Piezosurgery

By,
Prathusha.U
CRI
Department of public health dentistry
Chettinad dental college
CONTENTS
 Introduction
 Application Of Piezosurgery In Dentistry
 Piezosurgery In Orthodontics
 Piezosurgery In Endodontics
 Biological Effect Of Piezosurgery On Bone
 Ergonomics
 Advantages Of Piezosurgery
 Limitations Of Piezosurgery
 Conclusion
 References
 Introduction
 Piezosurgery (piezoelectric bone surgery)
devices were developed to cut bone
atraumatically using ultrasonic vibrations and
to provide an alternative to the mechanical
and electrical instruments used in
conventional oral surgery
Application in Orthodontics
Piezosurgery for surgically-assisted
rapid maxillary expansion

 Piezoelectric osteotome has found its role in

surgically assisted rapid maxillary expansion
(SARME), a procedure well established to correct
transverse maxillary discrepancies.
 The advantages include minimal risk to critical
anatomic structures.

Rana, Majeed et al. “Evaluation of surgically assisted rapid maxillary expansion with piezosurgery versus oscillating
saw and chisel osteotomy - a randomized prospective trial.” Trials vol. 14 49. 17 Feb. 2013
Evaluation of surgically assisted rapid maxillary expansion
with piezosurgery versus oscillating saw and chisel
osteotomy - a randomized prospective trial

Rana M, Gellrich NC, Rana M, Piffkó J, Kater W. Evaluation of surgically assisted rapid maxillary expansion with
piezosurgery versus oscillating saw and chisel osteotomy - a randomized prospective trial. Trials. 2013;14:49. Published
2013 Feb 17.
Piezosurgery for exposure of
palatally impacted canines

 Grenga and Bovi et al came up with the use of piezoelectric instrument which controls
bleeding during the surgical procedure, ensuring a dry field for bonding to the impacted
tooth and eliminating the need for gauze sponges or electrocoagulation.

Grenga, Vittorio and Mauro Bovi. “Piezoelectric surgery for exposure of palatally impacted canines.” Journal of clinical
orthodontics : JCO 38 8 (2004): 446-8 .
 Piezosurgery to accelerate tooth
movement

 Vercellotti and Podesta reported a reduction of

the orthodontic treatment time by 60 to 70%
after corticotomy performed by means of a
piezosurgical micro-saw.

Vercellotti T, Podesta A. Orthodontic microsurgery: a new surgically guided technique for dental movement. Int J
Periodontics Restorative Dent. 2007;27(4):325‐331.
Piezosurgery -assisted Periodontally Accelerated Osteogenic Orthodontics

Muhamad, Abu-Hussein & Watted, Nezar & Zere, Edlira & Borbély, Péter. (2016). Periodontally Accelerated Osteogenic Orthodontics
with Piezoelectric Surgery: A Case Report. IOSR Journal of Dental and Medical Sciences.
Piezoosteotomy in orthognathic
surgery
Piezoelectric distraction osteogenesis

 Piezosurgery is a very convenient device

through which it is possible to get direct
visibility over entire osteotomies. The only
minor limitation is the slightly longer time
required for the operation
APPLICATION IN ENDODONTICS
Bone-tissue Management

 Piezosurgery is useful when bone must be cut close

to important soft tissues, such as nerves, vessels, and
the dura mater, or when mechanical or thermal injury
must be avoided.
Enucleation of Radicular Cysts
 One important application of piezosurgery is in the
enucleation of radicular cysts.
 Diamond-coated inserts can be used to remove the bone
lamina over the cyst, whereas dull, bellshaped inserts can be
used for the dissection of the cyst epithelium from the bone
Root-end Resection
 Minimization of the bevel angle during root resection is one
of the most important developments in endodontic
microsurgery
 Resection of the entire root-end using burs , ultrasonic
systems, or lasers , with proper identification of anatomic
details, is fundamental.
Root-end Cavity Preparation
 Ultrasonic retrotips have shown many advantages over the
traditional handpiece used in surgical endodontics.
 The long axis of the tooth can be followed, thus preserving
canal morphology, and apical cavities can be shaped more
easily, safely, and with greater precision
 Diamond-coated retrotips produce quality root-end
preparations faster and more effectively than stainless steel
tips
https://www.youtube.com/watch?v=YhLw13oQrgA
Biological effects on bone

