion and esthetic results were analyzed. The experience of the craniofacial surgeon was also evaluated and quantified in order to weigh the results. Twenty children were included in the study: 10 in the Group 1 and 10 in the Group 2. No statistical difference was observed between these 2 groups concerning the duration of the surgery (137 min ± 39,17 versus 137,2 min ± 64,50; p = 0,85), complications (20% in group 1 versus 10% in group 2; p = 1), the realization of blood transfusion (80% in group 1 versus 70% in group 2) and the esthetic results (5/5 in group 1 versus 4,6/5 in group 2; p = 0,21). However, the use of CAD-CAM technology significantly accelerates the duration of surgery by 25.8 min on average for the surgeon starting in craniofacial surgery (from 197,8 ± 10,21 min without CAD-CAM to 172 ± 18,76 min with CAD-CAM; p = 0.05) but significantly slows the experienced surgeon by 25.4 min on average (from 76,6 ± 8,65 min without CAD-CAM to 102 ± 6,2 min with CAD-CAM; p = 0.01). In the management of trigonocephaly, CAD/CAM technology seems to present a modest interest for the experienced surgeon but presents a real interest for the young surgeon. Within the limitations of the study, it seems that CAD/CAM technology is a relevant addition to the armamentarium of doctors who are in training because surgical time is reduced.
Collapse
Affiliation(s)
- Chauvel-Picard Julie
- Department of Pediatric Cranio-Maxillo-Facial Surgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France; Department of Cranio-Maxillo-Facial Surgery, Centre Hospitalo-Universitaire Nord, Avenue Albert Raimond, 42000, Saint-Etienne, France; Université Jean Monnet, 6 Rue Basse des Rives, 42100, Saint-Étienne, France.
| | - Beuriat Pierre-Aurélien
- Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France; Université Claude Bernard Lyon 1, 43 Boulevard Du 11 Novembre 1918, 69100, Villeurbanne, France
| | - Daurade Mathieu
- Department of Pediatric Cranio-Maxillo-Facial Surgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France; Université Claude Bernard Lyon 1, 43 Boulevard Du 11 Novembre 1918, 69100, Villeurbanne, France
| | - Szathmari Alexandru
- Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France
| | - Mottolese Carmine
- Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France
| | - Paulus Christian
- Department of Pediatric Cranio-Maxillo-Facial Surgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France
| | - Di Rocco Federico
- Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France; Université Claude Bernard Lyon 1, 43 Boulevard Du 11 Novembre 1918, 69100, Villeurbanne, France
| | - Gleizal Arnaud
- Department of Pediatric Cranio-Maxillo-Facial Surgery, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France; Department of Cranio-Maxillo-Facial Surgery, Centre Hospitalo-Universitaire Nord, Avenue Albert Raimond, 42000, Saint-Etienne, France; Université Jean Monnet, 6 Rue Basse des Rives, 42100, Saint-Étienne, France; Université Claude Bernard Lyon 1, 43 Boulevard Du 11 Novembre 1918, 69100, Villeurbanne, France
| |
Collapse
|
3
|
Steiert C, Masalha W, Grauvogel TD, Roelz R, Klingler JH, Heiland DH, Beck J, Scheiwe C, Grauvogel J. Piezosurgery for safe and efficient petrous bone cutting in cerebellopontine angle and petroclival meningioma surgery. J Clin Neurosci 2021; 89:319-328. [PMID: 34119287 DOI: 10.1016/j.jocn.2021.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
Intradural petrous bone drilling has become a widespread practice, providing extended exposure in the removal of cerebellopontine angle (CPA) or petroclival tumors. Adjacent neurovascular structures are at risk, however, when drilling is performed in this deep and narrow area. Hence, this study evaluates the use of Piezosurgery (PS) as a non-rotating tool for selective bone cutting in CPA surgery. A Piezosurgery® device was used in 36 patients who underwent microsurgery for extra-axial CPA or petroclival tumors in our Neurosurgical Department between 2013 and 2019. The clinical and radiological data were retrospectively analyzed. The use of PS was evaluated with respect to the intraoperative applicability and limitations as well as efficacy and safety of the procedure. Piezosurgical petrous bone cutting was successfully performed in the removal of meningiomas or extra-axial metastases arising from the dura of the petroclival region (21 patients) or petrous bone (15 patients). PS proved to be very helpful in the deep and narrow CPA region, considerably reducing the surgeon's distress toward bone removal in close proximity to cranial nerves and vessels in comparison to common rotating drills. The use of PS was safe without injuries to neurovascular structures. Gross total resection was achieved in 67% of petroclival and 100% of petrous bone tumors. Piezosurgery proved to be an effective and safe method for selective petrous bone cutting in CPA surgery avoiding rotating power and associated risks. This technique can particularly be recommended for bone cutting in close vicinity to critical neurovascular structures.
