However, heat is produced during cutting and the degree of thermal injury to the tissues is related to parameters of the instrument (design, diameter, sharpness, material) and to parameters of bone cutting (speed, feed rate, power, depth of cut, cooling, clearance of bone chips, bone density, and thickness) ( 1– 4). Use of such high forces is not necessary with rotary drills and oscillating saws.
#Piezoelectric ultrasonic scaler manual#
Manual bone cutting instruments do not generate heat but require use of high forces, which may lead to uncontrolled damage to the bone or to the surrounding structures. Bone cutting can be performed with different instruments, either manual (bone chisels, rongeurs) or powered (rotary burs, oscillating saws). These can be either to prepare or permit access to the surgical site or as part of a radical resection in oncology. Oral and maxillofacial surgery often involves bone surgery. Training is required to master the technique.
Piezoelectric instruments are different from rotary instrumentation or oscillating saws, they require light pressure with constant motion of the tip. It is also indicated when performing more invasive bone surgery such as maxillectomy, mandibulectomy, and condylectomy, where preservation of neurovascular structures is important. Piezoelectric surgery is particularly useful when performing delicate bone procedures such as periodontal or endodontic surgery. The handpiece of the instrument is equipped with a sterile irrigation system and light-emitting diode (LED) light, which improves visibility and overall safety. The major advantages of this technology include high precision, a design that increases ease of curvilinear osteotomy, less trauma to soft tissue, preservation of neurological and vascular structures, reduced hemorrhage, minimal thermal damage to the bone, as well as overall improvement of healing. However, the power of the piezosurgical instrument is three to six times higher than that of a dental scaler. Similar to a dental scaler, a high frequency vibration, in the range of 25–35 kHz, is transmitted to a metallic tip. Piezoelectric bone surgery is a recent and innovative technology, permitting a selective cut of mineralized tissue while sparing soft tissue.
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