Ağız, diş ve çene cerrahisinde piezoelektrik cerrahi aletlerinin kullanımı

Year 2019, , 596 - 601, 01.12.2019

Özgün Yıldırım , Mustafa Öztürk

https://doi.org/10.21601/ortadogutipdergisi.536945

Abstract

Piezoelektrik cerrahi, piezoelektrik ultrasonik titreşimler kullanarak güvenli ve etkili osteotomiler yapılmasını sağlayan nispeten yeni bir tekniktir, her geçen gün yeni özelliklere sahip cihazlar üretilip piyasaya sürülmektedir. Piezocerrahi aletleri, konvansiyonel döner cerrahi aletlerine göre üstün özelliklere sahiptir. Mikrometrik ve seçici kesim yapabilmesinden dolayı piezoelektrik cerrahi cihazı, kemik üzerinde nekrotik hasarlar vermeden güvenli ve hassas bir osteotomi sağlar. Geleneksel döner aletlere kıyasla en önemli özelliği, yumuşak doku ve kan desteğini koruyarak sadece mineralize dokular üzerinde çalışmasıdır. Operasyon alanında ve çevresindeki kemik harici sinir ve mukoza gibi yumuşak dokularla teması halinde bu dokulara zarar vermemektedir. Bu çalışmada tıbbın ortopedi ve beyin cerrahisi gibi birçok alanında olduğu gibi Ağız, Diş ve Çene Cerrahisi uygulamalarında da sıklıkla tercih edilen piezoelektrik cerrahi aletlerinin özellikleri, kullanım alanları, avantaj ve dezavantajları anlatılmıştır.

Keywords

ağız diş ve çene cerrahisi, diş hekimliği, piezoelektrik cerrahi

Using of piezoelectric surgical instruments in oral and maxillofacial surgery

Abstract

Piezoelectric surgery is a relatively new technique that provides safe and effective osteotomies using piezoelectric ultrasonic vibrations, and every day new devices with new features are produced and marketed. Piezosurgery instruments have superior properties compared to conventional rotary surgical instruments. Because of its micrometric and selective cutting, the piezoelectric surgery device provides a safe and sensitive osteotomy without causing necrotic damage to the bone. Compared to conventional rotary instruments, the most important feature is that it works only on mineralized tissues while maintaining soft tissue and blood support. It does not damage the tissues in contact with soft tissues such as the bone and mucous membranes in and around the operation area. In this study, properties, usage areas, advantages and disadvantages of piezoelectric surgical instruments which are frequently preferred in Oral, Dental and Maxillofacial Surgery applications as in many fields of orthopedics and brain surgery of medicine are explained.