Collapse
Affiliation(s)
- C Steiert
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
| | - W Masalha
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - T D Grauvogel
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - R Roelz
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - J H Klingler
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - D H Heiland
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - J Beck
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - C Scheiwe
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - J Grauvogel
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| |
Collapse
|
4
|
Maxillary osteotomy complications in piezoelectric surgery compared to conventional surgical techniques: a systematic review. Int J Oral Maxillofac Surg 2019; 48:720-731. [DOI: 10.1016/j.ijom.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 12/20/2018] [Accepted: 01/04/2019] [Indexed: 02/05/2023]
|
5
|
Vetrano IG, Prada F, Perin A, Casali C, DiMeco F, Saini M. Piezosurgery for Infra- and Supratentorial Craniotomies in Brain Tumor Surgery. World Neurosurg 2019; 122:e1398-e1404. [DOI: 10.1016/j.wneu.2018.11.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 11/30/2022]
|
6
|
AlAsseri N, Swennen G. Minimally invasive orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg 2018; 47:1299-1310. [PMID: 29857982 DOI: 10.1016/j.ijom.2018.04.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 04/16/2018] [Accepted: 04/18/2018] [Indexed: 12/31/2022]
Abstract
Minimally invasive techniques are currently applied in many oral and maxillofacial surgical procedures, including orthognathic surgery. A systematic review on the application of potentially minimally invasive procedures in orthognathic surgery was performed to provide a clear overview of the relevant published data. Articles in English on minimally invasive orthognathic procedures, published in the scientific literature, were obtained from the PubMed, Embase, and Cochrane Library databases, and an additional manual search (revised 31 December 2016). After screening the abstracts and applying the eligibility criteria, 403 articles were identified. All articles reporting the potential for minimally invasive orthognathic surgery were included (n=44). The full papers were evaluated in detail and categorized as articles on a minimally invasive surgical approach (n=4), endoscopically assisted orthognathic procedures (n=17), or the use of a piezoelectric device in orthognathic surgery (n=25); two articles were each included in two categories. Although a small incision and minimal dissection is the basic principle of a minimally invasive technique, most articles (90.9%) reported the endoscope and piezoelectric instrument as important tools in minimally invasive orthognathic surgery. Evidence from available studies suggests that patients undergoing minimally invasive orthognathic surgery have less morbidity and make a faster recovery. Further research should aim to obtain higher levels of evidence.
