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Bessen S, Gadkaree SK, Derakhshan A. Use of piezoelectric instrumentation in craniofacial surgery. Curr Opin Otolaryngol Head Neck Surg 2024:00020840-990000000-00133. [PMID: 38900192 DOI: 10.1097/moo.0000000000000986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
PURPOSE OF REVIEW The use of piezoelectric instrumentation is increasingly recognized as an alternative to traditional bone-cutting techniques across a wide array of surgeries. Here, we provide an overview of the technique, including device principles, benefits, and drawbacks. We also review its use in craniofacial surgery. RECENT FINDINGS Piezoelectric surgery is a minimally invasive bone-cutting system with lower risk of damage to surrounding soft tissue structures. Indications for its use are rapidly expanding across multiple fields, including craniofacial surgery. To date, piezosurgical techniques have been most widely adopted and studied in the contexts of rhinoplasty, orthognathic surgery, and cranioplasty in craniosynostosis. Piezosurgery can facilitate more precise and consistent osteotomies while decreasing morbidities associated with traditional osteotomy techniques. Primary limitations include cost and concerns regarding increased operative times secondary to operator learning curves and decreased cutting efficiency. SUMMARY Piezoelectric surgery represents an alternative to traditional bone-cutting modalities to improve precision, consistency, and safety of osteotomies. Further research is needed to better understand the efficacy of the technique as well as potential for additional applications.
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Affiliation(s)
- Sarah Bessen
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Shekhar K Gadkaree
- Department of Otolaryngology - Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Adeeb Derakhshan
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Loma Linda University, Loma Linda, California, USA
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Dura Haddad C, Andreatti L, Zelezetsky I, Porrelli D, Turco G, Bevilacqua L, Maglione M. Primary Stability of Implants Inserted into Polyurethane Blocks: Micro-CT and Analysis In Vitro. Bioengineering (Basel) 2024; 11:383. [PMID: 38671804 PMCID: PMC11048430 DOI: 10.3390/bioengineering11040383] [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: 03/01/2024] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The approach employed for the site preparation of the dental implant is a variable factor that affects the implant's primary stability and its ability to integrate with the surrounding bone. The main objective of this in vitro study is to evaluate the influence of different techniques used to prepare the implant site on the primary stability of the implant in two different densities of artificial bone. MATERIALS AND METHODS A total of 150 implant sites were prepared in rigid polyurethane blocks to simulate two distinct bone densities of 15 pounds per cubic foot (PCF) and 30 PCF, with a 1-mm-thick simulated cortex. The implant sites were equally distributed among piezoelectric surgery (PES), traditional drills (TD), and black ruby magnetic mallet inserts (MM). Two methods have been employed to evaluate the implant's primary stability, Osstell and micro-tomography. RESULTS In the present study, we observed significant variations in the implant stability quotient (ISQ) values. More precisely, our findings indicate that the ISQ values were generally higher for 30 PCF compared to 15 PCF. In terms of the preparation technique, PES exhibited the greatest ISQ values, followed by MM, and finally TD. These findings corresponded for both bone densities of 30 PCF (PES 75.6 ± 1.73, MM 69.8 ± 1.91, and TD 65.8 ± 1.91) and 15 PCF (PES 72.3 ± 1.63, MM 62.4 ± 1.77, and TD 60.6 ± 1.81). By utilizing Micro-CT scans, we were able to determine the ratio of the implant occupation to the preparation site. Furthermore, we could calculate the maximum distance between the implant and the wall of the preparation site. The findings demonstrated that PES had a higher ratio of implant to preparation site occupation, followed by TD, and then the MM, at a bone density of 30 PCF (PES 96 ± 1.95, TD 94 ± 1.88, and MM 90.3 ± 2.11). Nevertheless, there were no statistically significant differences in the occupation ratio among these three approaches in the bone density of 15 PCF (PES 89.6 ± 1.22, TD 90 ± 1.31, and MM 88.4 ± 1.17). Regarding the maximum gap between the implant and the site preparation, the smallest gaps were seen when TD were used, followed by MM, and finally by PES, either in a bone density 15 PCF (PES 318 ± 21, TD 238 ± 17, and MM 301 ± 20 μm) or in a bone density 30 PCF (PES 299 ± 20, TD 221 ± 16, and MM 281 ± 19 μm). A statistical analysis using ANOVA revealed these differences to be significant, with p-values of < 0.05. CONCLUSION The outcomes of this study indicate that employing the PES technique and osteo-densification with MM during implant insertion may enhance the primary stability and increase the possibility of early implant loading.
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Affiliation(s)
- Chadi Dura Haddad
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell’Ospitale 1, 34129 Trieste, Italy; (C.D.H.); (L.A.); (I.Z.); (G.T.); (L.B.)
| | - Ludovica Andreatti
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell’Ospitale 1, 34129 Trieste, Italy; (C.D.H.); (L.A.); (I.Z.); (G.T.); (L.B.)
| | - Igor Zelezetsky
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell’Ospitale 1, 34129 Trieste, Italy; (C.D.H.); (L.A.); (I.Z.); (G.T.); (L.B.)
| | - Davide Porrelli
- Department of Life Sciences, University of Trieste, Via Alexander Fleming 31-B, 34127 Trieste, Italy;
| | - Gianluca Turco
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell’Ospitale 1, 34129 Trieste, Italy; (C.D.H.); (L.A.); (I.Z.); (G.T.); (L.B.)
| | - Lorenzo Bevilacqua
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell’Ospitale 1, 34129 Trieste, Italy; (C.D.H.); (L.A.); (I.Z.); (G.T.); (L.B.)
| | - Michele Maglione
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell’Ospitale 1, 34129 Trieste, Italy; (C.D.H.); (L.A.); (I.Z.); (G.T.); (L.B.)
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Martins L, Fagundes MSC, Koener HN, Fakih-Gomez N, D'Souza AR. The Fish Bone Technique: An Innovative Approach for the Bony Nasal Pyramid. Facial Plast Surg 2024; 40:93-100. [PMID: 37225140 DOI: 10.1055/a-2098-6366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Among many contributions to the world of art and science, Renaissance artist Leonardo da Vinci created the technique known as sfumato. In this technique, da Vinci considered that the regions to be highlighted should be lit up, while the regions to be hidden should be darkened. Drawing parallel with the face, we can work on the anatomical structures underlying the skin and create a favorable surface anatomy for the entire face, including the nose. However, to achieve the ideal hourglass shape of the nose, the bones must be shaped, and a variety of osteotomies are described and used to achieve this. The new and innovative Fish Bone technique, described in this article, allows for the bony nasal pyramid to be shaped and adapted to the hourglass shape, resulting in a harmonious contour, with smooth transitions and preservation airway.
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Affiliation(s)
- Lessandro Martins
- Brazilian Association of Otorhinolaryngology and Brazilian Academy of Facial Plastic Surgery, Private Office, Sao Paulo, Parana, Brazil
| | - Marina Serrato Coelho Fagundes
- Brazilian Association of Otorhinolaryngology and Brazilian Academy of Facial Plastic Surgery, Private Office, Sao Paulo, Parana, Brazil
| | - Heloisa Nardi Koener
- Brazilian Association of Otorhinolaryngology and Brazilian Academy of Facial Plastic Surgery, Private Office, Sao Paulo, Parana, Brazil
| | - Nabil Fakih-Gomez
- Department of Facial Plastic & Cranio-Maxillo-Facial Surgery, Fakih Hospital, Lebanon
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Marin E, Lanzutti A. Biomedical Applications of Titanium Alloys: A Comprehensive Review. MATERIALS (BASEL, SWITZERLAND) 2023; 17:114. [PMID: 38203968 PMCID: PMC10780041 DOI: 10.3390/ma17010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
Titanium alloys have emerged as the most successful metallic material to ever be applied in the field of biomedical engineering. This comprehensive review covers the history of titanium in medicine, the properties of titanium and its alloys, the production technologies used to produce biomedical implants, and the most common uses for titanium and its alloys, ranging from orthopedic implants to dental prosthetics and cardiovascular devices. At the core of this success lies the combination of machinability, mechanical strength, biocompatibility, and corrosion resistance. This unique combination of useful traits has positioned titanium alloys as an indispensable material for biomedical engineering applications, enabling safer, more durable, and more efficient treatments for patients affected by various kinds of pathologies. This review takes an in-depth journey into the inherent properties that define titanium alloys and which of them are advantageous for biomedical use. It explores their production techniques and the fabrication methodologies that are utilized to machine them into their final shape. The biomedical applications of titanium alloys are then categorized and described in detail, focusing on which specific advantages titanium alloys are present when compared to other materials. This review not only captures the current state of the art, but also explores the future possibilities and limitations of titanium alloys applied in the biomedical field.
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Affiliation(s)
- Elia Marin
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Kyoto 606-8585, Japan
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
- Department Polytechnic of Engineering and Architecture, University of Udine, 33100 Udine, Italy
- Biomedical Research Center, Kyoto Institute of Technology, Sakyo-ku, Kyoto 606-8585, Japan
| | - Alex Lanzutti
- Department Polytechnic of Engineering and Architecture, University of Udine, 33100 Udine, Italy
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Blagova B, Krastev D, Krastev N, Malinova L. Tissue changes and tissue reactivity following osteotomy by a conventional rotary device, an ultrasonic unit, and an Er: YAG laser - A comparative study in humans. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 125:101750. [PMID: 38142938 DOI: 10.1016/j.jormas.2023.101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/11/2023] [Accepted: 12/21/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION Innovative technologies from other fields of science are constantly being introduced in medicine. Research works on animals strongly confirm the belief in better results following ultrasound and laser surgery. The main conclusions are based on observations from different animal species, whose biological characteristics differ from those of humans. This requires scientific experiments to be performed and confirmed in humans. MATERIAL & METHODS Human mandible specimens harvested in vivo by a conventional low-speed rotary device, an ultrasonic unit, or an Er: YAG laser were studied and analyzed to compare their effects on bone morphology and tissue response following surgery. RESULTS The cutting surface of eighty biopsies was studied, as well the facial edema, pain levels, and jaw dysfunction were followed up in the same eighty patients from whom the slices were obtained. In the piezosurgery and drill groups, the borders exhibited irregular edges full of bone fragments and debris. Thermal alterations within the superficial surface in all bone samples were generally minimal. In all specimens, intact osteocytes were detectable away from the area of direct action of the bone-cutting device. It was established, that the reactive facial edema, pain levels, and jaw disfunction were with milder values following in vivo osteotomy by an ultrasonic unit and Er: YAG laser compared to the conventional drilling. Moreover, the recovery of the patients in these two groups was more pronounced. The observed tissue changes proved to affect the follow-up tissue reactions in the postoperative period (p ≤ 0.05). DISCUSSION Based on the established effects on human bone by its in vivo cutting, it can be concluded that laser and ultrasonic bone surgery was a superior alternative osteotomy method in humans to conventional drilling.