Keywords

dentistry, oral and maxillofacial surgery, piezoelectric surgery

References

• Schaller BJ, Gruber R, Merten HA, ve ark. Piezoelectric bone surgery: a revolutionary technique for minimally invasive surgery in cranial base and spinal surgery. Technical note. Neurosurgery 2005; 57(4): 410.
• Vercellotti T, Nevins ML, Kim DM, ve ark. Osseous response following resective therapy with piezosurgery. Int J Periodontics Restorative Dent 2005; 25: 543-549.
• Sherman JA, Davies HT. Ultracision: the harmonic scalpel and its possible uses in maxillofacial surgery. Br J Oral Maxillofac Surg 2000; 38: 530-532.
• Horton JE, Tarpley TM Jr., Wood LD. The healing of surgical defects in alveolar bone products with ultrasonic instrumentation, chisel, and rotary bur. Oral Surg Oral Med Oral Pathol 1975; 39: 536-546.
• Vercelotti T. Piezoelectric surgery in implantology: a case report--a new piezoelectric ridge expansion technique. Int J Periodontics Restorative Dent. 2000; 20: 358-365.
• Robiony M, Polini F, Costa F, Zerman N, Politi M. Ultrasonic bone cutting for surgically assisted rapid maxillary expansion (SARME) under local anaesthesia. Int J Oral Maxillofac Surg 2007; 36: 267-269.
• Robiony M, Polini F, Costa F, Vercelotti T, Polliti M. Piezoelectric bone cutting in multipiece maxillary osteotomies. J Oral Maxillofac Surg 2004; 62: 759-761.
• Vercellotti T, De Paoli S, Nevins M. The piezoelectric bony window osteotomy and sinus membrane elevation: introduction of a new technique for simplification of the sinus augmentation procedure. Int J Periodontics Restorative Dent 2001; 21: 561-567.
• Aly LAA. Piezoelectric surgery: Applications in oral & maxillofacial surgery. Future Dental Journal 2018(4); 105–111.
• Gruber, RM, Kramer FJ, Merten HA, Schliephake H. Ultrasonic surgery an alternative way in orthognathic surgery of the mandible: A pilot study. International journal of oral and maxillofacial surgery 2005; 34(6): 590-593.
• Eggers, G, Klein J, Blank J, Hassfeld S. Piezosurgery®: an ultrasound device for cutting bone and its use and limitations in maxillofacial surgery. British Journal of oral and maxillofacial surgery 2004; 42(5): 451-453.
• Torrella, F, Cabanes G, Pitarch J, Anitua E. Ultrasonic ostectomy for the surgical approach of the maxillary sinus: a technical note. International Journal of Oral and Maxillofacial Implants 1998; 13(5): 697-700.
• Schaeren, S, Jaquiéry C, Heberer M, Tolnay M, Vercellotti T, Martin I. Assessment of nerve damage using a novel ultrasonic device for bone cutting. Journal of oral and maxillofacial surgery, 2008; 66(3): 593-596.
• Pavlíková, G, Foltán R, Horká M, Hanzelka T, Borunská H, Sedý J. Piezosurgery in oral and maxillofacial surgery. International journal of oral and maxillofacial surgery 2011; 40(5): 451-457.
• Schlee, M, Steigmann M, Bratu E, Garg AK. Piezosurgery: basics and possibilities. Implant dentistry 2006; 15(4): 334-340.
• Eggers G, Blank J, Hassfeld S. Piezosurgery: an ultrasound device for cutting bone and its use and limitations in maxillofacial surgery. . British Journal Oral Maxillofacial Surgery 2004; 42: 451-3.
• Vercellotti T. A new bone surgery device: sinus grafting and periodontal surgery. Compend Contin Education Dentistry 2006; 27: 319-25.
• Gruber RM, Merten HA, Schliephake H. Ultrasonic surgery an alternative way in orthognathic surgery of the mandible. A pilot study. International Journal Oral Maxillofacial Surgery 2005; 34: 590-3.
• Robiony M, Costa F, Vercelotti T, Polliti M., Piezoelectric bone cutting in multipiece maxillary osteotomies. International Journal Oral Maxillofacial Surgery 2004; 62: 759-61.
• Kotrikova B, Krempien R, Blank J, Eggers G, Samiotis A, Mühling J.,Piezosurgery--a new safe technique in cranial osteoplasty. International Journal Oral Maxillofacial Surgery 2006; 35: 461-5.
• Schultes G, Gaggl A, Kärcher H. Periodontal disease associated with interdental osteotomies after orthognathic surgery. Journal of oral and maxillofacial surgery 1998; 56(4): 414-417.
• Sohn DS, Ahn MR, Lee WH, Yeo DS, Lim SY. Piezoelectric osteotomy for intraoral harvesting of bone blocks. The International journal of periodontics & restorative dentistry 2007; 27(2): 127.
• Labanca M, Azzola F, Vinci R, Rodella LF. Piezoelectric surgery: twenty years of use. British Journal of Oral and Maxillofacial Surgery 2008; 46(4): 265-269.
• Kotrikova, B, R. Wirtz, R. Krempien, ve ark. Piezosurgery a new safe technique in cranial osteoplasty. International journal of oral and maxillofacial surgery 2006; 35(5): 461-465.
• Alexandre A, Marzia F, Francesco C, ve ark. Structural and ultrastructural analyses of bone regeneration in rabbit cranial osteotomy: Piezosurgery versus traditional osteotomes. Journal of Cranio-Maxillo-Facial Surgery 2018; 107-118.
• Friedhelm H, Istabrak H, Christiane KK, ve ark. Experimental and histological investigations of the bone using two different Oscillating Osteotomy techniques compared with conventional rotary osteotomy. Annals of Anatomy 2012(164); 165-170.
• Li M, Nikos M, Yan S, Xi LL, Ying YC, Niklaus PL. Wound healing of osteotomy defects prepared with piezo or conventional surgical instruments: a pilot study in rabbits. Journal of Investigative and Clinical Dentistry 2015(6); 211-220.
• Stephan H, Eike H, Jurgen V, Frank H, Nora P, Peter M. Micromorphometrical analyses of five different ultrasonic osteotomy devices at the rabbit skull. Clin. Oral Impl. Res 2012(23); 713–718.
• Li M, Stefan S, Xi LL, Urs AS, Niklaus PL. Healing of osteotomy sites applying either piezosurgery or two conventional saw blades: a pilot study in rabbits. International Orthopaedics (SICOT) 2013(37); 1597–1603.
• Jônatas CE, Elcio MJ, Ana PSF, ve ark. Dynamics of bone healing after osteotomy with piezosurgery or conventional drilling – histomorphometrical, immunohistochemical, and molecular analysis. Esteves ve ark. Journal of Translational Medicine 2013(11); 221.
• Hoigne DJ, Stübinger S, Von Kaenel O, Shamdasani S, Hasenboehler P. Piezoelectric osteotomy in hand surgery: first experiences with a new technique. BMC Musculoskeletal Disord 2006; 7: 36.