iDentistry The Journal identistry_may_aug2019 | Page 9

*Dr. Anita Mehta
**Dr. Nitin Khuller
***Dr. Ramandeep Singh Brar
****Dr. Deepti Vashisht
*****Dr. Simran Sandhu
The Journal
Piezosurgery : A New Era
Piezoelectric bone surgery or Piezosurgery is a technique of osteoplasty and osteotomy which
requires the use of microvibrations of ultrasonic frequency scalpels. The piezosurgery principle is
ultrasonic transduction which is obtained by piezoelectric ceramic contraction and expansion. The
vibrations obtained are amplified and transferred onto the insert of a drill which when rapidly applied 1 ,
with some pressure upon the bony tissue in the presence of irrigation with physiological solution in the
cavitation phenomenon with a mechanical cutting effect on the mineralized tissues. With
piezoelectric surgery, there is precise osteotomy lines, micrometric and curvilinear with absolute
confidence, particularly in close proximity to the vessels and nerves and important facial structures
2
like dura mater.
Key Words : Piezosurgery, dental implants
Introduction
piezoelectric bone surgery or Piezosurgery is a
technique of osteoplasty and osteotomy which
is based upon the use of ultrasonic (US)
frequency scalpels microvibrations. Principle of
Piezosurgery is based upon ultrasonic
transduction which is obtained by piezoelectric
ceramic expansion and contraction. 3 The
vibrations obtained are amplified and
transferred onto the insert of a drill which when
1
rapidly applied with some pressure upon the
bony tissue in the presence of irrigation with
physiological solution in the cavitation
phenomenon with a mechanical cutting effect
on the mineralized tissues.
Piezosurgery principles
Piezosurgery was invented and developed in
bone surgery to reach increasingly higher levels
of precision, safety and rapidity in recovery. In
1
1980’s, in odontostomatologic surgery this
device was used. First attempt in bone surgery,
showed good results in the cutting phase, 4 but
was not strong enough for performing
osteotomy in the presence of highly mineralized
bone or when thicker than 1 mm. Repeated
3
application of this instrument gave a cut, but
was associated with an excessive increase in
temperature, with the risk of subsequent bone
necrosis.
These limitations were overcome with the
development of piezosurgery. Piezosurgery
employs a instrument which is characterized by
a cutting power three times greater than that of
ultrasonic instruments currently in use. The
instrument transfers a significantly elevated
level of ultrasonic energy upon the bony
surfaces thus allowing osteotomy to be carried
out even when the bone is highly mineralized
and thick. 2-4 This system comprises a
piezoelectric device, with a functional
frequency of 25-29 kHz and the possibility of 30
Hz digital modulation and a series of inserts, of
different forms, with 60 to 200 μm linear
vibration.
Clinical applications
Piezosurgery offers the possibility of a cut with
the characteristics like it is
micrometric, the insert vibrates with a range of
60-200 μm at a modulated ultrasonic frequency
whilst cutting it maintains the bone constantly
clean, so avoid excessive temperature.
* Associate Professor, Department of Periodontology & Implantology, D.I.R.D.S, Affiliated with B.F.U.H.S, Faridkot, Punjab, India
** Prof and HOD, Department of Periodontology & Implantology, D.I.R.D.S, Affiliated with B.F.U.H.S, Faridkot, Punjab, India
*** Professor, Department of Oral & Maxillo facial Surgery, D.I.R.D.S, Affiliated with B.F.U.H.S, Faridkot, Punjab, India
****Associate Professor, Department of Oral & Maxillo facial Surgery, D.I.R.D.S, Affiliated with B.F.U.H.S, Faridkot, Punjab, India
*****Professor, Department of Endodontics & Conservative Dentistry, BRS Dental College and Hospital, Haryana, India
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Vol. 15
No. 2
May-Aug 2019