Rotatory Osteotomy Research Articles

Effect of Er:YAG Laser Exposure on the Amorphous Smear Layer in the Marginal Zone of the Osteotomy Site for Placement of Dental Screw Implants: A Histomorphological Study.

The placement of dental screw implants typically involves the use of rotary techniques and drills to create a bone bed. This study explores the potential benefits of combining this method with an Er:YAG laser. Split osteotomies were performed on 10 jaws of euthanized domestic pigs (Sus scrofa domestica), with 12 mandibular implant osteotomies in each jaw, divided into 4 groups. In order to make a comprehensive assessment of the effect of Er:YAG lasers, histomorphological techniques were used to measure the reduction in amorphous layer thickness after Er:YAG laser treatment, both with and without the placement of dental screw implants from different manufacturers. Following bone decalcification and staining, the thickness of the amorphous layer was measured in four groups: Group A-osteotomy performed without Er:YAG laser treatment-had amorphous layer thicknesses ranging from 21.813 to 222.13 µm; Group B-osteotomy performed with Er:YAG laser treatment-had amorphous layer thicknesses ranging from 6.08 to 64.64 µm; Group C-an implant placed in the bone without laser treatment-had amorphous layer thicknesses of 5.90 to 54.52 µm; and Group D-an implant placed after bone treatment with Er:YAG laser-had amorphous layer thicknesses of 1.29 to 7.98 µm. The examination and photomicrodocumentation was performed using a LEICA DM1000 LED microscope (Germany) and LAS V 4.8 software (Leica Application Suite V4, Leica Microsystems, Germany). When comparing group A to group B and group C to D, statistically significant differences were indicated (p-value = 0.000, p < 0.05). The study demonstrates the synergistic effects and the possibility of integrating lasers into the conventional implantation protocol. By applying our own method of biomodification, the smear layer formed during rotary osteotomy can be reduced using Er:YAG lasers. This reduction leads to a narrower peri-implant space and improved bone-to-implant contact, facilitating accelerated osseointegration.

A Pilot Randomized Controlled Clinical Trial Comparing Piezo Versus Conventional Rotary Surgery for Removal of Impacted Mandibular Third Molars.

Background: The extraction of impacted mandibular third molars is a frequent dental surgery, interfering with patients’ quality of life. Ultrasonic surgery is an alternative to osteotomy with conventional rotary instruments. This study compares postoperative signals and symptoms after extracting impacted mandibular third molars using ultrasonic surgery or conventional rotary osteotomy. Methods: A pilot randomized controlled clinical trial was conducted. Thirty patients were randomly divided into the test group (ultrasonic technique) and a control group (conventional rotatory technique). All surgeries were timed. Swelling parameters, trismus and paraesthesia were evaluated on the day of surgery and the third, fifth and seventh postoperative days. Intraoperative bleeding was evaluated during surgery. Postoperative pain was evaluated daily by the patient through a visual analogue scale and the number of ingested analgesics. Results: Pain, swelling and trismus present beneficial results with the ultrasonic technique but without statistical significance. Intraoperative bleeding was significantly lower with ultrasonic surgery (t(28) = 3.258; p = 0.003). Operating time was significantly higher in extractions involving osteotomy and cutting crown and roots either with the conventional technique (p = 0.020) or ultrasonic technique (p = 0.039). Regardless of the surgical difficulty, no statistically significant results were detected between techniques regarding the procedure duration. Conclusions: The beneficial postoperative signs and symptoms make ultrasonic surgery a favourable therapeutic option, especially when the integrity of noble anatomical structures is the most important risk factor. Further studies with larger samples are needed to support the use of piezosurgery as a valid option for impacted mandibular third molar extraction.

Comparison of the C-Reactive Protein Level and Visual Analog Scale Scores between Piezosurgery and Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction.

This study aimed to compare the C-reactive protein level and visual analog scale scores of piezo- and rotatory-based surgical extraction of the third molar. As a split-mouth study, the comparative groups consisted of 25 patients, each of whom underwent surgical removal of the third molar by piezo on one side and rotatory bur on the other side. C-reactive protein levels were quantitatively assessed (enzyme-linked immunosorbent assay) before and immediately post-extraction. The immediate postoperative blood sample (baseline) C-reactive protein levels were compared with 24 h and 72 h post-op samples, both within and between the groups. Pain was assessed using the visual analog scale at 24 h and 72 h post-operatively. The C-reactive protein levels were lower in the piezo group than in the rotatory group, although the difference was not significant (p > 0.05). The visual analog scale score was significantly (p < 0.01) lower in the piezo group than in the rotatory group. The C-reactive protein levels increased in both the rotary and piezo groups from the pre-op to the immediate post-op value, but in the piezo group, the levels dropped back after 24 h. On the contrary, in the rotatory group, the C-reactive level kept increasing until 24 h; the visual analog scale score dropped significantly from 24 to 72 h for both the rotatory and piezo groups. Surgical techniques that could spare the surrounding soft tissues, such as the piezo, could aid in reducing overall postoperative morbidity.