 The effects of mechanical instruments on the structure of bone

and the viability of cells are important in regenerative surgery.
 Piezosurgery not only selectively cuts the hard tissue but also
produces the haemostatic effect on the surrounding tissue .
 It can be applied in areas where bone is in close proximity to
vital and delicate structures such as nerves, blood vessels or the
sinus mucosa 

Agarwal, Esha et al. “Escalating role of piezosurgery in dental therapeutics.” Journal of clinical and diagnostic research :
JCDR vol. 8,10 (2014): ZE08-11. doi:10.7860/JCDR/2014/9161.4988
Stubingers, et al. Ultrasonic bone cutting in oral surgery: a review of 60 cases. UltraschallMed. 2008;29(1):66–71.
Ergonomics

 In piezoelectric surgery, the surgical handling required is

completely different from that used with the drills and
oscillating saws, as the piezoelectric cutting employs
microvibrations.
Advantages

 Piezoelectric bone surgery seems to be more efficient in the

first phases of bony healing
 It provides faster bone regeneration and healing process
 Great control of surgical device
 Selective cutting and minimal operative invasion
 Reduced traumatic stress
 Decreased postintervention pain, and
 No risk of emphysema.
Deepa D, Jain G, Bansal T. Piezosurgery in
dentistry. J Oral Res Rev 2016;8:27-31.
Disadvantages

 The main disadvantage is its slowness. Cutting very dense

bone with ultrasound can take up to 4 times longer than with a rotary bur
 Tip breakage can be frequent which makes it necessary to maintain a stock of
tips
 The cost of ultrasonic osteotomy equipment is more than mechanical
osteotomes
 Longer operating time and increasing the working pressure impedes the
vibration of device that transforms the vibrational energy into heat, so tissues
can be damaged,
 Moreover, the technique is difficult to learn.
Deepa D, Jain G, Bansal T. Piezosurgery in
dentistry. J Oral Res Rev 2016;8:27-31.
CONCLUSION

 Piezoelectric devices are an innovative ultrasonic technique

for safe and effective osteotomy or osteoplasty compared with
traditional hard and soft tissue methods
 Considering the advantages and disadvantages of this new
technology, the oscillating technology allows clinicians to
perform atraumatic bony surgery in operator-sensitive cases,
 Tharani A et al.2018, Application of Piezosurgery In
Periodontics And Implant Dentistry. Int J Recent Sci Res.
9(4),pp. 26291-26295.
 Almohaimeed, Mohammad. (2014). Piezosurgery in
surgically assisted orthodontic treatment. Life Science
Journal. 11. 141-144.
 Deepa D, Jain G, Bansal T. Piezosurgery in dentistry. J Oral
Res Rev 2016;8:27-31.
 Firoz Babu P, Polepalle T, Loya M, Mani Deepthi CH and
Nayyar AS. Piezosurgery: A Boon to Dentistry. J Dent App.
2016; 3(4): 365-369.
 Thind SK, Chatterjee A, Arshad F, Sandhu PS, Thind MS,
Nahin J. A clinical comparative evaluation of periodontally
accelerated osteogenic orthodontics with piezo and surgical
bur: An interdisciplinary approach. J Indian Soc Periodontol
2018;22:328-33.
 Abella F, de Ribot J, Doria G, Duran-Sindreu F, Roig M.
Applications of piezoelectric surgery in endodontic surgery: a
literature review. J Endod. 2014;40(3):325-332
 Agarwal, E., Masamatti, S. S., & Kumar, A. (2014).
Escalating role of piezosurgery in dental therapeutics. Journal
of clinical and diagnostic research : JCDR, 8(10), ZE08–
ZE11.