Collapse
Affiliation(s)
- N AlAsseri
- Division of Maxillofacial Surgery, Department of Surgery, General Hospital St-Jan Bruges, Bruges, Belgium; Department of Maxillofacial Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
| | - G Swennen
- Division of Maxillofacial Surgery, Department of Surgery, General Hospital St-Jan Bruges, Bruges, Belgium
| |
Collapse
|
7
|
Tel A, Costa F, Sembronio S, Lazzarotto A, Robiony M. All-in-one surgical guide: A new method for cranial vault resection and reconstruction. J Craniomaxillofac Surg 2018; 46:967-973. [PMID: 29716817 DOI: 10.1016/j.jcms.2018.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/05/2018] [Accepted: 03/28/2018] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Great precision is required for craniofacial surgery, and computer-aided design (CAD) methods may be used to plan surgery before it is performed. In this study, three-dimensional (3D)-printed cutting guides are used to match computer models with surgical procedures. We describe a novel method of computer-aided surgery for autologous cranioplasty that includes a new strategy for generating and using cutting guides. These guides may be used not only for osteotomies, but also for many other steps in the surgical procedure. MATERIALS AND METHODS Preoperatively, anatomical data were imported into a CAD package and used for virtual surgical planning (VSP). Cutting guides were designed after considering how to integrate all the surgical steps. Models of the microplates and micro-screws were also made. Surgical guides were exported and printed, and preoperative simulations using a replica of the patient's skull established the sequence of steps. The accuracy of the procedure was evaluated postoperatively using computed tomography (CT) scans. RESULTS In every patient examined, the all-in-one surgical-guide system was able to automate the many steps in the procedure and dramatically decreased the duration of surgery. The experimental guide enhanced every phase of surgery, including excising the lesion, and harvesting, positioning, and fixing the graft. In each step, precision was enhanced and the outcome corresponded with the VSP. CONCLUSIONS The few previous reports on cutting guides used in cranioplasty generally describe the use of separate guides for dismantling and reconstruction. The ability to perform more surgical sequences using a single tool can improve surgical accuracy. Clearly there is no single perfect surgical guide; however, effective surgical-design strategies should be used to build the best approach to each procedure.
Collapse
Affiliation(s)
- Alessandro Tel
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy
| | - Fabio Costa
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy
| | - Salvatore Sembronio
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy
| | - Andrea Lazzarotto
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy
| | - Massimo Robiony
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| |
Collapse
|
8
|
Klug C, Cede J. Technical Modifications for Intraoral Quadrangular Le Fort II Osteotomy. J Oral Maxillofac Surg 2017; 75:402.e1-402.e16. [DOI: 10.1016/j.joms.2016.09.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/29/2016] [Accepted: 09/29/2016] [Indexed: 11/28/2022]
|
9
|
Spinelli G, Valente D, Mannelli G, Raffaini M, Arcuri F. Surgical management of ankyloses of the temporomandibular joint by a piezoelectric device. J Craniomaxillofac Surg 2016; 45:441-448. [PMID: 28223015 DOI: 10.1016/j.jcms.2016.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/26/2016] [Accepted: 12/06/2016] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Piezosurgery is commonly used in different field of craniomaxillofacial surgery; since its introduction it has become one of the widely adopted technique for performing osteotomies in orthognathic surgery, distraction osteogenesis and dentoalveolar surgery. Little has been written regarding ultrasonic system for temporomandibular joint surgery (TMJ). In this prospective study we describe the use of piezoelectric device for ankylosis of the TMJ. MATERIALS AND METHODS We enrolled in this study 19 patients, 10 males and 9 females, mean (SD) age 24.6 (7.6) years, affected by unilateral ankylosis of TMJ who were surgically managed between January 2009 and December 2014 by interpositional arthroplasty with temporomyofascial muscle flap. We adopted in all cases a preauricular approach with temporal extension. The ankylotic block was removed with piezoelectric device in 9 patients and using traditional rotary bur in 10 cases. We investigated and compared the following parameters as surgical outcomes: intraoperative bleeding, duration of operation, incidence of infection, postoperative swelling and hematoma, mouth opening, nerve impairment and rate of recurrence. RESULTS We noticed a substantial reduction in bleeding with the piezoelectric bone cutter when compared to traditional mechanical surgery (103 ml versus 117 ml; p < 0.05); however, we did not report any severe bleeding from the pterygoid plexus or maxillary artery. Operating time was longer in the piezo group (101 min versus 88 min; p < 0.05). There was a lower incidence of postoperative hematoma and swelling following piezoosteotomy. However, regarding postoperative nerve impairment and infection we did not observe any differences between the two groups. At one year follow-up mean (SD) mouth opening was 34 (4.3) mm. We did not report recurrence of the disease. CONCLUSION Piezoelectric bone removal for the release of ankylosis of the TMJ is associated with minimal bleeding and few postoperative complications. We believe that piezosurgery allows surgeons to achieve better results compared to a traditional surgery. It is a possible alternative due to the clinical benefits demonstrated.