Treatment outcome of tardy ulnar nerve palsy associated with traumatic cubitus valgus by supracondylar shortening wedge rotary osteotomy and ulnar nerve in situ tension release

BackgroundTardy ulnar nerve palsy is a common late complication of traumatic cubitus valgus. At present, the treatment of tardy ulnar nerve palsy associated with traumatic cubitus valgus is still controversial, whether these two problems can be corrected safely and effectively in one operation is still unclear. To investigate the supracondylar shortening wedge rotary osteotomy combined with in situ tension release of the ulnar nerve in the treatment of tardy ulnar nerve palsy associated with traumatic cubitus valgus.MethodsBetween 2012 and 2019, 16 patients who had traumatic cubitus valgus deformities with tardy ulnar nerve palsy were treated with simultaneous supracondylar shortening wedge rotary osteotomy and ulnar nerve in situ tension release. we compared a series of indicators of preoperative and postoperative follow-up for at least 24 months, (1) elbow range of motion; (2) the radiographic correction of the preoperative and postoperative humerus-elbow-wrist angles; (3) the static two-point discrimination and grip strength; and (4) the preoperative and postoperative DASH scores of upper limb function. The minimum follow-up was 24 months postoperative (mean, 33 months; range, 24 ~ 44 months).ResultsThe mean ROM was improved from 107 ° preoperatively to 122 ° postoperatively (P = 0.001). The mean preoperative elbow wrist angle was 24.6 °, and the mean postoperative humerus-elbow wrist angle was 12.1 ° (P < 0.001). The average grip strength and static two-point discrimination improved from 21 kgf and 8 mm to 28 kgf and 4.0 mm (P < 0.001 and P < 0.001, respectively). The ulnar nerve symptoms were improved in all patients except one. The mean HASH score improved from 29 to 16 (P < 0.001).ConclusionSupracondylar shortening wedge rotary osteotomy combined with in situ tension release of ulnar nerve is an effective method for the treatment of traumatic cubitus valgus with tardy ulnar nerve palsy, which restored the normal biomechanical characteristics of the affected limb and improved the elbow joint function.

An ultrasonic osteotomy device enhanced post-osteotomy bone healing beyond that with a conventional rotary device in a rat calvarial model

ObjectiveUltrasonic osteotomy devices (UODs) are reported to have many clinical benefits; for example, they cause little damage to adjacent tissues in oral surgery. However, the difference in the tissue repair process between rotary osteotomy devices (RODs) and UODs is still unclear. This study aimed to compare bone healing after osteotomy with UODs versus RODs in a rat calvarial defect model. MethodsCalvarial bone defects were made in male Wistar rats with a UOD on the right side and an ROD on the left side. Bone and morphological changes were quantitatively evaluated for 4 weeks by micro-CT, light microscopy and electron microscopy. Furthermore, after calvarial bone osteotomy, osteoblastic cells were collected from the bone chips and cultured for 2 weeks, and their proliferation and differentiation activities were analysed. ResultsScanning electron microscopy (SEM) showed that UOD cuts had smoother surfaces than ROD cuts. In HE-stained sections and micro-CT images, the bone wound gap was closed earlier on the UOD side than on the ROD side. Bone thickness, the quantity of newly formed bone, and the number of osteocytes were greater on the UOD side than on the ROD side. Cultured osteoblast-like cells harvested from bone chips cut by the UOD had greater proliferative activity than those harvested from ROD-cut bone chips. ConclusionsThe use of a UOD may assist bone regeneration, presumably because osteoblasts differentiated from mesenchymal cells are activated by ultrasonic microvibration and because UODs cause less damage to the bone than conventional RODs.