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Affiliation(s)
- Bistra Blagova
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, 2 Zdrave Str., Sofia 1431, Bulgaria.
| | - Dimo Krastev
- Medical College "Jordanka Filaretova", Medical University of Sofia, Bulgaria; Faculty of Public Health, Health Care and Sport, South-West University "Neofit Rilski", Blagoevgrad, Bulgaria
| | - Nikolay Krastev
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, 2 Zdrave Str., Sofia 1431, Bulgaria
| | - Lina Malinova
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, 2 Zdrave Str., Sofia 1431, Bulgaria
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Blagova B, Krastev D, Malinova L. Conventional drilling versus ultrasound and laser osteotomy in mandibular third molar surgery: A comparative study. Lasers Surg Med 2023; 55:862-870. [PMID: 37811576 DOI: 10.1002/lsm.23730] [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: 05/30/2023] [Revised: 08/13/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND There are few research works with in-depth studies and direct simultaneous comparisons of the effects on tissue reactions and patients' recovery following in vivo conventional drilling, ultrasound- and laser-assisted osteotomy in humans. OBJECTIVE The current study aims to compare bone cutting duration, pain, swelling, and trismus in patients following surgical mandible third molar extraction by bone removal using three different osteotomes-a conventional rotary device, an ultrasonic unit, and an Er:YAG laser. METHODS A prospective, randomized three-group comparative clinical trial was performed. As an experimental setting for the study, аn open mandible third molar surgery was chosen because osteotomy is included in its protocol. Patients were divided into three groups according to the used device for bone removal. Bone cutting time intraoperatively, facial swelling, trismus, and pain on the first, second, and third postoperative days were assessed. The statistical analyses were performed using the SPSS v. 17.0-Kolmogorov-Smirnov test, one-way ANOVA, Student's t-test, Mann-Whitney test, and χ2 test. Statistical results were considered significant at p < 0.05 (confidence interval of difference, 95% CI). RESULTS Eighty patients (34 males and 46 females with an average age of 25.18 years) were included in the study. The average time for bone removal by the conventional low-speed device (4.95 min), by the ultrasonic unit (5.13 min), and by the Er:YAG laser (9.00 min) differed significantly (p = 0.001). The mean postoperative facial swelling showed a marked difference between the groups (p < 0.05), in favor of the laser and piezo groups. The osteotome proved to influence pain intensity not only immediately after surgery (p = 0.002), but also during the followed-up period (p = 0.001), again in favor of the two above-mentioned groups. No association was found between trismus and the osteotome used by the followed-up patients (p > 0.05). CONCLUSION Bone-cutting mechanism and the biological influence of the laser beam and ultrasound on living tissues proved to be favorable factors for patients' pain levels and tissue swelling postoperatively independent of the longer osteotomy duration compared to conventional drilling.
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Affiliation(s)
- Bistra Blagova
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, Sofia, Bulgaria
| | - Dimo Krastev
- Medical College "Jordanka Filaretova", Medical University of Sofia, Sofia, Bulgaria
- Faculty of Public Health, Health Care and Sport, South-West University "Neofit Rilski", Blagoevgrad, Bulgaria
| | - Lina Malinova
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, Sofia, Bulgaria
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Toplu G, Altinel D, Evin ŞG, Yiğit E, Toplu SG, Serin M. Impact of Different Osteotomy Techniques on Bone Reserve in the Osteotomy Line in Sagittal Split Osteotomy: Experimental In Vitro Study in Caprine Mandible Model. J Craniofac Surg 2023; 34:e785-e788. [PMID: 37646346 DOI: 10.1097/scs.0000000000009656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/20/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE The objective of this study was to investigate of the effect of piezzo and conventional osteotomy techniques on bone reserve in the osteotomy line and comminuted fracture ratios that is able to compromise bone to bone contact negatively. METHODS Bilateral sagittal split ramus osteotomy was performed on 12 fresh male Thracian curly caprine mandible. In the first group (n: 12) osteotomies were performed with piezzo device. In the second group (n: 12) osteotomies were performed with micromotor and manual osteotomes. Operative time was measured. The number of comminuted fractures, length and width of the osteotomy, and the space between the osteotomy lines was evaluated from 3-dimensional computed tomography scans. RESULTS The mean value of procedure duration was 320.4±10.76 seconds for piezo osteotomy and 238.8±8.29 seconds for conventional micromotor ( P <0.0001). Number of comminuted fractures was 1.41±1.3 in piezoelectric group, 1.5±1.3 in conventional group and the difference was not statistically significant (p: 0,88). Osteotomy lengths and widths were 35.58±5.2, 2.196±1.9 and 36.23±5.05, 2.27±1.85 in the piezzo and conventional groups, respectively. (p lengths :0,75; p widths :0,92) The volume of the bony interface between the distal and proximal segments of the mandible after osteotomy was 166.3±184.2 mm 3 in the piezzo group and 163.5±129.3 mm 3 in the conventional group (p: 0,96). CONCLUSION The piezo surgery and the conventional osteotomy were found to be similar in terms of the gap between the distal and proximal mandible and the number of comminuted fractures. The duration to perform the conventional osteotomy was found to be shorter than the piezo surgery.
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Affiliation(s)
| | - Dinçer Altinel
- Health Sciences University, Istanbul Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery Department
| | - Şeyda Güray Evin
- Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery Department
| | - Enes Yiğit
- Health Sciences University, Istanbul Training and Research Hospital, Ear, Nose and Throat Department, Istanbul, Turkey
| | | | - Merdan Serin
- Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery Department
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Wang X, Kim BS, Zhang Z, Wang HC, Zhang Y, Chai G. Piezosurgery in hemifacial microsomia: a promising exemption from conventional peri-osteotomy suffering. Front Pediatr 2023; 11:1149710. [PMID: 37456572 PMCID: PMC10348876 DOI: 10.3389/fped.2023.1149710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Mandibular distraction osteogenesis, a recommended therapy for hemifacial microsomia, has brought much agony because of its traumatic procedures and peri-osteotomy complications. Our study aims to retrospectively compare piezoelectric osteotome with conventional reciprocal bone saw for hemifacial microsomia patients and validate its meliority in operability, surgical risks and patient outcomes. Methods All patients included underwent osteotomies conducted by either piezosurgery or bone saw. Information of intraoperative blood loss, operation duration, postoperative pain and complications was collected from patient files, ward round inspections and follow-ups. Results Among all 40 patients, 13 underwent piezo-osteotomy. Piezosurgery performed better than conventional reciprocal bone saw in decreasing intraoperative blood loss (p < 0.001) and operation duration (p = 0.030). No significant difference was found in hospitalization duration, total expenses or complication rates between two groups. There were positive relations between operation duration and intraoperative blood loss (p = 0.042), and between hospitalization duration and total expenses (p = 0.0096). Postoperative pain scores of both groups declined over time while the piezosurgery group had a statistically significant tendency (p = 0.006) to suffer less than the conventional group. Discussion Piezosurgery diminishes intraoperative blood loss, operative duration, and postoperative pain, making an alternative to conventional osteotomes to mitigate patients' and families' peri-osteotomy sufferings, and a more humane solution to HFM.
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Cicciù M, Pratella U, Fiorillo L, Bernardello F, Perillo F, Rapani A, Stacchi C, Lombardi T. Influence of buccal and palatal bone thickness on post-surgical marginal bone changes around implants placed in posterior maxilla: a multi-centre prospective study. BMC Oral Health 2023; 23:309. [PMID: 37217911 DOI: 10.1186/s12903-023-02991-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/26/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Numerous clinical variables may influence early marginal bone loss (EMBL), including surgical, prosthetic and host-related factors. Among them, bone crest width plays a crucial role: an adequate peri-implant bone envelope has a protective effect against the influence of the aforementioned factors on marginal bone stability. The aim of the present study was to investigate the influence of buccal and palatal bone thickness at the time of implant placement on EMBL during the submerged healing period. METHODS Patients presenting a single edentulism in the upper premolar area and requiring implant-supported rehabilitation were enrolled following inclusion and exclusion criteria. Internal connection implants (Twinfit, Dentaurum, Ispringen, Germany) were inserted after piezoelectric implant site preparation. Mid-facial and mid-palatal thickness and height of the peri-implant bone were measured immediately after implant placement (T0) with a periodontal probe and recorded to the nearest 0.5 mm. After 3 months of submerged healing (T1), implants were uncovered and measurements were repeated with the same protocol. Kruskal-Wallis test for independent samples was used to compare bone changes from T0 to T1. Multivariate linear regression models were built to assess the influence of different variables on buccal and palatal EMBL. RESULTS Ninety patients (50 females, 40 males, mean age 42.9 ± 15.1 years), treated with the insertion of 90 implants in maxillary premolar area, were included in the final analysis. Mean buccal and palatal bone thickness at T0 were 2.42 ± 0.64 mm and 1.31 ± 0.38 mm, respectively. Mean buccal and palatal bone thickness at T1 were 1.92 ± 0.71 mm and 0.87 ± 0.49 mm, respectively. Changes in both buccal and palatal thickness from T0 to T1 resulted statistically significant (p = 0.000). Changes in vertical bone levels from T0 to T1 resulted not significant both on buccal (mean vertical resorption 0.04 ± 0.14 mm; p = 0.479) and palatal side (mean vertical resorption 0.03 ± 0.11 mm; p = 0.737). Multivariate linear regression analysis showed a significant negative correlation between vertical bone resorption and bone thickness at T0 on both buccal and palatal side. CONCLUSION The present findings suggest that a bone envelope > 2 mm on the buccal side and > 1 mm on the palatal side may effectively prevent peri-implant vertical bone resorption following surgical trauma. TRIAL REGISTRATION The present study was retrospectively recorded in a public register of clinical trials ( www. CLINICALTRIALS gov - NCT05632172) on 30/11/2022.
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Affiliation(s)
- Marco Cicciù
- School of Dentistry, Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, 95124, Italy
| | | | - Luca Fiorillo
- School of Dentistry, Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, 95124, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, 80121, Italy
- School of Dentistry, Aldent University, Tirana, 1001, Albania
| | | | | | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, 34125, Italy.