Collapse
Affiliation(s)
- Giuseppe Spinelli
- Unit of Maxillo-Facial Surgery, (Head: Chief Dr. Giuseppe Spinelli), Orthopedic Traumatological Center, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Domenico Valente
- Unit of Maxillo-Facial Surgery, (Head: Chief Dr. Giuseppe Spinelli), Orthopedic Traumatological Center, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Giuditta Mannelli
- First Clinic of Otorhinolaryngology Head and Neck Surgery, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Mirco Raffaini
- Unit of Maxillo-Facial Surgery, (Head: Chief Dr. Giuseppe Spinelli), Orthopedic Traumatological Center, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Francesco Arcuri
- Unit of Maxillo-Facial Surgery, (Head: Chief Dr. Giuseppe Spinelli), Orthopedic Traumatological Center, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
| |
Collapse
|
10
|
Chahed H, Hachicha H, Bachraoui R, Marrakchi J, Mediouni A, Zainine R, Ben Amor M, Beltaief N, Besbes G. Paranasal sinus osteomas: Diagnosis and treatment. ACTA ACUST UNITED AC 2016; 117:306-310. [PMID: 27496644 DOI: 10.1016/j.revsto.2016.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 01/22/2016] [Accepted: 04/29/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Osteoma is the most common benign tumor of the nose and paranasal sinuses. It is a slow-growing bony tumor, often asymptomatic, occurring mainly in frontal and ethmoid sinuses. Theories regarding the origin of osteomas are still discussed. The aims of the study were to describe diagnosis circumstances in our series and to set out our respective indications for open and endoscopic approaches in the treatment of nasosinusal osteomas. PATIENTS AND METHODS A retrospective study was conducted on the files of all the patients treated for a paranasal sinus osteoma in our department between 1990 and 2013. Diagnosis circumstances and kind of treatment were collected and analyzed. RESULTS The files of 45 patients (mean age: 49.2; sex-ratio: 1.19) could be collected. The most common symptom was headache found in all patients. The most common location was the frontal sinus (30 cases). Thirty-nine open procedures were performed. Four osteomas were removed under endoscopic assistance. In one case, a combined approach has been used. Overall complication rate was 11.1%. Symptoms improved in all patients. Two recurrences were observed. DISCUSSION Surgical indications in paranasal sinus osteomas are theorically well codified. However, approaches remain controversial. In our experience, the preferred approach was the open one. Endoscopic techniques, when indicated, are more challenging and need sophisticated instrumentation and a long learning curve.
Collapse
Affiliation(s)
- H Chahed
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia.
