Abstract
Abstract Introduction Piezoelectric device or piezosurgery device was originally developed for the atraumatic cutting of bone by way of ultrasonic vibrations and as an alternative to the mechanical and electrical instruments that are used in conventional oral surgery. Over the past two decades, an increasing amount of literature has shown that piezoelectric devices are innovative tools and that there is extensive indication of their use in dental implantology and oral and maxillofacial surgery. Recent publications have also shown the benefits of their use in craniofacial surgery, plastic and reconstructive surgery, head and neck surgery, neurosurgery, ophthalmology, traumatology, and orthopaedics. Key features of piezosurgery include the selective cutting of bone without damaging the adjacent soft tissue (e.g. vessels, nerves or mucosa), providing a clear visibility in the operating field, and cutting with micron sensitivity without the generation of heat. The cutting characteristics of piezosurgery are mainly depending upon the degree of bone mineralization, the design of the insert being used, the pressure being applied on the handpiece and the speed of movement during usage. Therefore, a novice user must know these factors and adapt their operating technique in order to utilize the advantages of piezosurgery. This critical review summarizes the basic operating principles of piezoelectric devices and outlines the application areas in oral and maxillofacial surgery that piezosurgery can be utilized supported by clinical examples. Conclusion Piezosurgery can create clear vision of the surgical area from pressurized irrigation and cavitation effect. Disadvantages can include large initial costs. The number of studies covering this topic is insufficient; thus, further research needs to be conducted to enable us to learn more and clarify any misconceptions.
Highlights
Piezoelectric device or piezosurgery device was originally developed for the atraumatic cutting of bone by way of ultrasonic vibrations and as an alternative to the mechanical and electrical instruments that are used in conventional oral surgery
The instruments that are being used for bone surgery have evolved to include motorized devices that can run on air pressure or electrical energy
Authors have argued that piezosurgery should take a place in the surgical armamentarium of a surgeon that deals with bone procedures
Summary
Most studies on the use of piezosurgery are case reports and clinical experiences of surgeons that rarely adhered to the recommendations of the International. This critical review reaches the same conclusion as of Pavlikova et al that sufficient clinical studies are not available at this point in time to perform a meaningful meta-analysis. The main advantages of piezosurgery in the oral and maxillofacial areas are:. Clear vision of the surgical area from the pressurized irrigation and cavitation effect. Piezosurgery provides the ease of harvesting intra- or extra-oral autogenous graft. Use in patients with pacemakers is not recommended. To gain experience with piezosurgery in the oral and maxillofacial areas, more practice time might be required for clinicians
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