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, 34125, Italy
| | - Teresa Lombardi
- Department of Health Sciences, Magna Graecia University, Catanzaro, 88100, Italy
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Battista MD, Kernitsky J, Exarchos E, Ohira T, Dibart S. Quantification and comparison of the regional acceleratory phenomenon in bone following piezosurgery or bur osteotomy: A pilot study in rats. Clin Exp Dent Res 2023; 9:66-74. [PMID: 36369743 PMCID: PMC9932235 DOI: 10.1002/cre2.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/OBJECTIVE The Regional Acceleratory Phenomenon (RAP) can be induced surgically via decortication (selective cortical penetrations) of bone to accelerate orthodontic tooth movement. Few studies have compared the impact and efficiency of different decortication methods to induce the RAP. The aim of this study was to determine if there is a significant difference in the intensity of the RAP induced by a surgical defect created either using a piezoelectric knife or a rotary bur. METHODS Twenty-two Sprague-Dawley rats were divided into two treatment groups (each n = 8) and a control group (n = 6). The treatment groups were subjected to transcortical penetrations (TP) of the right tibia using either a piezoelectric knife (PTP) or a rotary bur (BTP). The right tibias of the control group animals had reflection of tissues (SHAM) and the left legs were kept for comparison (INTACT). The animals were killed at 7 and 14 days after the operation in an equally distributed manner. Microcomputed tomography images were obtained and analyzed utilizing artificial intelligence for bone cortical porosity (Ct.Po) locally and regionally. RESULTS/CONCLUSION Regionally, TP using a PTP induced significantly (p < .05, Kruskal-Wallis test) more Ct.Po than BTP or INTACT for both the 7- and 14-day time points. PTP was not found to induce significantly more Ct.Po than SHAM at any time point. However, PTP induced significantly more Ct.Po than the INTACT group for each time point, while SHAM did not. The local analysis did not reveal any relevant significant differences between groups.
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Affiliation(s)
- Massimo Di Battista
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
| | - Jeremy Kernitsky
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
| | - Elias Exarchos
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
| | - Taisuke Ohira
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
| | - Serge Dibart
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
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Arakji H, Osman E, Aboelsaad N, Shokry M. Evaluation of implant site preparation with piezosurgery versus conventional drills in terms of operation time, implant stability and bone density (randomized controlled clinical trial- split mouth design). BMC Oral Health 2022; 22:567. [PMID: 36463145 PMCID: PMC9719637 DOI: 10.1186/s12903-022-02613-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The preparation of the implant bed has a major influence on the success rate and long-term survival of dental implants. Piezoelectric devices and special implant drilling inserts are now emerging to replace conventional drills showing improved bone response and healing around implants. The purpose of this study is to compare the piezoelectric inserts versus the traditional drills for implant site preparation. METHODS Twelve male patients who received a total of twenty-four dental implants have been selected to participate in this split-mouth clinical trial. Each patient received two implants; one installed after piezosurgery assisted osteotomy, while the contralateral side received the implant with the original drilling protocol. The timing of surgery, implant stability, and bone density around the installed dental implants have been evaluated during a follow-up period extended to 4 months. RESULTS a significant difference in terms of time of surgery (p < 0.005) and in implant stability at 4 months (p = 0.024) on the study side, while a non-statistical significance in terms of bone density was detected (p = 0.468). CONCLUSION The piezoelectric implant site drilling protocol seemed to be a reliable and repeatable technique. Despite the limited sample size and lengthier operative time, the piezoelectric inserts enhanced bone quality and implant stability. Clinical trial registration Current Controlled Trials (ClinicalTrials.gov) https://clinicaltrials.gov/ct2/show/NCT05512273 ; the date of registration: 23/08/2022. Retrospectively registered.
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Affiliation(s)
- Hani Arakji
- grid.18112.3b0000 0000 9884 2169Oral Surgical Sciences Department, Faculty of Dentistry, Beirut Arab University, Riad El Solh, P.O. Box 11-5020, Beirut, Lebanon
| | - Essam Osman
- grid.18112.3b0000 0000 9884 2169Oral Rehabilitation Sciences Department, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Nayer Aboelsaad
- grid.18112.3b0000 0000 9884 2169Oral Surgical Sciences Department, Faculty of Dentistry, Beirut Arab University, Riad El Solh, P.O. Box 11-5020, Beirut, Lebanon
| | - Mohamed Shokry
- grid.7155.60000 0001 2260 6941Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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12
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Honigmann P, Hofer M, Hirsch S, Morawska M, Müller‐Gerbl M, Thieringer FM, Coppo E. Cold ablation robot‐guided laser osteotomy in hand, wrist and forearm surgery—A feasibility study. Int J Med Robot 2022; 18:e2438. [PMID: 35770622 PMCID: PMC9541476 DOI: 10.1002/rcs.2438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 11/11/2022]
Abstract
Introduction Traditional bone surgery using saws and chisels is associated with direct contact of instruments with the bone causing friction, heat and pressure and hence, damaging the bone and the surrounding soft tissues. Method Cold ablation laser osteotomy offers new possibilities to perform corrective osteotomies in the field of bone surgery. We introduce the technology of navigated cold ablation robot‐guided laser osteotomy, present potential applications, and preliminary pre‐clinical cadaver test results in the field of hand‐, wrist‐ and forearm surgery. Results The cadaver tests showed first promising results for corrections in all planes and axes using different cutting patterns. Conclusion Cold ablation laser osteotomy seems to be a feasible new method to perform osteotomies in the field of hand‐, wrist‐ and forearm surgery. Primary osseous stability could be achieved using various cutting patterns which could lead to reduction of the amount of hardware required for osteosynthesis. Further tests are required to proof the latter and precision.
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Affiliation(s)
- Philipp Honigmann
- Hand and Peripheral Nerve Surgery Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) Bruderholz Switzerland
- Department of Biomedical Engineering Medical Additive Manufacturing Research Group (MAM) University of Basel Allschwil Switzerland
- Department of Biomedical Engineering and Physics Amsterdam UMC University of Amsterdam Amsterdam Movement Sciences Amsterdam The Netherlands
- Faculty of Medicine University of Basel Basel Switzerland
| | - Maximilian Hofer
- Department of Biomedical Engineering Medical Additive Manufacturing Research Group (MAM) University of Basel Allschwil Switzerland
- Faculty of Medicine University of Basel Basel Switzerland
| | | | | | - Magdalena Müller‐Gerbl
- Faculty of Medicine University of Basel Basel Switzerland
- Institute of Anatomy University Basel Basel Switzerland
| | - Florian M. Thieringer
- Department of Biomedical Engineering Medical Additive Manufacturing Research Group (MAM) University of Basel Allschwil Switzerland
- Faculty of Medicine University of Basel Basel Switzerland
- Department of Oral and Cranio‐Maxillofacial Surgery University Hospital Basel Basel Switzerland
| | - Enrico Coppo
- Hand and Peripheral Nerve Surgery Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) Bruderholz Switzerland
- Department of Biomedical Engineering Medical Additive Manufacturing Research Group (MAM) University of Basel Allschwil Switzerland
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Pandey V, Chandra J, Sequeira J. Piezosurgery Versus Conventional Method Alveoloplasty: A Comparative Study. J Maxillofac Oral Surg 2022; 21:1032-1037. [PMID: 36274873 PMCID: PMC9474792 DOI: 10.1007/s12663-022-01716-3] [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: 12/31/2021] [Accepted: 03/25/2022] [Indexed: 10/18/2022] Open
Abstract
Purpose The conventional alveoloplasty approach which uses manual equipment results in more resorption of the underlying alveolar ridge that makes denture prosthesis unstable. The goal of this study was to compare results of piezosurgery alveoloplasty to those of conventional alveoloplasty. Materials and Methods This was an in-vivo comparative study consisting of ten edentulous individuals who needed alveoloplasty due to bilateral bony projection. On one side, a conventional alveoloplasty was performed with a bone rongeur and bone file, whereas the contralateral side was treated with a piezosurgery unit. The clinical parameters were analyzed using SPSS version 21 software including operating time, postoperative pain evaluation on day 3 and a healing on day 7. Results There was a statistically significant difference between the two groups in terms of outcome variables such as operating time, pain and healing. The Conventional group has a lower mean of operating time, a higher mean rank of VAS and a lower mean rank of healing index compared to the piezosurgery group. Conclusion Piezosurgery alveoloplasty not only lowers postoperative patient discomfort but also preserves alveolar bone integrity by not disrupting soft and hard tissue architecture thus allowing faster tissue healing and easier prosthesis replacement in the future.
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Affiliation(s)
- V. Pandey
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College and Hospital, Yenepoya (Deemed to Be University), Deralakatte, Mangalore, Karnataka 575018 India
| | - J. Chandra
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College and Hospital, Yenepoya (Deemed to Be University), Deralakatte, Mangalore, Karnataka 575018 India
| | - J. Sequeira
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College and Hospital, Yenepoya (Deemed to Be University), Deralakatte, Mangalore, Karnataka 575018 India
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14
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Abdelazez AKH, Hany HED, El Din MEG, El Meregy MMM, Abdelhameed AMF, El-Kabany IM, Abdelraouf AM, Salah M, El Hadidi YN, El Abdien MDZ. The evaluation of the effect of performing guided lid surgery with enucleation of a cystic lesion; a case report. Int J Surg Case Rep 2022; 97:107385. [PMID: 35868132 PMCID: PMC9403024 DOI: 10.1016/j.ijscr.2022.107385] [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: 05/28/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Dentigerous cysts are benign odontogenic cysts of developmental origin. Enucleation and marsupialization are still considered the blueprint of cystic lesion treatment. CASE PRESENTATION A 23-year-old male patient presented complaining of a minimal swelling in his upper jaw with slight tenderness in his upper anterior teeth. Cone Beam Computed Tomography (CBCT) on the maxilla was requested. The cystic lesion was found to be minimally expansile with intact cortical plates of the maxilla in the affected area. The CBCT was used to fabricate a cutting guide to determine the exact location of the bony window to fully access the lesion. Root canal treatment was done for the affected non-vital teeth. The cuts were done using a piezo-electric device. Complete enucleation was done for the lesion followed by fixation of the cortical bone lid using micro-plates and screws. The case was followed up after 6 months for new bone deposition using CBCT and 1 week, 1 month, and 6 months postoperatively for postoperative pain using the Visual Analogue Scale (VAS). CLINICAL DISCUSSION Piezo-electric surgery was used due to the selective cutting merit to cut through bone while preserving the cystic lining intact. Lid surgery aims to maximize the volume of bone deposited in place of the defect by converting the cavity of the cystic lesion into a contained defect. CONCLUSION Guided lid surgery using a piezo-electric device could be a useful technique for cystic enucleation regarding the new bone formation and pain level.