| | - H Hachicha
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - R Bachraoui
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - J Marrakchi
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - A Mediouni
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - R Zainine
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - M Ben Amor
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - N Beltaief
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - G Besbes
- Department of ear, nose and otorhinolaryngology and cervicofacial surgery of Rabta hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| |
Collapse
|
11
|
Chang HH, Lee MS, Hsu YC, Tsai SJ, Lin CP. Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars. J Formos Med Assoc 2015; 114:929-35. [DOI: 10.1016/j.jfma.2014.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 01/29/2014] [Accepted: 02/07/2014] [Indexed: 11/29/2022] Open
|
12
|
Spinelli G, Mannelli G, Zhang YX, Lazzeri D, Spacca B, Genitori L, Raffaini M, Agostini T. Complex craniofacial advancement in paediatric patients: Piezoelectric and traditional technique evaluation. J Craniomaxillofac Surg 2015; 43:1422-7. [PMID: 26302936 DOI: 10.1016/j.jcms.2015.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 07/04/2015] [Accepted: 07/15/2015] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The piezoelectric device allows bone cutting without damaging the surrounding soft tissues. The purpose of this study was to assess the role of this surgical instrument in paediatric craniofacial surgery in terms of safety and surgical outcomes. METHODS Thirteen consecutive paediatric patients underwent craniofacial Le Fort osteotomies type III and IV. The saw was used on the right side in seven patients and on the left side in six patients; the piezoelectric instrument was used on the right side in six patients and on the left side in seven patients. Intraoperative blood loss, surgical procedure length, incision precision, postoperative haematoma and swelling, and nerve impairment were evaluated to compare the outcomes of both procedures. RESULTS A longer surgical procedure was observed in 28% of the patients when using the piezoelectric device (p = 0.032), with an intraoperative blood loss reduction of 18% (p = 0.156). Greater precision in bone cutting was reported, together with a reduction in the requirement to protect and incise adjacent soft tissues during piezoelectric osteotomies. There was a lower incidence of postoperative haematoma and swelling following piezo-osteotomy, and a significant reduction in postoperative nerve impairment (p = 0.002). CONCLUSIONS The ultrasonic surgical device guaranteed a clean bone cut, preserving the integrity of the adjacent soft tissues beneath the bone. Although the time required for a piezoelectric osteotomy was longer, the total operation time remained approximately the same. In conclusion, the device's lack of power appears to be a minor problem compared with the advantages, and an ultrasonic device could be considered a valuable instrument for paediatric craniofacial advancement.
Collapse
Affiliation(s)
- Giuseppe Spinelli
- Maxillo-Facial Surgery Unit, Neurosensorial Department (Head in Chief: Dr. G. Spinelli), Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Giuditta Mannelli
- First Clinic of Otorhinolaryngology Head and Neck Surgery, Department of Surgery and Translational Medicine, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
| | - Yi Xin Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Davide Lazzeri
- Plastic and Reconstructive Surgery Unit, Hospital of Pisa, Italy
| | - Barbara Spacca
- Department of Pediatric Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - Lorenzo Genitori
- Department of Pediatric Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - Mirco Raffaini
- Maxillo-Facial Surgery Unit, Neurosensorial Department (Head in Chief: Dr. G. Spinelli), Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Tommaso Agostini
- Maxillo-Facial Surgery Unit, Neurosensorial Department (Head in Chief: Dr. G. Spinelli), Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| |
Collapse
|
13
|
Gao Y, Lin Z, Rodella LF, Buffoli B, Wu X, Zhou Y. Piezoelectric ultrasonic bone surgery system in the extraction surgery of supernumerary teeth. J Craniomaxillofac Surg 2014; 42:1577-82. [PMID: 24942094 DOI: 10.1016/j.jcms.2014.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 02/19/2014] [Accepted: 04/14/2014] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The anterior maxillary region is a common site for supernumerary teeth. The aim of this study was to compare the use of piezoelectric ultrasonic bone surgery for the extraction of supernumerary teeth and the use of traditional method using bone chisels. METHODS 60 patients with supernumerary anterior maxillary teeth were considered in this study. They were randomly divided into two groups: 1) the control group, in which the supernumerary teeth were extracted using the traditional bone chisels method; 2) the experimental group, in which the supernumerary teeth were extracted using a piezoelectric ultrasonic bone surgery system. The operative time, amount of bleeding and post-operative pain were quantified and compared; in addition, the post-operative swelling was evaluated. RESULTS We observed a significant decrease (P < 0.01) in the amount of bleeding and post-operative pain in the experimental group respect to the control group; but the operative time was significantly increased (P < 0.01) with the use of piezoelectric system. In addition, post-operative swelling resolved more quickly in the experimental group. CONCLUSION Although the operative time for the extraction of the maxillary anterior supernumerary teeth was longer using the piezoelectric ultrasonic bone surgery system, the amount of bleeding and the post-operative complications were less, so this system could be considered an appropriate surgical method for the extraction of supernumerary teeth.