APPLICATION OF PIEZOSURGERY IN EXTRACTION OF IMPACTED THIRD MOLARS

Removal of impacted permanent third molars is considered to be one of the most common and routine oral surgical procedures. This intervention is usually performed in the classical way with the use of rotatory &nbsp;instruments and burs. As an alternative to this classical approach, piezosurgery can be used, which is an osteotomy technique based on ultrasonic vibrations. The crucial advantage of piezosurgery is that it is inert to soft tissues. The aim of this study was to compare piezosurgery with the rotatory osteotomy technique, with particular reference to the time required to perform the intervention and the intensity of postoperative sequelae: pain, swelling, and trismus. This paper summarizes published experiences and knowledge of piezosurgery, with special regard to the extraction of mandibular third molars. For the purposes of this research, an automatic detailed search was performed on the electronic database PubMed for the period 2012-2022. Keywords used in the search were: piezosurgery, impacted third molars. The initial filtration resulted in 47 scientific papers, 17 of which met the selection criteria. Of particular interest were papers such as Meta-analyzes and systematic reviews. A review of the literature indicates that although patients undergoing piezosurgery required longer operating times, they had less postoperative pain, swelling, and trismus. Keywords: impacted molar, piezosurgery. &nbsp

Comparative Characteristics of Osteofixators in Treatment of Dogs with Cranial Cruciate Ligament Rupture

Cranial cruciate ligament rupture is one of the most common pathologies of the knee joint in dogs. It leads to greater knee flexion and subluxation of the tibia throughout the gait cycle, as well as to excessive internal rotation of the tibia during the standing phase. There are many works in domestic and foreign literature on the criteria for choosing the place of osteotomy and the angle of rotation of the osteotomized segment. However, information on the comparative assessment of fixation devices is not provided enough and there is no reliable information on the advantages and disadvantages of blocked compression and dynamic compression plates for osteofixation when performing rotary osteotomy. The process of remodeling of the proximal part of the tibia is completed in subgroup B2 by 45 days. In subgroup A2, in 50% of cases, and in subgroup B2 in 83.3% of cases, the 1st degree of lameness was noted 45 days after surgery. 60 days after surgery, no significant differences between the subgroups were found. The use of proximal tibia metaepiphysis in rotary osteotomy for dogs of medium and giant breeds of Synthes LCP clover leaf allows optimal osteofixation and stabilization of bone fragments, as well as reduction of rehabilitation time.

Randomized clinical study comparing Piezoelectric Surgery with conventional rotatory osteotomy in mandibular third molars surgeries

PurposeThe aim of this study was to evaluate the performance and to assess the postoperative sequel and quality of life after removal of impacted mandibular third molars using piezoelectric surgery compared with conventional rotatory osteotomy. Patients and methodsA single blinded, randomized, control clinical study was performed. Sixty-three patients (44 males, 19 females) who presented with bilaterally asymptomatic impacted mandibular third molars were included in this analysis. Each patient was treated, at two separate sessions approximately 4 weeks apart, with a conventional rotatory hand piece on one side of the mandible and a piezoelectric device on the contralateral side. Patients were followed up on postoperative days 1, 3, 5, 7, and 15 to rate the pain, swelling and trismus. Inferior alveolar nerve paresthesia was evaluated up to 12 months postoperatively. ResultsThe severity of the pain, trismus and swelling using the piezosurgery were significantly different from the rotary group. In both groups, pain was most intense and peaked during the first post-operative day, while swelling and trismus reached peak levels on the third postoperative day. The piezoelectric procedure resulted in a significantly longer procedural duration compared to the rotatory surgery (P < 0.001). ConclusionPiezoelectric surgery is considered a viable alternative technique compared to the conventional rotary systems and can improve a patient’s quality of life. Thus, piezoelectric surgery might be a preferred modality for patients undergoing complicated surgical extraction of impacted lower third molars.

Piezoelectric device versus conventional rotary osteotomy for the prevention of postoperative sequelae following surgical removal of mandibular third molars: a metaanalysis

Piezoelectric device versus conventional rotary osteotomy for the prevention of postoperative sequelae following surgical removal of mandibular third molars: a metaanalysis

Piezosurgery versus Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction.

