Piezoelectric osteotomy for the placement of titanium implants in rabbits: histomorphometry study.

OBJECTIVE: To evaluate bone remodeling around dental implants inserted into recipient sites prepared using either the piezoelectric or the conventional drilling technique. MATERIAL AND METHODS: Twenty-four male New Zealand white rabbits (4 months, 2.70 kg) received dental implants (3.3 mm diameter and 6 mm length) on the medial surface of the tibia and were divided into 3 groups (n = 8). Group I was euthanized at 7 days; group II, at 14; and group III, at 28 days. Each animal received four implants, two in the right and two in the left tibia (96 implants were installed). Each tibia was operated by the same technique, and there are therefore neighbor's implants installed by different techniques. Histomorphometric parameters were used: the volume occupied by trabecular bone around the implants (BV/TV), media thickness, separation and number of trabeculae around the loops, and the contact area (interface) directly between the bone and implant (BIC). RESULTS: BV/TV was similar for both techniques (P = 0.291). Reduction in trabecular thickness was observed for both techniques (P < 0.05), but then returned to prior levels, with no significant difference between techniques (P = 0.217). Trabecular number increased from day 7 to day 14 (P < 0.001) and remained constant afterward for both techniques. No difference in BIC was observed between techniques on day 28 (P = 0.961). CONCLUSIONS: Piezoelectric osteotomy allowed bone formation for osseointegration of titanium implants, was not associated with bone necrosis, and provided results similar to those of the conventional technique. The piezoelectric technique can be considered a viable alternative in dental implantology.

Sagittal and vertical maxillary effects after surgically assisted rapid maxillary expansion (SARME) using Haas and Hyrax expanders.

The purpose of this study was to evaluate the effect of surgically assisted rapid maxillary expansion on the sagittal and vertical maxillary planes. Thirty-three adult patients aged between 18 and 40 years who required surgically assisted rapid maxillary expansion were included in this study. They were divided into two groups: the Haas type expander (16) and the Hyrax type expander (17). All patients were subjected to subtotal LeFort I osteotomy with pterygomaxillary disjunction. Lateral cephalometric radiographs were taken during the preoperative assessment (T1), soon after completion of the expansion (T2), and 4 months after the end of the expansion (T3). The following cephalometric measures were obtained in each of the three radiographs for all the patients: SNA, SN palatal plane, Frankfurt horizontal plane. NA, CF-A, CF-NA, Nperp-A, CF-A, Frankfurt horizontal plane-ANS, and Frankfurt horizontal plane-PNS. Statistically significant changes were observed in the cephalometric measures: SNA, Frankfurt horizontal plane, NA, Nperp-A in the patients in the Haas group, and CF-A in the patients in the Hyrax group, demonstrating anterior displacement of the maxilla. The cephalometric measures SN.palatal plane, CF-A, CF-NA, Frankfurt horizontal plane-ANS, and Frankfurt-PNS plane that evaluated vertical displacement did not show changes in either group. The surgically assisted rapid maxillary expansion caused anterior displacement of the maxilla in both groups, but only the Haas group had statistical significance. Neither the Haas group nor the Hyrax group showed vertical displacement of the maxilla. When Hyrax and Haas groups were compared, there were no statistically significant differences for sagittal and vertical changes.

Cirurgia piezoelétrica em implantodontia: aplicações clínicas / Piezoelectric surgery in implant dentistry: clinical applications

A piezocirurgia possui características terapêuticas nas osteotomias, como cortes extremamente precisos, seletivos e milimétricos e campo cirúrgico claro. A piezoeletricidade utiliza frequências ultrassônicas que fazem vibrar pontas especialmente desenhadas para osteotomia. As pontas do instrumento oscilam, permitindo uma osteotomia efetiva, com mínima ou nenhuma injúria aos tecidos moles adjacentes, membranas e tecidos nervosos. Esse artigo apresenta as várias aplicações da piezeletricidade em cirurgia oral implantológica como: a remoção de osso autógeno; janela óssea durante a elevação da membrana sinusal e remoção de implantes fraturados. O efeito cavitacional promovido pela vibração da ponta e o spray de soro fisiológico, proporcionaram um campo livre de sangramento e de fácil visualização. O estudo mostrou que a cirurgia piezelétrica é um novo procedimento cirúrgico que apresenta vantagens para cortes ósseos em múltiplas situações em implantodontia, com grandes vantagens em comparação com instrumentações convencionais. O tempo operatório apresentou-se maior em relação às fresas convencionais.

Pizosurgery has therapeutic characteristics in osteotomies, such as extremely precise, selective and millimetric cuts and a clear operating. Piezoelectricity uses ultrasonic frequencies, which cause the points specially designed for osteotomy to vibrate. The points of the instrument oscillate, allowing effective osteotomy with minimal or no injury to the adjacent soft tissues, membranes and nerve tissues. This article presents the various applications of piezoelectricity in oral implant surgery such as: removal of autogenous bone; bone window during elevation of thesinus membrane and removal of fractured implants. The cavitational effect caused by the vibration of the point and the spray of physiological solution, provided a free of bleeding and easy to visualize. The study showed that the piezoelectric surgery is a new surgical procedure that presents advantages for bone cutting in many situations in implant dentistry, with great advantages in comparison with conventional instrumentation. Operating time is longer when compared with that of conventional cutters.