Collapse
Affiliation(s)
- Yongbo Gao
- Department of Stomatology, Longgang District Central Hospital, Affiliated of Zunyi Medical College, Shenzhen, Guangdong, China
| | - Zhenyan Lin
- Zunyi Medical College, Zunyi, Guizhou, China
| | - Luigi Fabrizio Rodella
- Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Barbara Buffoli
- Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Xifeng Wu
- Department of Stomatology, Longgang District People's Hospital, Shenzhen, Guangdong, China
| | - Yanmin Zhou
- School of Stomatology (Prof. Yanmin Zhou), Jilin University, 1500 Qinghua Road, Changchun 130021, Jilin, China.
| |
Collapse
|
14
|
Philippe B. Chirurgie maxillofaciale guidée : simulation et chirurgie assistée par guides stéréolithographiques et miniplaques titane préfabriquées. ACTA ACUST UNITED AC 2013; 114:228-246. [PMID: 23928253 DOI: 10.1016/j.revsto.2013.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 06/27/2013] [Indexed: 11/18/2022]
Affiliation(s)
- B Philippe
- 19, rue de Téhéran, 75008 Paris, France; Clinique Sainte-Isabelle, 92200 Neuilly-sur-Seine, France.
| |
Collapse
|
15
|
|
16
|
Vandone AM, Donadio M, Mozzati M, Ardine M, Polimeni MA, Beatrice S, Ciuffreda L, Scoletta M. Impact of dental care in the prevention of bisphosphonate-associated osteonecrosis of the jaw: a single-center clinical experience. Ann Oncol 2012; 23:193-200. [PMID: 21427065 DOI: 10.1093/annonc/mdr039] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Osteonecrosis of the jaw (ONJ) is associated with bisphosphonate (BP) therapy and invasive dental care. An Interdisciplinary Care Group (ICG) was created to evaluate dental risk factors and the efficacy of a preventive restorative dental care in the reduction of ONJ risk. PATIENTS AND METHODS This prospective single-center study included patients with bone metastases from solid tumors. Patients who received at least one BP infusion between October 2005 and 31 August 2009 underwent one or more ICG evaluation and regular dental examinations. We also retrospectively evaluated patients with bone metastases from solid tumors who did not undergo dental preventive measures. RESULTS Of 269 patients, 211 had received at least one infusion of BP therapy: 62% were BP naive and 38% had previous BP exposure. Of these 211 patients followed for 47 months, 6 patients developed ONJ (2.8%). Of 200 patients included in the retrospective analysis, 11 patients developed ONJ (5.5%). CONCLUSIONS In comparison with published ONJ rates and those extrapolated from the retrospective analysis, the observed ONJ rate in the prospective group was lower, suggesting that implementation of a preventive dental program may reduce the risk of ONJ in metastatic patients treated with i.v. BP therapy.