Aim:The aim of this study is to compare piezoelectric surgery versus rotatory osteotomy technique in removal of mandibular impacted third molar.Materials and Methods:Sample size of 30 patients 18 males, 12 females with a mean age of 27.43 ± 5.27. Bilateral extractions were required in all patients. All the patients were randomly allocated to two groups in one group, namely control group, surgical extraction of mandibular third molar was done using conventional rotatory osteotomy and in the other group, namely test group, extraction of lower third molar was done using Piezotome.Results:Parameters assessed in this study were – mouth opening (interincisal opening), pain (visual analog scale VAS score), swelling, incidence of dry socket, paresthesia and duration of surgery in both groups at baseline, 1st, 3rd, and 7th postoperative day. Comparing both groups pain scores with (P < 0.05) a statistically significant difference was found between two groups. Mean surgical time was longer for piezosurgery group (51.40 ± 17.9) minutes compared to the conventional rotatory group with a mean of (37.33 ± 15.5) minutes showing a statistically significant difference (P = 0.002).Conclusion:The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient, and protection of tooth structures. Therefore, the piezoelectric device was efficient in decreasing the short-term outcomes of pain and swelling although taking longer duration than conventional rotatory technique it significantly reduces the associated postoperative sequelae of third molar surgery.

Evaluation of the Effects of Platelet-Rich Fibrin and Piezosurgery on Surgical Outcomes After Removal of Impacted Mandibular Third Molars

Introduction: We compared postoperative outcomes in impacted mandibular third molars that were treated using either platelet-rich fibrin (PRF), piezosurgery, a combination of PRF and piezosurgery, or conventional rotatory osteotomy.

Comparative morphological study of bone regeneration in different rabbit cranial osteotomies: traditional versus new generation osteotomes

The aim of this study was to compare the bone regeneration after skull surgery by means of different recent osteotomy devices, piezosurgery medical (PM) and piezosurgery medical plus (PMP), versus a conventional rotary osteotomy device (OT) in 16 adult white New Zealand rabbits. After 14 days from surgery, the recovery of different resulting bone gaps were observed under structural and TEM-ultrastructural analyses. Our preliminary observations showed that the minimum distance from the osteotomy edge, at which it is possible to observe viable osteocytes in the pre-existent bone, was lower in PMP samples (average 38.2µm) with respect to PM (65.7µm) and OT (83.4µm) ones. Moreover, the size of osteotomy gap performed with OT was about twice in thickness with respect to those obtained by PM and PMP. In relation to our previous investigations (1) on two different types of bone formation occurring in sequence (static and dynamic osteogenesis), we observed in the present study that in PM and PMP samples the osteotomy gap is in a more advanced step of recovery with respect to OT ones: in OT samples numerous cords of stationary osteoblasts, forming preliminary bony trabeculae, were observed in the regenerating newly-formed bone (step of static osteogenesis); whereas, in PM and PMP samples bony trabeculae appeared mostly covered by typical prismatic osteoblasts, arranged in movable laminae (advanced step of dynamic osteogenesis). By histomorphometry, in PM and PMP samples with respect to OT ones: i) values of the regenerated bone area with respect to the total osteotomy area (BV/TV%) are about twice; ii) the number of TRAP positive osteoclasts per linear surface showed a significant increase, suggesting higher bone remodelling. Concerning SEM analysis, in all samples the regenerated bone displays, as expected, higher cell density and less mineralized matrix with respect to the pre-existent bone, independently from the device used. In conclusion, our results indicate that osteotomies performed with PM and PMP can be considered equivalent and show more advanced stages of healing compared to OT, in part due to the lower osteotomy thickness in PM and PMP with respect to OT. This work was supported by grants from MECTRON 2013-15.

Piezoelectric Versus Conventional Rotary Techniques for Impacted Third Molar Extraction: A Meta-analysis of Randomized Controlled Trials.

Impacted third molars are frequently encountered in clinical work. Surgical removal of impacted third molars is often required to prevent clinical symptoms. Traditional rotary cutting instruments are potentially injurious, and piezosurgery, as a new osteotomy technique, has been introduced in oral and maxillofacial surgery. No consistent conclusion has been reached regarding whether this new technique is associated with fewer or less severe postoperative sequelae after third molar extraction.The aim of this study was to compare piezosurgery with rotary osteotomy techniques, with regard to surgery time and the severity of postoperative sequelae, including pain, swelling, and trismus.We conducted a systematic literature search in the Cochrane Library, PubMed, Embase, and Google Scholar.The eligibility criteria of this study included the following: the patients were clearly diagnosed as having impacted mandibular third molars; the patients underwent piezosurgery osteotomy, and in the control group rotary osteotomy techniques, for removing impacted third molars; the outcomes of interest include surgery time, trismus, swelling or pain; the studies are randomized controlled trials.We used random-effects models to calculate the difference in the outcomes, and the corresponding 95% confidence interval. We calculated the weighted mean difference if the trials used the same measurement, and a standardized mean difference if otherwise.A total of seven studies met the eligibility criteria and were included in our analysis. Compared with rotary osteotomy, patients undergoing piezosurgery experienced longer surgery time (mean difference 4.13 minutes, 95% confidence interval 2.75-5.52, P < 0.0001). Patients receiving the piezoelectric technique had less swelling at postoperative days 1, 3, 5, and 7 (all Ps ≤0.023). Additionally, there was a trend of less postoperative pain and trismus in the piezosurgery groups.The number of included randomized controlled trials and the sample size of each trial were relatively small, double blinding was not possible, and cost analysis was unavailable due to a lack of data.Our meta-analysis indicates that although patients undergoing piezosurgery experienced longer surgery time, they had less postoperative swelling, indicating that piezosurgery is a promising alternative technique for extraction of impacted third molars.