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Affiliation(s)
- Aly Khaled Hussein Abdelazez
- Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Egypt,Faculty of Dentistry, Ain Shams University, Egypt,Corresponding author at: Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Egypt.
| | - Hossam El-Dien Hany
- Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Egypt,Faculty of Dentistry, Ain Shams University, Egypt
| | | | | | | | | | | | - Mohamed Salah
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Egypt
| | | | - Mohammed Diaa Zein El Abdien
- Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Egypt,Faculty of Dentistry, Ain Shams University, Egypt
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15
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Evaluation of the Iatrogenic Sciatic Nerve Injury following Double Pelvic Osteotomy Performed with Piezoelectric Cutting Tool in Dogs. Vet Sci 2022; 9:vetsci9060259. [PMID: 35737311 PMCID: PMC9228764 DOI: 10.3390/vetsci9060259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/12/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
(1) Background: The double pelvic osteotomy (DPO) is a prophylactic surgical procedure associated with 0.4% incidence of sciatic nerve injury. The piezoelectric cutting tool is a surgical device able to involve only mineralized tissue avoiding neurovascular tissue and other soft tissue. This study aimed to evaluate the sciatic nerve injury observed in dogs underwent iliac osteotomy performed using the piezoelectric cutting tool. (2) Methods: Dogs underwent DPO performed with piezoelectric cutting tool were included. Neurological assessment was performed 6 and 24 h after surgery and then repeated 12 days, 4 and 8 weeks after surgery. Temporary and or permanent sciatic nerve injury were recorded. (3) Results: 84 DPOs performed in fifty dogs were included. No temporary/permanent neurological disease associated with iatrogenic damage of the sciatic nerve were observed. (4) Conclusions: The iliac osteotomy performed with piezoelectric cutting tool was not associated to iatrogenic sciatic nerve injury.
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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.
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Schierano G, Baldi D, Peirone B, Mauthe von Degerfeld M, Navone R, Bragoni A, Colombo J, Autelli R, Muzio G. Biomolecular, Histological, Clinical, and Radiological Analyses of Dental Implant Bone Sites Prepared Using Magnetic Mallet Technology: A Pilot Study in Animals. MATERIALS 2021; 14:ma14226945. [PMID: 34832347 PMCID: PMC8618607 DOI: 10.3390/ma14226945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/05/2021] [Accepted: 11/12/2021] [Indexed: 02/07/2023]
Abstract
Background. A new instrumentation exploiting magneto-dynamic technology (mallet) proposed for implant site preparation was investigated. Methods. In the tibias of three minipigs, two sites were prepared by mallet and two by drill technique. Primary stability (ISQ) was detected after implant positioning (T0) and at 14 days (T14). X-rays and computed tomography were performed. At T14, bone samples were utilized for histological and biomolecular analyses. Results. In mallet sites, histological evaluations evidenced a significant increase in the newly formed bone, osteoblast number, and a smaller quantity of fibrous tissue. These results agree with the significant BMP-4 augmentation and the positive trend in other osteogenic factors (biological and radiological investigations). Major, albeit IL-10-controlled, inflammation was present. For both techniques, at T14 a significant ISQ increase was evidenced, but no significant difference was observed at T0 and T14 between the mallet and drill techniques. In mallet sites, lateral bone condensation was observed on computed tomography. Conclusions. Using biological, histological, clinical, and radiological analyses, this study first shows that the mallet technique is effective for implant site preparation. Based on its ability to cause osseocondensation and improve newly formed bone, mallet technology should be chosen in all clinical cases of poor bone quality.
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Affiliation(s)
- Gianmario Schierano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Via Nizza 230, 10126 Torino, Italy
- Correspondence: ; Tel.: +39-(0)11-6331531/1532; Fax: +39-(0)11-6331513
| | - Domenico Baldi
- Department of Surgical Science (DISC), Division of Prosthetic Dentistry, University of Genoa, 16132 Genoa, Italy; (D.B.); (J.C.)
| | - Bruno Peirone
- Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, Grugliasco, 10095 Torino, Italy; (B.P.); (M.M.v.D.)
| | - Mitzy Mauthe von Degerfeld
- Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, Grugliasco, 10095 Torino, Italy; (B.P.); (M.M.v.D.)
| | - Roberto Navone
- Department of Medical Science, University of Turin, Via Santena 5, 10126 Torino, Italy; (R.N.); (A.B.)
| | - Alberto Bragoni
- Department of Medical Science, University of Turin, Via Santena 5, 10126 Torino, Italy; (R.N.); (A.B.)
| | - Jacopo Colombo
- Department of Surgical Science (DISC), Division of Prosthetic Dentistry, University of Genoa, 16132 Genoa, Italy; (D.B.); (J.C.)
| | - Riccardo Autelli
- Department of Clinical and Biological Sciences, University of Turin, Corso Raffaello 30, 10125 Torino, Italy; (R.A.); (G.M.)
| | - Giuliana Muzio
- Department of Clinical and Biological Sciences, University of Turin, Corso Raffaello 30, 10125 Torino, Italy; (R.A.); (G.M.)
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18
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Martins M, Vieira WDA, Paranhos LR, Motta RHL, da Silva CEXDSR, Rodriguez C, Ramacciato JC. Comparison of piezosurgery and conventional rotary instruments in schneider's membrane sinus lifting: A pilot randomized trial. J Clin Exp Dent 2021; 13:e802-e808. [PMID: 34512920 PMCID: PMC8412807 DOI: 10.4317/jced.57953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/15/2021] [Indexed: 12/20/2022] Open
Abstract
Background The present study aimed to evaluate and compare the postoperative effects of the piezoelectric device and conventional rotary instruments in Schneider’s membrane sinus lifting procedure.
Material and Methods Twenty patients requiring bilateral maxillary bone graft augmentation in the posterior maxillary region were selected. Piezoelectric surgery was performed on one side and conventional surgery with a rotary diamond bur on the other. Postoperative pain, swelling, edema, and mouth opening were evaluated at one hour and two and seven days after the procedures. All variables were submitted to Friedman or Wilcoxon tests at a 5% significance level.
Results The comparison between groups showed that postoperative pain after one hour and two days was significantly lower (p< 0.05) in the piezoelectric device group. Regarding the edema, the results of both techniques were similar at all times assessed (p> 0.05). Piezosurgery was statistically associated (p< 0.05) with greater mouth opening only at the 48-hour evaluation.
Conclusions Osteotomy with a piezoelectric device causes less pain and greater mouth opening postoperatively compared with the conventional technique. Key words:Piezosurgery, sinus lift, edema, pain, rotative instruments.
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Affiliation(s)
| | - Walbert-de Andrade Vieira
- Department of Restorative Dentistry, Endodontics division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Luiz-Renato Paranhos
- Department of Community and Preventive Dentistry, School of Dentistry of Uberlândia, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Effect of the Piezoelectric Device on Intraoperative Hemorrhage Control and Quality of Life after Endodontic Microsurgery: A Randomized Clinical Study. J Endod 2021; 47:1052-1060. [DOI: 10.1016/j.joen.2021.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 11/17/2022]
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Rashad A, Schwan S, Nasirpour A, Schmitz I, Hanken H, Friedrich RE, Gosau M. Bone Micromorphology and Material Attrition After Sonic, Ultrasonic and Conventional Osteotomies. In Vivo 2021; 35:1499-1506. [PMID: 33910827 DOI: 10.21873/invivo.12402] [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: 02/25/2021] [Revised: 03/17/2021] [Accepted: 03/31/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Osteotomy as the first step in surgery, provides access to the field and its application could influence the outcome. Nowadays, the conventional burr reduction is being challenged by newer sonic and ultrasonic methods. We investigated the bone structural integrity and metal attrition residues both in bone and the irrigation fluid. MATERIALS AND METHODS Bovine ribs were cut using three methods. Bone cuts were studied using Environmental Scanning Electron Microscopy (ESEM) for tissue discrepancies and Scanning Electron Microscopy/Energy Dispersion X-Ray Microanalysis (SEM/EDX) for organic and inorganic debris. RESULTS Better preservation of bone architecture was seen in piezo and sono surgery while metal attrition was not conclusive (p>0.05). Unlike in bone analyses, both bur and ultrasonic osteotomies showed statistically significant higher median inorganic detection per analysis (p=0.021 and p=0.037, respectively). CONCLUSION Sono and piezo surgery proved to be less invasive while attrition properties were the same.
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Affiliation(s)
- Ashkan Rashad
- Department of Oral, Maxillofacial and Facial Plastic Surgery, RWTH Aachen University Hospital, Aachen, Germany.,Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Schwan
- Fraunhofer Institute for Microstructure of Materials and Systems (IMWS), Halle (Saale), Germany
| | - Alireza Nasirpour
- Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Inge Schmitz
- Department of Pathology, Ruhr University Bochum, Bochum, Germany
| | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Gabrić D, Aumiler D, Vuletić M, Gjorgievska E, Blašković M, Mladenov M, Pavlić V. Thermal Evaluation by Infrared Thermography Measurement of Osteotomies Performed with Er:YAG Laser, Piezosurgery and Surgical Drill-An Animal Study. MATERIALS 2021; 14:ma14113051. [PMID: 34205094 PMCID: PMC8199930 DOI: 10.3390/ma14113051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
The bone healing process following osteotomy may vary according to the type of surgical instrumentation. The aim of the present in vivo study was to determine thermal changes of the bone tissue following osteotomies performed by Er:YAG laser ablation in contact and non-contact modes, piezoelectric surgery, and surgical drill using an infrared thermographic camera. For each measurement, the temperature before the osteotomy-baseline (Tbase) and the maximal temperature measured during osteotomy (Tmax) were determined. Mean temperature (ΔT) values were calculated for each osteotomy technique. The significance of the difference of the registered temperature between groups was assessed by the ANOVA test for repeated measures. Mean baseline temperature (Tbase) was 27.9 ± 0.3 °C for contact Er:YAG laser, 29.9 ± 0.3 °C for non-contact Er:YAG laser, 29.4 ± 0.3 °C for piezosurgery, and 28.3 ± 0.3 °C for surgical drill. Mean maximum temperature (Tmax) was 29.9 ± 0.5 °C (ΔT = 1.9 ± 0.3 °C) for contact Er:YAG laser, 79.1 ± 4.6 °C (ΔT = 49.1 ± 4.4 °C) for non-contact Er:YAG laser, 29.1 ± 0.2 °C (ΔT = −0.2 ± 0.3 °C) for piezosurgery, and 27.3 ± 0.4 °C (ΔT = −0.9 ± 0.4 °C) for surgical drill. Statistically significant temperature changes were observed for the non-contact laser. The results of the study showed beneficial effects of the osteotomy performed by the Er:YAG laser used in the contact mode of working as well as for piezosurgery, reducing the potential overheating of the bone tissue as determined by means of infrared thermography.
