Review Article
Year: 2020 | Month: January-March | Volume: 5 | Issue: 1 | Pages: 121-129
Piezosurgery in Periodontics
Mithlesh Bhagat1, Roopali Tapashetti2, Ghousia Fatima3, Neha Bhutani2
1Post graduate student, 2Reader, 3HOD & Professor,
Department of Periodontics, Al Badar Rural Dental College and Hospital, Kalaburagi, Karnataka
Corresponding Author: Mithlesh Bhagat
ABSTRACT
Dental surgical techniques have been developed rapidly over the last two decades. In all these, one new surgical technique based on the novel application of the principle of piezoelectric ultrasonic vibration is introduced with wide range of applications in dentistry and periodontics. Ultrasonic vibrations have been used to cut tissue for two decades. However, it is only in the last five - six years that experimental applications have been used routinely for standard clinical applications in many different fields of surgery.1Until a few years ago, ultrasonic dental instruments were exclusively utilized for tooth scaling. Ultrasonic scalers are handheld devices which remove calculus and plaque on teeth through the vibrational movements of resonant inserts driven by magnetostrictive, or piezoelectric ultrasonic transducers.2
In the 1980’s use of devices employing ultrasonic (US) were well known for odontostomatologic surgery. The first attempts at using US equipment in bone surgery showed good results in the cutting phase, but was not strong enough for performing osteotomy in the presence of highly mineralized bone or when thicker than 1 mm. Repeated application of these instruments did effect a cut, but was associated with an excessive increase in temperature including the risk of subsequent bone necrosis.3 In the last decade, a novel family of power ultrasonic devices has been successfully created to dissect hard tissue in various maxillofacial operations. This revolutionary surgical technique, known as piezosurgery was invented by Professor Thomas Vercellotti in 1988 to overcome the limits of traditional instrumentation in oral bone surgery by modifying and improving conventional ultrasound techonology. It is a promising, meticulous and soft tissue sparing system for bone cutting, based on ultrasonic microvibrations.4 The Piezosurgery device consists of a novel piezoelectric ultrasonic transducer powered by an ultrasonic generator capable of driving a range of resonant cutting inserts. This innovative device is designed and commercialised by Mectron Medical Technology to overcome limits of traditional instruments and to reach increasingly higher levels of precision, safety and rapidity in recovery after bone surgery.2 Use of micromotors could be very dangerous in close proximity to delicate anatomical structures such as vessels and nerves. Also the traditional motorized instruments generate macrovibrations which reduce the surgical safety. The cutting action of the piezoelectric drill is the result of linear microvibrations of an ultrasound nature with a range of only 20-60 ɳm in a longitudinal direction with control of surgical procedures in all anatomical situations. So, Piezosurgery can be defined as a saw characterized by the versatility of a drill particularly in performing curvilinear osteotomies.3
This article thus aims to review Piezosurgery in Periodontics its mechanism of action, the instrument, its biologic effects on the bone, its advantages and limitations and its applications.
Keywords: Scaling, Root planning, Periodontal Surgery, Piezosurgery