Is Erbium:Yttrium-Aluminum-Garnet Laser Versus Conventional Rotary Osteotomy Better in the Postoperative Period for Lower Third Molar Surgery? Randomized Split-Mouth Clinical Study

Lasers have been extensively used in dentistry for several applications. We investigated and compared the use of an erbium:yttrium-aluminum-garnet laser and conventional rotary instruments for bone removal in third molar surgery. We implemented a randomized, split-mouth clinical trial. Patients with bilateral and symmetrical third molar impaction referred to the Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, were enrolled in the study. Each patient was treated once with the erbium:yttrium-aluminum-garnet laser and once with conventional rotary instruments for bone removal during third molar surgery. Pain, swelling, and trismus were taken into account to match the 2 techniques.In addition, the times required to complete osteotomy and for the full operation were recorded. Descriptive and bivariate statistics were computed, and the P value was set at .05. The sample was composed of 15 patients (8 men and 7 women) ranging in age from 18 to 30 years. Pain perceived in the laser-treated group was significantly less than that in the conventional group(P = .0013). This also was true for trismus (P = .0002) and swelling. The operating time for osteotomy was longer in the laser group. The results of this study suggest that the laser could be an interesting alternative to conventional rotary instruments. Future studies with a larger number of patients are required to confirm the conclusions achieved from this work.

Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery: Relationships between surgical difficulty and postoperative pain with histological evaluations

PurposeTo investigate and compare the influence of surgical difficulty on postoperative pain after treatment of impacted mandibular third molars by rotatory osteotomy or Piezoelectric surgery. Materials and methodsA prospective, randomized, split-mouth study was performed of 52 patients with bilateral and symmetrically oriented impacted mandibular third molars, who were surgically treated using a burr (Group A) on one random side of the lower jaw and a Piezoelectric device (Group B) on the contralateral side. Surgical difficulty was evaluated using a modified version of the Parant scale to categorize “simple extractions” and “complex extractions”. Primary outcome parameters were the comparison of the postoperative pain evaluation rated on the Visual Analogue Scale from day 0 to day 6 postsurgery, and the assessment of differences in surgery time between the groups. Bone biopsies were taken during surgery to assess differences in bone tissue damage levels between the two different techniques. ResultsIn “complex extractions” lower pain evaluation and significantly shorter surgery times were recorded when rotatory instruments were used. In “simple extractions”, similar surgery times were observed for both techniques, but pain was greatest on the day of surgery when the burr was used. Bone heat osteonecrosis was observed only in the rotatory group and a high level of alkaline phosphatase was noted only in the Piezoelectric group. ConclusionPain after extraction of a mandibular third molar increases with increased surgical difficulty and especially in longer interventions. The integrity of the bony structure observed after the ultrasonic technique may favour the bone healing process.

Randomized clinical study comparing Er:YAG laser and conventional rotary osteotomy for the third molar extraction: Preliminary Study

Randomized clinical study comparing Er:YAG laser and conventional rotary osteotomy for the third molar extraction: Preliminary Study

Experimental and histological investigations of the bone using two different Oscillating Osteotomy techniques compared with conventional rotary osteotomy

Over the past decade, coinciding with the appearance of a number of new ultrasonic surgical devices, there has been a marked increase in interest in the use of ultrasound in oral surgery and implantology as alternative osteotomy method. The aim of this study was the comparison of the effect of osteotomies performed using ultrasonic surgery (Piezosurgery(®)), sonic surgery SONICflex(®) and the conventional bur method on the heat generation within the bone underneath the osteotomy and light-microscopy observations of the bone at different cutting positions in porcine mandibular segments. It was found that the average heat generated by SONICflex(®) sonic device was close to that by conventional rotary bur (1.54-2.29°C), whereas Piezosurgery(®) showed a high generated heat up to 18.17°C. Histological investigations of the bone matrix adjacent to the defect radius showed intact osteocytes with all three instruments and similar wide damage diameter at the bottom region. SONICflex(®) showed smooth cutting surfaces with minimal damage in the upper defect zone. Finally, presented results showed that sonic surgery performed with SONICflex(®) is an alternative osteotomy method and can be used as an alternative to the conventional bur method.