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Affiliation(s)
- Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University Hospital Center, University of Zagreb, 10000 Zagreb, Croatia;
| | | | - Marko Vuletić
- Department of Oral Surgery, School of Dental Medicine, University Hospital Center, University of Zagreb, 10000 Zagreb, Croatia;
- Correspondence:
| | - Elizabeta Gjorgievska
- Department of Pediatric and Preventive Dentistry, Faculty of Dental Medicine, Ss. Cyril and Methodius University, 1000 Skopje, North Macedonia;
| | - Marko Blašković
- Department of Oral Surgery, Faculty of Dental Medicine, University Hospital Center, University of Rijeka, 51000 Rijeka, Croatia;
| | - Mitko Mladenov
- Faculty of Natural Sciences and Mathematics, Institute of Biology, Ss. Cyril and Methodius University, 1000 Skopje, North Macedonia;
| | - Verica Pavlić
- Department of Periodontology and Oral Medicine, Medical Faculty, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
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Role of rhBMP-7, Fibronectin, And Type I Collagen in Dental Implant Osseointegration Process: An Initial Pilot Study on Minipig Animals. MATERIALS 2021; 14:ma14092185. [PMID: 33923213 PMCID: PMC8123155 DOI: 10.3390/ma14092185] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 12/09/2022]
Abstract
Background: The biological factors involved in dental implant osseointegration need to be investigated to improve implant success. Methods: Twenty-four implants were inserted into the tibias of six minipigs. Bone samples were obtained at 7, 14, and 56 days. Biomolecular analyses evaluated mRNA of BMP-4, -7, Transforming Growth Factor-β2, Interleukin-1β, and Osteocalcin in sites treated with rhBMP-7, Type 1 Collagen, or Fibronectin (FN). Inflammation and osteogenesis were evaluated by histological analyses. Results: At 7 and 14 days, BMP-4 and BMP-7 increased in the sites prepared with rhBMP-7 and FN. BMP-7 remained greater at 56 days in rhBMP-7 and FN sites. BPM-4 at 7 and 14 days increased in Type 1 Collagen sites; BMP-7 increased from day 14. FN increased the TGF-β2 at all experimental times, whilst the rhBMP-7 only did so up to 7 days. IL-1β increased only in collagen-treated sites from 14 days. Osteocalcin was high in FN-treated sites. Neutrophilic granulocytes characterized the inflammatory infiltrate at 7 days, and mononuclear cells at 14 and 56 days. Conclusions: This initial pilot study, in a novel way, evidenced that Type 1 Collagen induced inflammation and did not stimulate bone production; conversely FN or rhBMP-7 showed neo-osteogenetic and anti-inflammatory properties when directly added into implant bone site.
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Godoy-Reina I, Moreu-Burgos G, González-Jaranay M. Stability and marginal bone loss in implants placed using piezoelectric osteotomy versus conventional drilling: systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2021; 26:e226-e237. [PMID: 33247573 PMCID: PMC7980295 DOI: 10.4317/medoral.24146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/28/2020] [Indexed: 12/30/2022] Open
Abstract
Background The main objective of this systematic review was to compare primary and secondary implant stability between placement with piezoelectric osteotomy and conventional drilling, comparing marginal bone losses as a secondary objective.
Material and Methods An electronic search was conducted using PubMed (MEDLINE), Scopus, and Cochrane Library (Wiley) databases, besides a manual search.
Results A total of 153 articles were retrieved, 39 from Pubmed, 44 from Scopus, and 70 from the Cochrane Library. After removing duplicates, 112 articles (1 from the manual search) were screened, and 9 were finally selected for qualitative and statistical analyses.
Conclusions Piezoelectric surgery is a predictable alternative to conventional drilling for dental implant placement. Medium/long-term survival rates and marginal bone losses are similar between piezoelectric osteotomy and conventional drilling, and there is no difference in ISQ values for primary stability. However, implants placed with ultrasound showed a lower decrease in implant stability quotient (ISQ) during the osseointegration period and a higher ISQ value for secondary stability. This study contributes further information on peri-implant bone tissue at 3 and 6 months after implant placement with piezoelectric osteotomy or conventional drilling and provides an updated meta-analysis of comparative studies. Key words:Piezosurgery, piezoelectric surgery, conventional drill, implant site preparation, dental implant, implant stability, marginal bone loss.
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Affiliation(s)
- I Godoy-Reina
- Department of Stomatology Faculty of Dentistry, University of Granada Campus Universitario de Cartuja Colegio Máximo s/n, E-18071 Granada, Spain +
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Costa DL, Thomé de Azevedo E, Przysiezny PE, Kluppel LE. Use of Lasers and Piezoelectric in Intraoral Surgery. Oral Maxillofac Surg Clin North Am 2021; 33:275-285. [PMID: 33518388 DOI: 10.1016/j.coms.2020.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Laser therapy has been delivering good results for more than 30 years. Therapeutic effects are seen due to its ability to stimulate cell proliferation, revascularization, cell regeneration, local microcirculation, and vascular permeability; leading to edema reduction and analgesic effects. The piezoelectric system has been used in several surgeries recently, following the trend of minimally invasive surgery. The system consists of crystals undergoing deformation when exposed to electric current, resulting in an oscillating movement with ultrasound frequency. In oral surgery it is used in orthognathic and temporomandibular joint procedures, alveolar corticotomies, tumor excision, bone grafts, third molars, and dental implants.
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Affiliation(s)
- Davani Latarullo Costa
- Oral and Maxillofacial Surgery, Faculdade ILAPEO, Rua Jacarezinho, 656 - Mercês, Curitiba, Paraná 80710-150, Brazil.
| | - Eduardo Thomé de Azevedo
- Oral and Maxillofacial Surgery, Faculdade ILAPEO, Rua Jacarezinho, 656 - Mercês, Curitiba, Paraná 80710-150, Brazil
| | - Paulo Eduardo Przysiezny
- Oral and Maxillofacial Surgery, Faculdade ILAPEO, Rua Jacarezinho, 656 - Mercês, Curitiba, Paraná 80710-150, Brazil
| | - Leandro Eduardo Kluppel
- Oral and Maxillofacial Surgery, Faculdade ILAPEO, Rua Jacarezinho, 656 - Mercês, Curitiba, Paraná 80710-150, Brazil
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Piezoelectric Cutting Devices for Osteotomy in Temporomandibular Joint Condylectomy. J Craniofac Surg 2020; 31:e800-e802. [PMID: 33136916 DOI: 10.1097/scs.0000000000006758] [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
Condylar hyperplasia is an alteration in mandibular growth that can cause facial asymmetry and occlusal changes that usually affect the aesthetics and function of patients. To date, condylectomy for its part remains a key part of the treatment. Although there are still controversies regarding the amount of bone to remove and the surgical approach, there are still other concerns, such as finding the benefit in terms of intraoperative safety and postoperative results with different cutting devices, including the use of piezoelectric, which is increasing its use in the maxillofacial field. This is why the main objective of this study is to compare the results found in medical records and databases of condylectomy procedures performed between 2017 and 2019 with different cutting devices.
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Bone Healing Evaluation Following Different Osteotomic Techniques in Animal Models: A Suitable Method for Clinical Insights. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10207165] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Osteotomy is a common step in oncological, reconstructive, and trauma surgery. Drilling and elevated temperature during osteotomy produce thermal osteonecrosis. Heat and associated mechanical damage during osteotomy can impair bone healing, with consequent failure of fracture fixation or dental implants. Several ex vivo studies on animal bone were recently focused on heating production during osteotomy with conventional drill and piezoelectric devices, particularly in endosseous dental implant sites. The current literature on bone drilling and osteotomic surface analysis is here reviewed and the dynamics of bone healing after osteotomy with traditional and piezoelectric devices are discussed. Moreover, the methodologies involved in the experimental osteotomy and clinical studies are compared, focusing on ex vivo and in vivo findings.
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Piezoelectric Implant Site Preparation: Influence of Handpiece Movements on Temperature Elevation. MATERIALS 2020; 13:ma13184072. [PMID: 32937785 PMCID: PMC7560358 DOI: 10.3390/ma13184072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/06/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022]
Abstract
Piezoelectric devices are widely used in oral surgical procedures, including implant site preparation. However, little is known about the influence of working movement on temperature elevation in bone. The aim of this study was to assess the effects of two different working cycles on temperature elevation during piezoelectric implant site preparation. Sixty osteotomies at a depth of 10 mm were performed on bone blocks of bovine ribs using a piezoelectric tip with external irrigation (IM1s, Mectron Medical Technology, Carasco, Italy). A mechanical positioning device was used to guarantee reproducible working and measuring conditions. Two different working cycles, of 4 and 6 s, respectively, were tested, including both longitudinal and rotational movements. Temperature was recorded in real time with a fiber optic thermometer and applied pressure was maintained under 150 g. For each test, the highest recorded temperature (Tmax) and the mean temperature recorded from 30 s before to 30 s after the highest recorded temperature (T±30) were extrapolated. Tests duration was also recorded. Both Tmax and T±30 were significantly higher in the '6 s cycles' group than the '4 s cycles' group (42.44 ± 7.3 °C vs. 37.24 ± 4.6 °C, p = 0.002; 37.24 ± 4.6 °C vs. 33.30 ± 3.3 °C, p = 0.003). Test duration was also significantly higher using 6 s cycles compared to 4 s cycles (143.17 ± 29.4 s vs. 119.80 ± 36.4 s, p = 0.002). The results of this study indicate that working cycles of 4 s effectively reduce heat generation and working time during piezoelectric implant site preparation.
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Fujiwara S, Kato S, Bengazi F, Urbizo Velez J, Tumedei M, Kotsu M, Botticelli D. Healing at implants installed in osteotomies prepared either with a piezoelectric device or drills: an experimental study in dogs. Oral Maxillofac Surg 2020; 25:65-73. [PMID: 32803459 DOI: 10.1007/s10006-020-00895-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/11/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare osseointegration and marginal bone level at implants placed in osteotomies prepared with either conventional drills or a piezoelectric device. MATERIAL AND METHODS Three months after the extraction of all mandibular premolars and first molars, two recipient sites were selected. The osteotomies were randomly prepared with either conventional drills (drill sites) or a piezoelectric device (piezoelectric sites). Implants were installed and a submerged healing was allowed. The animals were euthanized in groups of six after 4 and 8 weeks of healing. Biopsies were obtained for histological preparation. Coronal level of osseointegration (bone level) and bone-to-implant contact percentage (BIC%) were evaluated. RESULTS After 4 weeks of healing, the bone level was 0.6 ± 0.9 mm for the piezoelectric sites and 1.6 ± 0.7 mm for the drill sites (p = 0.173). After 8 weeks, the respective measures were 0.9 ± 0.3 mm and 1.0 ± 1.1 mm (p = 0.917). After 4 weeks of healing, a new bone apposed onto the implant surface was found at fractions of 54.9 ± 6.7% and 55.1 ± 16.6% for the piezoelectric and the drill sites, respectively (p = 0.674). The respective total bone fractions, including new and old bone, was 64.0 ± 4.8% and 63.4 ± 20.4% (p = 0.917). After 8 weeks, a new bone increased to 67.4 ± 6.7% and 62.9 ± 12.5% for the piezoelectric and the drill sites, respectively (p = 0.463). The respective total bone fractions were 70.4 ± 5.5% and 67.8 ± 12.1% (p = 0.753). CONCLUSIONS The use of a piezoelectric device for implant site preparation is a safe procedure that allows a proper integration since the early periods of healing similar to that observed using conventional drills.
