Stomatologist № 1 (32) – 2019, pp. 50-55                                                                                                                            SCIENTIFIC PUBLICATION

Clinical comparison of the effectiveness of piezosurgery application in sinus lift surgery

S.P. Rubnikovicha, I.S. Khomichb

aMD, PhD, DMSci, Professor, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
bMD, PhD, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus

https://doi.org/10.32993/stomatologist.2019.1(32).9

ABSTRACT
Aim of the study is to evaluate the effectiveness and compare the intraoperative and postoperative advantages and disadvantages of piezosurgery and traditional rotational instruments in the open sinus lift surgery when creating conditions for the subsequent dental implantation.
Objects and methods. The object of the study were 34 partially secondary edentulous patients that needed the sinus lift procedure. Cone-beam computed tomography was used to estimate the residual volume of bone tissue and determine the size of the intended implants. The patients were divided into two groups: I – the traditional method – with lateral approach to sinus membrane using rotating instruments and manual membrane elevators, II – with lateral approach and elevation of the Schneider membrane with a piezo-surgical instrument. Duration between creation of the bone window and the completion of the membrane elevation, membrane perforation frequency, visibility of the operative field, postoperative pain, swelling, sleep, food intake, phonetics, daily routine and missed working days, as well as the patient’s expectations before and after surgery were evaluated.
Results and discussion. There were no significant differences observed between groups in terms of frequency of Shneiderian membrane perforation, the duration of the surgery and the visibility of the surgical field, as well as the patient’s expectations before and after the. However, in the group with the traditional method (I), postoperative pain and swelling were significantly more common after the surgery compared with the piezo-surgical group (II).
Conclusions.. Sinus lift performed with the use of piezosurgery causes less postoperative pain and swelling compared with the traditional method. Neither of the surgical techniques impairs daily life nor increases the patient’s disability. The advantages of piezosurgery over traditional methods contribute to the improvement of bone wound healing and make it a highly effective method in dentistry.

Keywords: dental implant, secondary partial edentulism, cone-beam computed tomography, sinus lift, piezosurgery, rotating instruments

References

  1. Giraud JY, Villemin S, Darmana R, Cahuzac JP, Autefage A, Morucci JP. Bone cutting. Clin Phys Physiol Meas 1991 Feb;12(1):1-19.
  2. Schwieger K, Carrero V, Rentzsch R, Becker A, Bishop N, Hille E. Abrasive water jet cutting as a new procedure for cutting cancellous bone–in vitro testing in comparison with the oscillating saw. J Biomed Mater Res B Appl Biomater 2004 Nov;71(2):223–8
  3. Stubinger S, Ghanaati S, Saldamli B, Kirkpatrick CJ, Sader R. Er:YAG laser osteotomy: preliminary clinical and histological results of a new technique for contact-free bone surgery. Eur Surg Res 2009 Jan;42(3):150– 5. Vercellotti T . Technological characteristics and clinical indications of piezoelectric bone surgery. Minerva Stomatol 2004 May;53(5):207–14.
  4. Pavlikova G, Foltan R, Horka M, Hanzelka T, Borunska H, Sedy J. Piezosurgery in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2011 May;40(5):451–7
  5. Catuna MC . Sonic energy. A possible dental application. Preliminary report of an ultrasonic cutting method. Ann Dent 1953 Dec;112256–60
  6. Volkov MV, Shepeleva IS. The use of ultrasonic instrumentation for the transection and uniting of bone tissue in orthopaedic surgery. Reconstr Surg Traumatol 1974 Jan;14147–52
  7. Aro H, Kallioniemi H, Aho AJ, Kellokumpu-Lehtinen P. Ultrasonic device in bone cutting. A histological and scanning electron microscopical study. Acta Orthop Scand 1981 Feb;52(1):5–10
  8. Horton JE, Tarpley TMJr, Jacoway JR. Clinical applications of ultrasonic instrumentation in the surgical removal of bone. Oral Surg Oral Med Oral Pathol 1981 Mar;51(3):236–42
  9. Vercellotti T . Essentials in piezosurgery. Clinical advantages in dentistry. 1st ed. Milan: Quintessenza Edizioni 2009p65–107
  10. Schaeren S, Jaquiery C, Heberer M, Tolnay M, Vercellotti T, Martin I. Assessment of nerve damage using a novel ultrasonic device for bone cutting. J Oral Maxillofac Surg 2008 Mar;66(3):593–6
  11. Claire S, Lea SC, Walmsley AD. Characterisation of bone following ultrasonic cutting. Clin Oral Investig 2013 Apr;17(3):905–12
  12. Blus C, Szmukler-Moncler S, Vozza I, Rispoli L, Polastri C. Split-crest and immediate implant placement with ultrasonic bone surgery (piezosurgery): 3-year follow-up of 180 treated implant sites. Quintessence Int 2010 Jun;41(6):463–9
  13. Stelzle F, Frenkel C, Riemann M, Knipfer C, Stockmann P, Nkenke E. The effect of load on heat production, thermal effects and expenditure of time during implant site preparation – an experimental ex vivo comparison between piezosurgery and conventional drilling. Clin Oral Implants Res. 2012 Nov 17.
  14. Pekovits K, Wildburger A, Payer M, Hutter H, Jakse N, Dohr G. Evaluation of graft cell viability-efficacy of piezoelectric versus manual bone scraper technique. J Oral Maxillofac Surg 2012 Jan;70(1):154–62
  15. Happe A . Use of a piezoelectric surgical device to harvest bone grafts from the mandibular ramus: report of 40 cases. Int J Periodontics Restorative Dent 2007 Jun;27(3):241–9
  16. Landes CA, Stubinger S, Rieger J, Williger B, Ha TK, Sader R. Critical evaluation of piezoelectric osteotomy in orthognathic surgery: operative technique, blood loss, time requirement, nerve and vessel integrity. J Oral Maxillofac Surg 2008 Apr;66(4):657–74

Correspondence to:  Е-mail: rubnikovichs@mail.ru, ilya1gig@gmail.com