Tecnica osteotomica piezoelettrica e rotante nella chirurgia dei terzi molari inferiori inclusi: comparazione delle sequele postoperatorie

Objectives The aim of this study was to compare the outcomes of surgery for impaction of mandibular third molars performed with piezoelectric or high-speed rotatory osteotomy technique. Materials and methods One hundred fifty patients with impacted mandibular third molars were included in the study. Seventy-five were treated with a piezoelectric osteotomy technique (group A) and 75 patients were treated with high-speed rotatory osteotomy (group B). The treatment protocol was the same for both groups. Twenty-four hours after surgery, facial swelling and trismus were evaluated in both groups. Results Mean procedure duration was 22.65 minutes in group A and 17.56 minutes in group B. Mean facial swelling was 4.44 mm in group A and 6.67 mm in group B; trismus was 12.28 mm in group A and 17.28 mm in group B. Statistical analysis revealed significant reductions (p < 0.001) in postoperative facial swelling and trismus in group A, but the duration of the surgical procedure in this group was also significantly increased (p < 0.001 vs group A). Conclusions Compared with high-speed rotatory osteotomy, piezoelectric osteotomy produces less facial swelling and trismus 24 hours after surgery, but it also increases the duration of surgery.

Osteotomy for Lower Third Molar Germectomy: Randomized Prospective Crossover Clinical Study Comparing Piezosurgery and Conventional Rotatory Osteotomy

The aim of the present study was to compare piezoelectric surgery and conventional rotatory osteotomy for mandibular third molar germ extraction to determine the 2 methods' suitability and the postoperative outcomes. Mandibular third molar germectomy was performed bilaterally, randomly choosing 1 side for rotatory osteotomy (rotatory group) and the other for piezoelectric surgery (piezo group). The predictor variable was the duration of the surgical procedure. The outcome variables were the suitability of the method used, bleeding, and the postoperative parameters (ie, mouth opening range, clinical appearance of soft tissues, exudate, abscess, wound dehiscence, locoregional lymphadenopathy, pain on palpation at the extraction site, persistent edema) at 7 and 30 days postoperatively. The patients recorded their subjective postoperative pain daily for 7 days using a visual analog scale. The Wilcoxon rank-sum test and stepwise logistic regression model with binary variables were used for statistical analysis. A total of 26 patients (mean age 15.4 ± 1.29 years) were enrolled in the present study. The time needed to complete the osteotomy and extraction was significantly greater for the piezo group (15.77 ± 6.56 minutes) than for the rotatory group (11.77 ± 6.24 minutes; P = .028). No statistically significant differences emerged between the 2 methods for the other outcome variables considered. Piezoelectric osteotomy proved comparable to the rotatory method in terms of the surgeon's perception of the suitability of the 2 methods and the related postoperative sequelae. However, piezoelectric osteotomy took longer to complete than the rotatory method.

Mesenchymal stem cells cultured on tantalum used in early-stage avascular necrosis of the femoral head

Avascular necrosis of the femoral head (ANFH) is a common ailment characterized by necrosis of bone trabecular and bone marrow. It's mainly caused by the destruction of the blood supply in the femoral head and high rate of morbidity and disability is involved. Many methods have been tried including conservative treatment as drugs, electric stimulus, shock wave and electromagnetic field therapy and surgeries as core compression, rotary osteotomy and vascularized bone graft, but neither of them has definitive effect. Recently mesenchymal stem cells (MSCs) and tantalum robust have been widely used in ANFH. They have definite cure effects but advantages and disadvantages should not be neglected. In this paper, we hypothesize that mesenchymal stem cells cultured on tantalum can be used to prevent collapse of the articular surface in patients with ANFH. Unlike current treatment modalities, it would promote the regeneration of femoral head, provide structural support and allow for bony substitution over time.