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Affiliation(s)
| | - Shingo Kato
- ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, Italy
- , Nishinomiya City, Hyogo, Japan
| | - Franco Bengazi
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | | | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Mitsuo Kotsu
- ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, Italy
- , Suita City, Osaka, Japan
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Berton F, Pratella U, Motta Jones J, Lombardi T, Verardi S, Stacchi C. Letter to the editor. RE: Piezoelectric surgery versus conventional drilling for implant site preparation: A meta-analysis. J Prosthodont Res 2020; 64:517-518. [PMID: 32591134 DOI: 10.1016/j.jpor.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- F Berton
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - U Pratella
- President-Elect of International Piezoelectric Surgery Academy and Private Practice, Bologna, Italy
| | - J Motta Jones
- Vice-President of International Piezoelectric Surgery Academy and Humanitas University, Milano, Italy
| | - T Lombardi
- Secretary of International Piezoelectric Surgery Academy and Private Practice, Cassano allo Ionio, Italy
| | - S Verardi
- Treasurer of International Piezoelectric Surgery Academy and University of Washington, Seattle, United States
| | - C Stacchi
- President of International Piezoelectric Surgery Academy and Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Bone microRNA-21 as surgical stress parameter is associated with third molar postoperative discomfort. Clin Oral Investig 2020; 25:319-328. [PMID: 32495225 DOI: 10.1007/s00784-020-03366-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/20/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate an association between bone levels of inflammation/oxidative stress mediators and postoperative discomfort after third molar conventional or piezosurgery. MATERIAL AND METHODS Twenty-six subjects with bilaterally impacted mandibular third molars, who underwent either piezo or conventional surgery, were included in a split-mouth design study. MicroRNA-21 (miR-21) expression, interleukin-1 beta (IL-1β), and vascular endothelial growth factor (VEGF) proteins, as well as superoxide dismutase (SOD) activity in alveolar bone, were evaluated. Pain intensity, the first pain appearance, analgesic first use and total dose taken, trismus, and swelling were clinically recorded. RESULTS MiR-21 expression was higher while VEGF protein was lower in piezosurgery vs. conventional groups. The differences in IL-1β protein and SOD activity were not significant between groups. The pain intensity on the first day was significantly decreased in piezosurgery group. The first pain appearance and the first analgesic taken were reported sooner in conventional vs. piezosurgical group. Significantly pronounced trismus on the third day following conventional surgery was found. In conventional group, significantly increased trismus was observed on the third compared to the first postoperative day. MiR-21 showed significant correlation with the first pain appearance. CONCLUSION Delayed onset of less pronounced postoperative pain after piezosurgical vs. conventional extraction of impacted lower third molar was significantly associated with expression of bone miR-21. CLINICAL RELEVANCE Alveolar bone miR-21 may reflect surgical stress and is associated with third molar postoperative pain onset.
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Stacchi C, Barlone L, Rapani A, Berton F, Contardo L, Di Lenarda R. Modified Orthodontic Bone Stretching for Ankylosed Tooth Repositioning: A Case Report. Open Dent J 2020. [DOI: 10.2174/1874210602014010235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background:
Different approaches were proposed in the literature for the treatment of malpositioned ankylosed teeth. The present case report describes a modification of Orthodontic Bone Stretching Technique (OBS) for the repositioning of ankylosed teeth, consisting of dentoalveolar segmental osteotomies performed with piezoelectric instruments followed by orthodontic and orthopedic traction.
Case Report:
A 22-year-old female in good general health was referred by her orthodontist due to an infraoccluded and ankylosed maxillary upper left canine. Attempts of conventional and corticotomy-assisted orthodontic alignment of the tooth were previously performed with no success. After elevating a full-thickness flap, three osteotomies were performed by using piezoelectric inserts (Piezotome Cube, Acteon, Merignac, France). Mesial and distal cuts were full-thickness osteotomies, parallel to the long axis of the tooth, through the buccal and palatal cortical plates. The apical osseous incision was a horizontal corticotomy, involving only the buccal plate, and connecting the vertical osteotomies two millimetres over the apex of the tooth. Heavy orthodontic forces were immediately applied by using both dental and skeletal anchorage. The initial movement of the dentoalveolar segment was observed three weeks after surgery and case finishing has been completed in two months. At a one-year follow-up, the repositioned canine showed good periodontal conditions, no discoloration and positive pulp response to the electric test.
Conclusion:
Modified OBS technique was effective in repositioning an infraoccluded and ankylosed maxillary canine, providing satisfactory function and esthetics with short treatment time.
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Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series. Vet Sci 2020; 7:vetsci7020068. [PMID: 32456065 PMCID: PMC7357104 DOI: 10.3390/vetsci7020068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: To report the physical and technical principles, clinical applications, and outcomes of the minimal invasive piezoelectric osteotomy in a consecutive veterinary neurosurgical series. METHODS A series of 292 dogs and 32 cats underwent an osteotomy because a neurosurgical pathology performed with a Mectron Piezosurgery® bone scalpel (Mectron Medical Technology, Genoa, Italy) was retrospectively reviewed. Efficacy, precision, safety, and blood loss were evaluated intraoperatively by two different surgeons, on a case-by-case basis. Postoperative Rx and CT scans were used to assess the selectivity and precision of the osteotomy. A histological study on bony specimens at the osteotomized surface was carried out to evaluate the effects of piezoelectric cutting on the osteocytes and osteoblasts. All the patients underwent a six-months follow-up. A series of illustrative cases was reported. RESULTS All the osteotomies were clear-cut and precise. A complete sparing of soft and nervous tissues and vasculature was observed. The operative field was blood- and heat-free in all cases. A range of inserts, largely different in shape and length, were allowed to treat deep and difficult-to-reach sites. Two mechanical complications occurred. Average blood loss in dogs' group was 52, 47, and 56 mL for traumatic, degenerative, and neoplastic lesions, respectively, whereas it was 25 mL for traumatized cats. A fast recovery of functions was observed in most of the treated cases, early on, at the first sixth-month evaluation. Histology on bone flaps showed the presence of live osteocytes and osteoblasts at the osteotomized surface in 92% of cases. CONCLUSIONS Piezosurgery is based on the physical principle of the indirect piezo effect. Piezoelectric osteotomy is selective, effective, and safe in bone cutting during neurosurgical veterinary procedures. It can be considered a minimal invasive technique, as it is able to spare the neighboring soft tissues and neurovascular structures.
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Cicciù M, Stacchi C, Fiorillo L, Cervino G, Troiano G, Vercellotti T, Herford AS, Galindo-Moreno P, Di Lenarda R. Piezoelectric bone surgery for impacted lower third molar extraction compared with conventional rotary instruments: a systematic review, meta-analysis, and trial sequential analysis. Int J Oral Maxillofac Surg 2020; 50:121-131. [PMID: 32284166 DOI: 10.1016/j.ijom.2020.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/27/2020] [Accepted: 03/11/2020] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate whether piezoelectric bone surgery (PBS) for impacted lower third molar extraction reduces the surgical time and risk of intra- and postoperative complications in comparison with conventional rotary instruments. This meta-analysis followed the PRISMA guidelines and was registered in the PROSPERO database. The PubMed, Embase, Scopus, and OpenGrey databases were screened for articles published from January 1, 1990 to December 31, 2018. Selection criteria included randomized controlled trials (RCTs) comparing PBS with conventional rotary instruments for impacted lower third molar extraction and reporting any of the clinical outcomes (intra- and postoperative complications and duration of surgery) for both groups. A risk of bias assessment was performed using the Cochrane Collaboration tool. A meta-analysis was performed, and the power of the meta-analytic findings was assessed by trial sequential analysis (TSA). Strong evidence suggests that PBS prolongs the duration of surgery and low evidence suggests that PBS reduces postoperative morbidity (pain and trismus) in comparison with rotary instruments. Data were insufficient to determine whether PBS reduces neurological complications and postoperative swelling in comparison with burs.
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Affiliation(s)
- M Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - C Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - L Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy; Multidisciplinary Department of Medical, Surgical and Dental Specialities, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - G Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - T Vercellotti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - A S Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, California, USA
| | - P Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - R Di Lenarda
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Küçükkurt S, Değerliyurt K. Does Piezosurgery Decrease Patient Morbidity in Surgically Assisted Rapid Palatal Expansion Compared With Saw and Burrs? J Oral Maxillofac Surg 2020; 78:1019.e1-1019.e10. [PMID: 32112718 DOI: 10.1016/j.joms.2020.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE The present study compared the postoperative pain, edema, patient satisfaction, and operating time with the use of piezosurgery, a reciprocal microsaw, and conventional burrs in the surgically assisted rapid palatal expansion (SARPE) technique for the correction of transversal maxillary deficiency. The results of the present study may help clinicians minimize the postoperative complaints of patients after SARPE. PATIENTS AND METHODS The present randomized single-blind study included patients who had undergone SARPE with piezosurgery, a reciprocating microsaw, or conventional burrs. To determine the facial norms and postoperative facial edema, 4 anatomic distances were measured on the patients' face using the modified flexible ruler method. The mean facial edema score was determined to evaluate and compare the overall edema among the groups. Two separate visual analog scales were used to assess patients' postoperative pain and intraoperative satisfaction. The duration of the osteotomies was recorded. Intragroup data were statistically analyzed via a t test, and intergroup data were analyzed via a nonparametric Kruskal-Wallis test. Spearman's correlation was used to evaluate the relationships among the variables. RESULTS For the 80 patients, edema (second day: piezosurgery, 0.53 ± 0.34; microsaw, 0.61 ± 0.30; burrs, 0.94 ± 0.33; P < .001) and pain (piezosurgery, 2.3 ± 0.3; microsaw, 3.6 ± 0.4; burrs, 3.9 ± 0.6; P < .001) were greater for conventional burrs and microsaws, with statistically significant differences. Patient satisfaction (piezosurgery, 8.3 ± 0.3; microsaw, 5.5 ± 0.5; burrs, 5.1 ± 0.9; P < .001) was greater with piezosurgery. However, in the piezosurgery group, the duration of osteotomies was 50% greater (piezosurgery, 16.10 ± 3.30; microsaw, 11.05 ± 2.09; burrs, 11.2 ± 2.14; P < .001). CONCLUSIONS The results from the present study have shown that piezosurgery is an effective method for minimizing facial edema and patient morbidity and increasing patient satisfaction during SARPE. Moreover, the use of conventional burrs and microsaws prolonged the duration of facial edema.