Collapse
Affiliation(s)
- A M Vandone
- Department of Medical Oncology and Hematology, C.O.E.S. Subalpine OncoHematology Cancer Center. mailto:
| | - M Donadio
- Department of Medical Oncology and Hematology, C.O.E.S. Subalpine OncoHematology Cancer Center
| | - M Mozzati
- Department of Oral Surgery, San Giovanni Battista Molinette Hospital, Turin, Italy
| | - M Ardine
- Department of Medical Oncology and Hematology, C.O.E.S. Subalpine OncoHematology Cancer Center
| | - M A Polimeni
- Department of Medical Oncology and Hematology, C.O.E.S. Subalpine OncoHematology Cancer Center
| | - S Beatrice
- Department of Medical Oncology and Hematology, C.O.E.S. Subalpine OncoHematology Cancer Center
| | - L Ciuffreda
- Department of Medical Oncology and Hematology, C.O.E.S. Subalpine OncoHematology Cancer Center
| | - M Scoletta
- Department of Oral Surgery, San Giovanni Battista Molinette Hospital, Turin, Italy
| |
Collapse
|
17
|
Piezosurgery prevents brain tissue damage: an experimental study on a new rat model. Int J Oral Maxillofac Surg 2011; 40:840-4. [PMID: 21676589 DOI: 10.1016/j.ijom.2011.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 04/08/2011] [Accepted: 05/10/2011] [Indexed: 11/22/2022]
Abstract
Piezosurgery is a promising meticulous system for bone cutting, based on ultrasound microvibrations. It is thought that the impact of piezosurgery on the integrity of soft tissue is generally low, but it has not been examined critically. The authors undertook an experimental study to evaluate the brain tissue response to skull bone removal using piezosurgery compared with a conventional drilling method. In Wistar male rats, a circular bone window was drilled to the parietal bone using piezosurgery on one side and a conventional bone drill on the other side. The behavioural performance of animals was evaluated using the motor BBB test and sensory plantar test. The brains of animals were evaluated by magnetic resonance imaging (MRI) and histology. The results of MRI showed significantly increased depth and width of the brain lesion in the region of conventional drilling compared with the region where piezosurgery was used. Cresylviolet and NF 160 staining confirmed these findings. There was no significant difference in any of the behavioural tests between the two groups. In conclusion, piezosurgery is a safe method for the performance of osteotomy in close relation to soft tissue, including an extremely injury-sensitive tissue such as brain.
Collapse
|
18
|
Baldi D, Menini M, Pera F, Ravera G, Pera P. Sinus floor elevation using osteotomes or piezoelectric surgery. Int J Oral Maxillofac Surg 2011; 40:497-503. [PMID: 21353478 DOI: 10.1016/j.ijom.2011.01.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Revised: 12/06/2010] [Accepted: 01/12/2011] [Indexed: 10/18/2022]
Abstract
The aim of this paper is to describe a technique for sinus floor augmentation with a 1-step crestal approach where the residual bone is ≤ 7.5mm. 36 implants were installed in 25 patients in the atrophic posterior maxilla immediately after sinus floor elevation. Sinus floor elevation was performed with a crestal approach using either osteotomes and burs or piezosurgery. Standardized intraoral radiographs were taken prior to surgery and 1 year after surgery. The mean residual bone height was 5.61 mm (range 3-7.5mm). The mean gain of sinus elevation was 6.78 mm (range 3.5-10mm) at 1 year after surgery. Two patients dropped out of the study. Of the 23 patients completing the study, one implant failed, whilst the remaining 33 implants were stable 12 months after surgery (cumulative survival rate 97%). A statistically significantly higher bone height was achieved with tapered implants compared with cylindrical implants (P<0.05). No statistically significant differences were found in bone level using osteotomes or piezosurgery. Piezosurgery was considered to provide less discomfort for the patient and greater convenience for the surgeon.
Collapse
Affiliation(s)
- D Baldi
- Dept. Fixed and Implant Prosthodontics, Genoa University, Italy
| | | | | | | | | |
Collapse
|
19
|
Pavlíková G, Foltán R, Horká M, Hanzelka T, Borunská H, Sedý J. Piezosurgery in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2010; 40:451-7. [PMID: 21176870 DOI: 10.1016/j.ijom.2010.11.013] [Citation(s) in RCA: 147] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 10/09/2010] [Accepted: 11/17/2010] [Indexed: 11/28/2022]
Abstract
This review summarizes current knowledge and experience with piezosurgery, a promising, meticulous and soft tissue-sparing system for bone cutting, based on ultrasonic microvibrations. The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient and protection of tooth structure. To date it has been indicationed for use in oral and maxillofacial surgery, otorhinolaryngology, neurosurgery, ophthalmology, traumatology and orthopaedics. The main indications in oral surgery are sinus lift, bone graft harvesting, osteogenic distraction, ridge expansion, endodontic surgery, periodontal surgery, inferior alveolar nerve decompression, cyst removal, dental extraction and impacted tooth removal. In conclusion, piezosurgery is a promising technical modality for different aspects of bone surgery with a rapidly increasing number of indications throughout the whole field of surgery.
