Journal of Oral Implantology July 2014 - (Page 401)

LITERATURE REVIEW Piezosurgery Applied to Implant Dentistry: Clinical and Biological Aspects Cassiano Costa Silva Pereira, DDS, MS, PhD1* Walter Cristiano Gealh, DDS, MS1 Lamis Meorin-Nogueira, DDS, MS1 ´ Idelmo Rangel Garcia-Junior, DDS, PhD1 Roberta Okamoto, DDS, PhD1,2 Piezosurgery is a new and modern technique of bone surgery in implantology. Selective cutting is possible for different ultrasonic frequencies acting only in hard tissues (mineralized), saving vital anatomical structures. With the piezoelectric osteotomy technique, receptor site preparation for implants, autogenous bone graft acquistition (particles and blocks), osteotomy for alveolar bone crest expansion, maxillary sinus lifting, and dental implant removal can be performed accurately and safely, providing excellent clinical and biological results, especially for osteocyte viability. The aim of this review was, through literature review, to present clinical applications of piezosurgery in implant dentistry and outline their advantages and disadvantages over conventional surgical systems. Moreover, this study addressed the biological aspects related to piezosurgery that differentiate it from those of bone tissue approaches. Overall, piezosurgery enables critical operations in simple and fully executable procedures; and effectively, areas that are difficult to access have less risk of soft tissue and neurovascular tissue damage via piezosurgery. Key Words: piezosurgery, osteotomy, bone, soft tissues INTRODUCTION M any studies have demonstrated the high success rate of dental implants regarding their function and esthetics.1-4 However, dental implants will only be considered successful as part of the final rehabilitation that they support. Thus, the optimal placement of implants is critical. This focus on the final rehabilitation involves ''reverse planning'' wherein the placement of the implant should be related to finalization of the prosthetic restoration,5-9 not necessarily where there is greater bone volume. This goal often means planning of the bone graft and the bone regeneration to increase atrophic areas. 1 ˜ Arac atuba Dental of School, Sa o Paulo State University ¸ (UNESP), Aracatuba, SP, Brazil. ¸ 2 ˜ ˜ Faculty of Medicine Ribeirao Preto/Sao Paulo University (USP), ˜ Ribeirao Preto, SP, Brazil. * Corresponding author, e-mail: cassianopereira@hotmail.com DOI: 10.1563/AAID-JOI-D-11-00196 Implantology offers a variety of techniques to increase bone volume,10,11 including transplantation of particles and blocks of bone grafts from the chin and the mandibular ramus, iliac crest, and calvaria.12,13 The techniques make use of rotary drills; oscillating saws; and more recently, piezosurgery, a process that uses ultrasonic vibrations in the application of cutting bone tissue. Piezoelectric ultrasound was developed by maxillofacial surgeons. It uses radio waves that allow the ultrasound tips to oscillate and vibrate so that they can divide solid interfaces, such as bone tissue. The piezoelectric device is characterized by having ultrasonic vibrations with an average frequency of 25-29 kHz, an oscillation (amplitude) of 60-210 lm, and power up to 50 W, thereby allowing selective cutting only in mineralized structures without damaging soft tissue.14-17 The ultrasound tips can be an effective tool with a greater precision and safety, thereby minimizing tissue trauma, in several clinical situations: bone Journal of Oral Implantology 401

Table of Contents for the Digital Edition of Journal of Oral Implantology July 2014

Upcoming Enhancements to the Publishing Process
Enhanced Osteoblast Proliferation and Corrosion Resistance of Commercially Pure Titanium Through Surface Nanostructuring by Ultrasonic Shot Peening and Stress Relieving
An Interocclusal Recording Method for the Fabrication of Full-Arch Implant-Retained Restorations
Classification of the Alveolar Ridge Width: Implant-Driven Treatment Considerations for the Horizontally Deficient Alveolar Ridges
Repair of a Multiple Implant-Supported Fixed Superstructure With a Metal-Ceramic Resin- Bonded Fixed Partial Denture: A Clinical Report
Postoperative Perforation of the Schneiderian Membrane in Maxillary Sinus Augmentation: A Case Report
The ‘‘Washing Line’’ Suture Technique for Securing the Subepithelial Connective Tissue Graft
Trephine Core: An Alternative Sinus Lift Technique
Second Harvest of Mandibular Ramus Blocks in Bone Augmentation Procedures: A Case Letter
Piezosurgery Applied to Implant Dentistry: Clinical and Biological Aspects

Journal of Oral Implantology July 2014