Injertos

The International Journal of Periodontics & Restorative Dentistry

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Piezoelectric Osteotomy for Intraoral
Harvesting of Bone Blocks

Dong-Seok Sohn, DDS, PhD*
Mi-Ra Ahn, DDS**
Won-Hyuk Lee, DDS**
Duk-Sung Yeo, DDS**
So-Young Lim, DDS**

Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal
and vertical bone resorption in future implant sites. ThePiezosurgery System
(Mectron) creates an effective osteotomy with minimal or no trauma to soft tissue,
in contrast to conventional surgical burs or saws. In addition, piezoelectric surgery
produces less vibration and noise because it uses microvibration, in contrast to
the macrovibration and extreme noise that occur with a surgical saw or bur.
Microvibration and reduced noise minimize a patient’spsychologic stress and fear
during osteotomy under local anesthesia. The purpose of this article is to describe
the harvesting of intraoral bone blocks using the piezoelectric surgery device. (Int
J Periodontics Restorative Dent 2007;27:xxx–xxx.)

*Associate Professor and Chair, Department of Oral and Maxillofacial Surgery, Daegu
Catholic University, Daegu, South Korea.
**Resident,Department of Oral and Maxillofacial Surgery, Daegu Catholic University, Daegu,
South Korea.
Correspondence to: Dr Dong-Seok Sohn, Department of Oral and Maxillofacial Surgery,
Daegu Catholic University Hospital, 3056-6 Daemyung 4-Dong, Nam-Gu, Daegu, Republic
of Korea 705-034; fax: +82-53-622-7067; e-mail: dssohn@cu.ac.kr.

Placement of dental implants is difficult
in alveolar ridges with severehorizontal and vertical bone resorption. To
augment the severely atrophic ridge,
grafting with bone blocks harvested
intraorally has been recommended.1–7
To create the necessary osteotomy, clinicians have used variable surgical burs or saws. These surgical
instruments cut bone very effectively;
however, they can cause soft tissue
complications such as lacerations or
burns during osteotomyif the surgeon
does not pay close attention.8 In addition, these surgical devices are loud
and produce macrovibrations during
osteotomy. The noise and macrovibrations can cause fear and stress in
patients when surgery is performed
with local anesthesia.
Piezoelectric surgery systems
(Piezosurgery, Mectron) use ultrasonic
microvibrations to create an osteotomy. These microvibrations makeselective bone cuts possible.9,10 The
Piezosurgery device does not work on
soft tissue, so the device causes little
or no soft tissue trauma during intraoral bone harvesting. In addition, surgical access is easier in the deep oral cavity in comparison to surgical burs,

Volume 27, Number 2, 2007

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Fig 1a (left)

Patient 1. The intraoral radiograph shows severe bone resorption.

Fig1b (center) Preoperative intraoral view after 6 weeks of healing of extraction sites.
Note the severe vertical and horizontal bone resorption.
Fig 1c (right)
observed.

The recipient site is exposed, and vertical and horizontal bone defects are

which use a straight handpiece. The
Piezosurgery device makes a precise
and tactile-controlled osteotomy.
The purpose of this study is todescribe the efficacy and safety of
piezoelectric surgery during intraoral
harvesting of bone blocks.

Surgical procedure

Patient 1: Block graft in the
anterior maxilla
A 48-year-old man presented for
implant placement. The left central
incisor and left canine were considered hopeless. An intraoral radiograph
showed severe bone resorption at
both sites (Fig 1a). The hopeless teeth
wereextracted and soft tissue healing
was complete after 6 weeks. A preoperative intraoral view showed severe
horizontal and vertical bone resorption (Fig 1b). The recipient site was
exposed under local anesthesia with

The International Journal of Periodontics & Restorative Dentistry

no intravenous sedation, and the
severe resorption was apparent (Fig
1c). The chin was exposed to harvest
a...