Collapse
Affiliation(s)
- G Pavlíková
- Division of Oral and Maxillofacial Surgery, Department of Stomatology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | | | | | | | | | | |
Collapse
|
20
|
Pitak-Arnnop P, Dhanuthai K, Hemprich A, Pausch NC. Craniofacial fibrous dysplasia: current status of the literature. REVUE DE STOMATOLOGIE ET DE CHIRURGIE MAXILLO-FACIALE 2010; 111:244-246. [PMID: 20656311 DOI: 10.1016/j.stomax.2010.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 05/23/2010] [Indexed: 05/29/2023]
|
21
|
Beziat JL, Faghahati S, Ferreira S, Babic B, Gleizal A. Blocage maxillomandibulaire : technique et intérêt dans le clivage sagittal piézoélectrique. ACTA ACUST UNITED AC 2009; 110:273-7. [DOI: 10.1016/j.stomax.2009.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 07/09/2009] [Accepted: 09/01/2009] [Indexed: 11/24/2022]
|
22
|
Muñoz-Guerra MF, Naval-Gías L, Capote-Moreno A. Le Fort I osteotomy, bilateral sinus lift, and inlay bone-grafting for reconstruction in the severely atrophic maxilla: a new vision of the sandwich technique, using bone scrapers and piezosurgery. J Oral Maxillofac Surg 2009; 67:613-8. [PMID: 19231789 DOI: 10.1016/j.joms.2008.09.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Accepted: 09/06/2008] [Indexed: 11/16/2022]
Abstract
Severe atrophy of the edentulous maxilla and progressive pneumatisation of the maxillary sinus can compromise the insertion of dental implants. In this context, ideal implant positioning is limited by inadequate height, width, and quality of the bone. Le Fort I osteotomy and interpositional bone graft is an excellent treatment concept for the dental rehabilitation of patients with atrophied maxilla and reversed intermaxillary relationship. In this report, we indicate the transcendent aspect of elevation and preservation of maxillary sinus and nasal mucosa, modifying the sandwich technique by the useful of bone scrapers and piezosurgery. The procedure is described including a 1-stage approach using cortico-cancellous bone blocks through which implants are placed. In the extremely atrophied alveolar process of the maxilla, this technique provides the desired gain of bone, allows for the ideal placement of dental implants, and improves any discrepancy between the upper and lower arches.
Collapse
Affiliation(s)
- Mario Fernando Muñoz-Guerra
- Department of Oral and Maxillofacial Surgery, University Hospital La Princesa, Autónoma University, Madrid, Spain.
| | | | | |
Collapse
|
23
|
Peivandi A, Bugnet R, Debize E, Gleizal A, Dohan DM. [Piezoelectric osteotomy: applications in periodontal and implant surgery]. ACTA ACUST UNITED AC 2007; 108:431-40. [PMID: 17919670 DOI: 10.1016/j.stomax.2007.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Revised: 07/11/2007] [Accepted: 08/02/2007] [Indexed: 11/25/2022]
Abstract
Reverse piezoelectricity is currently used in Dentistry for ultrasonic scaling devices. Using this technology, increasingly more powerful ultrasonic surgical lancets were developed within a few years, and these new tools have provided many practical solutions in oral and maxillofacial surgery. This article reviews the basic principles of piezosurgery, and its numerous clinical applications: in oral surgery (atraumatic extractions, wisdom teeth exposure, periapical cyst debridement, pre-prosthetic surgery), more specifically in periodontal (root planning and bone remodeling, crown lengthening) and implant surgery (sinus lift, removal of fractured implants, bone ridge augmentation, bone graft harvesting (crestal, retromolar, chin or tori)). The recent increased power of these instruments allows emphasizing a much wider range of clinical applications, extending to all surgical fields.
Collapse
Affiliation(s)
- A Peivandi
- 49, rue Denfert-Rochereau, 69004 Lyon, France
| | | | | | | | | |
Collapse
|