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Affiliation(s)
- Sercan Küçükkurt
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Aydın University, Istanbul, Turkey.
| | - K Değerliyurt
- Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Aydın University, Istanbul, Turkey
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Baldi D, Colombo J, Schierano G, Carossa S, Rebaudi A, Pesce P, Pera P. Piezoelectric implant surgery and immediate loading in the aesthetic zone. MINERVA STOMATOLOGICA 2019; 68:217-225. [PMID: 31822045 DOI: 10.23736/s0026-4970.19.04281-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Replacement of missing teeth in the anterior aesthetic zone has challenged clinicians with fixed, removable or implant prosthodontics. Problems have been encountered could void aesthetic and functional results. The aim of this study was to present a clinical case report in which clinician challenged a very strong aesthetic case with an innovative surgical and prosthetic approach. METHODS A patient who presented to the authors with a maxillary central incisor that had a hopeless prognosis secondary to acute localized severe periodontitis. The patient was treated by extracting the tooth and replacing it immediately with a platform switched implant using piezoelectric surgery. The implant was then restored with an immediate, non-occlusal loading provisional restoration. RESULTS The implant became osseointegrated and was ultimately restored with a definitive abutment and crown restoration. CONCLUSIONS Innovative approaches could represent a valid alternative to restore patients functionally and aesthetically.
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Affiliation(s)
- Domenico Baldi
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | | | - Gianmario Schierano
- Department of Surgical Science, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Stefano Carossa
- Department of Surgical Science, C.I.R. Dental School, University of Turin, Turin, Italy
| | | | - Paolo Pesce
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Paolo Pera
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
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Stacchi C, De Biasi M, Torelli L, Robiony M, Di Lenarda R, Angerame D. Primary Stability of Short Implants Inserted Using Piezoelectric or Drilling Systems: An In Vitro Comparison. J ORAL IMPLANTOL 2019; 45:259-266. [PMID: 31532728 DOI: 10.1563/aaid-joi-18-00157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The primary objective of the present in vitro study was to evaluate the influence of implant site preparation technique (drills vs ultrasonic instrumentation) on the primary stability of short dental implants with two different designs inserted in simulated low-quality cancellous bone. Eighty implant sites were prepared in custom-made solid rigid polyurethane blocks with two different low cancellous bone densities (5 or 15 pounds per cubic foot [PCF]), equally distributed between piezoelectric (Surgysonic Moto, Esacrom, Italy) and conventional drilling techniques. Two short implant systems (Prama and Syra, Sweden & Martina) were tested by inserting 40 fixtures of each system (both 6.0 mm length and 5.0 mm diameter), divided in the four subgroups (drills/5 PCF density; drills/15 PCF density; piezo/5 PCF density; piezo/15 PCF density). Insertion torque (Ncm), implant stability quotient values, removal torque (Ncm), and surgical time were recorded. Data were analyzed by 3-way ANOVA and Scheffé's test (α = 0.05). With slight variations among the considered dependent variables, overall high primary implant stability was observed across all subgroups. Piezoelectric instrumentation allowed for comparable or slightly superior primary stability in comparison with the drilling procedures in both implant systems. The Prama implants group showed the highest mean reverse torque and Syra implants the highest implant stability quotient values. Piezoelectric implant site preparation took prolonged operative time compared to conventional preparation with drills; among the drilling procedures, Syra system required fewer surgical steps and shorter operative time.
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Affiliation(s)
- Claudio Stacchi
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Matteo De Biasi
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Lucio Torelli
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Massimo Robiony
- Department of Biomedicine, University of Udine, Udine, Italy
| | - Roberto Di Lenarda
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Daniele Angerame
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Observational Study on the Preparation of the Implant Site with Piezosurgery vs. Drill: Comparison between the Two Methods in terms of Postoperative Pain, Surgical Times, and Operational Advantages. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8483658. [PMID: 31662998 PMCID: PMC6791234 DOI: 10.1155/2019/8483658] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/09/2019] [Accepted: 09/12/2019] [Indexed: 11/17/2022]
Abstract
Purpose Recent advances show that ultrasonic implant site osteotomy is related to a decreased trauma and a better postoperative healing of the surgical site when compared to traditional drilling techniques. The micrometric bone cutting control and the operative advantages related to the piezoelectric approach are also characterized by a learning curve for the clinician in surgical practice and an increased operative duration of the procedure. The aim of this investigation is to compare the operative time, the postoperative pain, and the amount of painkillers taken by the patient during the healing period. Methods A total of 65 patients were treated at the Unit of Oral Surgery (Department of Medical Sciences, Surgery and Health, University of Trieste, Italy) using a split mouth model: 75 drill-inserted implants (G1) and 75 piezoelectric device-inserted implants (G2) were placed. The Visual Analogue Scale (VAS) was performed to evaluate the postoperative pain at 15 days from surgery. The operative time and frequency of intake of painkillers were measured. Results The G1 and G2 groups showed a significant difference with a higher use of painkillers observed for G1. The G2 patients showed a lower level of pain (VAS) at all experimental times between 8 hours to 7 days (p < 0.01) postsurgery. At 15 days, the pain levels were similar for both groups. No differences were found in site preparation duration between the study groups. Conclusions The evidence supports the application of the piezoelectric approach compared to the drill's osteotomy as a useful technique for implant site preparation. This trial is registered with NCT03978923.
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Jundt JS, Marchena JM, Hanna I, Dhanda J, Breit MJ, Perry AP. Evolving Technologies for Tissue Cutting. Oral Maxillofac Surg Clin North Am 2019; 31:549-559. [PMID: 31481290 DOI: 10.1016/j.coms.2019.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This article reviews evolving and lesser known technologies for tissue cutting and their application in oral and maxillofacial surgery.
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Affiliation(s)
- Jonathon S Jundt
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6100, Houston, TX 77054, USA.
| | - Jose M Marchena
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6100, Houston, TX 77054, USA; Ben Taub Hospital, Houston, TX, USA
| | - Issa Hanna
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6100, Houston, TX 77054, USA; Lyndon B. Johnson Hospital, Houston, TX, USA
| | - Jagtar Dhanda
- Maxillofacial/Head and Neck Surgery, Queen Victoria Hospital, Holtye Road, East Grinstead RH19 3DZ, UK
| | - Matthew J Breit
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6100, Houston, TX 77054, USA
| | - Andrew P Perry
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6100, Houston, TX 77054, USA
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In vitro proinflammatory gene expression changes in human whole blood after contact with plasma-treated implant surfaces. J Craniomaxillofac Surg 2019; 47:1255-1261. [DOI: 10.1016/j.jcms.2019.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 04/28/2019] [Accepted: 05/06/2019] [Indexed: 11/18/2022] Open
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40
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Patil C, Jadhav A, K R, Bhola N, Borle RM, Mishra A. "Piezosurgery vs bur in impacted mandibular third molar surgery: Evaluation of postoperative sequelae". J Oral Biol Craniofac Res 2019; 9:259-262. [PMID: 31249772 DOI: 10.1016/j.jobcr.2019.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/30/2019] [Accepted: 06/08/2019] [Indexed: 11/15/2022] Open
Abstract
Purpose Piezosurgery is a relatively novel, precise and safe technique of ostectomy in the domain of oral and maxillofacial surgery. Our aim was to compare the inflammatory outcomes of osteotomy using piezosurgery and conventional bur in impacted mandibular third molar (IM3M) surgery. Subjects and method The study implemented a randomized, double-blind, crossover design. 120 sides in 60 patients were randomly allocated to the two interventions used, viz; conventional bur and piezosurgery. The primary outcome variables evaluated were facial swelling, trismus, pain, and paresthesia. Additionally, the duration of surgery and the frequency of soft tissue injuries with the use of two techniques were also evaluated. Results Pain, swelling, trismus, and soft tissue injuries emerged to be significantly higher with the use of bur as compared to the piezo. The duration of surgery was significantly extended in the piezo group and no significant difference was observed in the occurrence of paresthesia between the two groups. Conclusion The result suggests that piezosurgical osteotomy technique is superior to conventional bur in terms of the postoperative inflammatory outcomes in IM3M surgery.
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Affiliation(s)
- Chirag Patil
- Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, 442004, India
| | - Anendd Jadhav
- Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, 442004, India
| | - Rajanikanth K
- Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, 442004, India
| | - Nitin Bhola
- Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, 442004, India
| | - Rajiv M Borle
- Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, 442004, India
| | - Apoorva Mishra
- Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, 442004, India
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Noetzel N, Fienitz T, Kreppel M, Zirk M, Safi AF, Rothamel D. Osteotomy speed, heat development, and bone structure influence by various piezoelectric systems-an in vitro study. Clin Oral Investig 2019; 23:4029-4041. [PMID: 30826919 DOI: 10.1007/s00784-019-02838-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate osteotomy speed, heat development, and bone structure influence from osteotomies performed by various piezoelectric devices and insert tips. These devices and tips were compared among each other with regard to conventional rotatory and oscillating systems with special focus on the insert tip design and thickness. MATERIAL AND METHODS The osteotomies were conducted on porcine ribs utilizing 12 different insert tips (straight and angulated) and three conventional systems. After time and temperature measurements, histological analysis was carried out. Light microscopy was used to evaluate the roughness of the osteotomic surface and to search for indications of thermal bone necrosis. A special software analyzing tool was employed to determine cutting width (mm) and debris (%). RESULTS All piezoelectric tips created smooth cuts. Cutting widths in general were wider than the actual insert tip size with a tendency for narrow straight insert tips producing relatively wide osteotomies, whereas narrow angulated inserts produced relatively small osteotomies. None of the samples demonstrated distinct indication of necrosis. Overall, there was only a small amount of debris in all osteotomy gaps. Conventional rotatory saws were faster and created less heat compared to all tested piezoelectric systems. Straight tips proved faster osteotomy speed than angulated tips. Thin insert tips indicated to have a positive correlation to osteotomy time and performed faster than conventional microsaw. The average temperature rise was lower when using conventional systems, but critical exceeding temperatures were only observed in short-time exceptional cases. In general, temperature rise was less when using angulated inserts. CONCLUSION All tested tips are appropriate for bone surgery. Only small differences were found among the piezoelectric insert tips. Although conventional rotatory systems in general performed faster osteotomies, special designed and thin piezoelectric insert tips seem to have a positive influence on osteotomy speed. Ultimately, none of the tested devices or inserts combined all best features of speed, heat development, bone structure influence, and safety. CLINICAL RELEVANCE Narrow and straight piezoelectric insert tips demonstrated reduced osteotomy times. Nevertheless, a combination of conventional and piezoelectric systems in clinical practice might be the best way to work time-efficient, patient-oriented, and safe. The choice of instrument should be based on clinical experience of the user and should be evaluated individually depending on the case.
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Affiliation(s)
- Nicolas Noetzel
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Tim Fienitz
- Department for Oral and Maxillofacial Plastic Surgery, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Matthias Kreppel
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Matthias Zirk
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Ali- Farid Safi
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Daniel Rothamel
- Department for Oral and Maxillofacial Plastic Surgery, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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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]
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Piezoelectric Surgery in the Inferior Alveolar Nerve Lateralization With Simultaneous Implant Placement: A Case Report. IMPLANT DENT 2019; 28:86-90. [PMID: 30624393 DOI: 10.1097/id.0000000000000855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this case report was to describe the inferior alveolar nerve (IAN) lateralization technique using the piezoelectric device for the posterior rehabilitation of an atrophic mandible with implants. The patient presented the absence of elements 35 and 36 associated with a vertical defect impairing the adequate dental implant placement without IAN damage. A full-thickness mucoperiosteal flap was raised, and a bone window was made with a piezoelectric device centralized on the IAN canal position. After dissection, the IAN was moved buccally with a sterile elastic strip. Morse cone 4.0 × 1.5-mm implants were inserted while the IAN remained retracted. At the 4-month follow-up, the screw-retained prosthesis was installed guaranteeing the recovering masticatory function. In conclusion, the case report showed that the IAN lateralization performed with an adequate surgical technique can be successfully indicated for longer implant placement in edentulous atrophic posterior mandible with no permanent neural damage.
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Tretto P, Fabris V, Cericato G, Sarkis-Onofre R, Bacchi A. Does the instrument used for the implant site preparation influence the bone–implant interface? A systematic review of clinical and animal studies. Int J Oral Maxillofac Surg 2019; 48:97-107. [DOI: 10.1016/j.ijom.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/27/2018] [Accepted: 04/09/2018] [Indexed: 12/13/2022]
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Gürkan A, Tekdal GP, Bostancı N, Belibasakis GN. Cytokine, chemokine, and growth factor levels in peri‐implant sulcus during wound healing and osseointegration after piezosurgical versus conventional implant site preparation: Randomized, controlled, split‐mouth trial. J Periodontol 2018; 90:616-626. [DOI: 10.1002/jper.18-0216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Ali Gürkan
- Department of PeriodontologySchool of Dentistry, Ege University Izmir Turkey
| | - Gözde Peker Tekdal
- Department of PeriodontologySchool of Dentistry, Ege University Izmir Turkey
- Department of PeriodontologyKarşıyaka Oral and Dental Health Center Izmir Turkey
| | - Nagihan Bostancı
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Stockholm Sweden
- Center of Dental MedicineUniversity of Zürich Zürich Switzerland
| | - Georgios N. Belibasakis
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Stockholm Sweden
- Center of Dental MedicineUniversity of Zürich Zürich Switzerland
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Scarano A, Carinci F, Lorusso F, Festa F, Bevilacqua L, Santos de Oliveira P, Maglione M. Ultrasonic vs Drill Implant Site Preparation: Post-Operative Pain Measurement Through VAS, Swelling and Crestal Bone Remodeling: A Randomized Clinical Study. MATERIALS 2018; 11:ma11122516. [PMID: 30544962 PMCID: PMC6316965 DOI: 10.3390/ma11122516] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 12/17/2022]
Abstract
Background: Piezosurgery is a surgical procedure that is able to perform osteotomies by a micrometric and selective cut of the bone tissue. The objective of this investigation was to evaluate two different techniques; an ultrasonic device, and a drill approach for implant site preparation. Methods: A total of fifty patients were recruited for the randomized clinical trial to receive dental implants for fixed prosthetic restoration in the posterior mandible and were allotted to two groups. In Group A the implant site was prepared following a drilling technique, while in Group B the implant site was prepared using an ultrasonic device; moreover, the operative duration was recorded. Postoperative pain and swelling were evaluated at 1, 2, 4, and 6 days. The crestal bone resorption was measured at 3 months from implant placement by a three-dimensional tomography evaluation. Results: The findings suggest that osteotomies performed by an ultrasonic device cause less pain and swelling. On the other hand, the piezoelectric preparation was characterized by a significative increase in the operative time. No statistical differences in crestal bone resorption were evident in the two different approaches. Conclusions: According to the outcome of the study, ultrasonic implant bed preparation can be used with success in implantology and could be considered a suitable alternative to traditional drilling techniques for dental fixture placement.
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Affiliation(s)
- Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences and CeSi Met, University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Francesco Carinci
- Department of Maxillofacial Surgery, University of Ferrara, 44121, Ferrara, Italy.
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences and CeSi Met, University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Felice Festa
- Department of Medical, Oral and Biotechnological Sciences and CeSi Met, University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Lorenzo Bevilacqua
- Department of Medical Sciences, University of Trieste, 34127, Trieste, Italy.
| | - Pablo Santos de Oliveira
- Department of Oral Implantology, Dental Research Division, College Ingà, UNINGÁ, Cachoeiro de Itapemirim 29312, Brazil.
| | - Michele Maglione
- Department of Medical Sciences, University of Trieste, 34127, Trieste, Italy.
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García-Moreno S, González-Serrano J, López-Pintor R, Pardal-Peláez B, Hernández G, Martínez-González J. Implant stability using piezoelectric bone surgery compared with conventional drilling: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 47:1453-1464. [DOI: 10.1016/j.ijom.2018.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 01/14/2023]
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Gomez JP, Giraldo L, Montoya D, Urrea M. Cortical Piezo-Puncture as a Minimally Invasive Method for Reducing MiniScrew Implant Insertion Torque: A Preliminary in vitro Study. APOS TRENDS IN ORTHODONTICS 2018. [DOI: 10.4103/apos.apos_53_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective
The objective of this study was to determine the effect of cortical piezo-puncture (CPP) on maximum insertion torque (MIT), maximum removal torque (MRT), and maximum axial load (MAL) during the insertion of self-drilling miniscrew implants (MSI), in an experimental model with proximal epiphysis of bovine tibia.
Materials and Methods
A comparative study was conducted using two groups of 20 self-drilling MSI inserted in intact bone (control group) and in bone with previous CPP (experimental group). MIT, MRT, and MAL of the 20 mini implants of each group were measured. Using SPSS software, Student’s t-test was applied to compare MIT and MRT and the U-test Mann–Whitney test was applied to compare MAL in both groups as well as Pearson and Spearman correlation.
Results
In the experimental group, average values of 12.85 (±4,32) Newton x centimeters (Ncm), 13.7 (±4,54) Ncm, and 22,474 (±895,95) gF for MIT, MRT, and MAL were found, respectively. In the control group, average values found for MIT, MRT, and MAL were 20.2 (±4,7) Ncm, 22.3 (±5,17) Ncm, and 4688,7 (±320,18) gF, respectively. Statistically significant differences were observed in MIT, MRT, and MAL between control and experimental groups (P < 0,001).
Conclusions
CPP before insertion of orthodontic MSI in bovine tibia significantly reduces MIT, MRT, and MAL.
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Affiliation(s)
| | | | | | - Miguel Urrea
- Private Practice, Implantology Pereira, Colombia
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Immediate Loading of Implant-Supported Single Crowns after Conventional and Ultrasonic Implant Site Preparation: A Multicenter Randomized Controlled Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6817154. [PMID: 30186865 PMCID: PMC6112219 DOI: 10.1155/2018/6817154] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/05/2018] [Indexed: 12/30/2022]
Abstract
Aim To compare implant survival rate and marginal bone loss (MBL) of immediately loaded single implants inserted by using ultrasonic implant site preparation (UISP) (test) and conventional rotary instrumentation (control). Methods Two single implants were inserted for each patient: after randomization, test site was prepared by using an ultrasonic device (Piezosurgery Touch, Mectron, Italy) and control site was prepared by using the drills of the selected implant system (Premium AZT, Sweden & Martina, Italy), until reaching a final diameter of 3 mm in both groups. Identical implants (3.8x11.5 mm) were inserted in all sites at crestal level. Impressions were taken and screwed resin single crowns with platform-switched provisional abutments were delivered with 48 hours. Periapical radiographs were taken at provisional crown insertion (T0), 6 months (T1) and one year (T2) after prosthetic loading to measure MBL. All data were tested for normality and subsequently analyzed by paired samples t-test and forward multiple linear regression. Results Forty-eight patients were treated in six centers with the insertion of ninety-six implants (48 test; 48 control). Four implants in four patients failed within the first six months of healing (two in test group; two in control group; no difference between groups). Forty patients (age 60.1±10.7 years; 22 female, 18 male) were included in the final analysis. Mean MBL after six months of loading was 1.39±1.03 mm in the test group and 1.42±1.16 mm in the control group (p>0.05) and after one year was 1.92±1.14 mm and 2.14±1.55 mm in test and control, respectively (p>0.05). Conclusions No differences in survival rate and MBL were demonstrated between UISP and conventional site preparation with rotary instruments in immediately loaded dental implants: UISP, with its characteristics of enhanced surgical control and safety in proximity of delicate structures, may be used as a reliable alternative to the traditional drilling systems.
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Neurosensory Disturbances After Bilateral Sagittal Split Osteotomy Using Piezoelectric Surgery: A Systematic Review. J Oral Maxillofac Surg 2018; 77:380-390. [PMID: 30055164 DOI: 10.1016/j.joms.2018.06.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE The objective of the present systematic review was to test the hypothesis of no difference in neurosensory disturbances (NSDs) after bilateral sagittal split osteotomy (BSSO) with piezoelectric surgery compared with conventional techniques. MATERIALS AND METHODS A PubMed (Medline), Embase Library, and Cochrane Library search in combination with a manual search of relevant journals was conducted from January 2000 to November 2017. Randomized controlled trials and controlled trials in humans were considered. Primary outcome measures (assessment of neuro-sensitivity by subjective and objective evaluations) and secondary outcome measures (NSD risk factors, patient-reported outcome measures, complications, operating time, and intraoperative bleeding) were considered. RESULTS The search provided 241 studies of which 5 eligible studies were included. Meta-analysis was not possible because of considerable heterogeneity. Two studies were characterized by a moderate risk of bias and 3 were characterized by a high risk of bias. Piezoelectric surgery substantially decreased NSDs as evaluated by subjective tests. NSD after BSSO varied from 1.8 to 23.0% with piezoelectric surgery and from 7.3 to 52.0% with conventional techniques after 2 to 12 months. Furthermore, piezoelectric surgery seemed to considerably decrease the frequency of intraoperative bleeding in bimaxillary procedures and decrease the risk of an unfavorable split of the mandible and macroscopic damage of the inferior alveolar nerve. CONCLUSIONS The hypothesis of no difference in NSD after BSSO with piezoelectric surgery compared with conventional techniques could be neither confirmed nor rejected owing to insufficient knowledge. However, piezoelectric surgery seems to decrease the risk of NSDs after BSSO compared with conventional techniques. Long-term randomized controlled trials comparing the 2 treatment modalities by standardized subjective and objective electrophysiologic tests are needed before one treatment modality can be considered superior to another.
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