Maurer Peter, Kriwalsky Marcus S, Block Veras Rafael, Brandt Jörg, Heiss Christian
Abteilung für Mund-Kiefer- und Gesichtschirurgie, Hochtaunus-Kliniken Bad Homburg, Deutschland.
Biomed Tech (Berl). 2007 Oct;52(5):351-5. doi: 10.1515/BMT.2007.058.
The novel ultrasonic osteotomy technique (Piezosurgery) is an alternative to conventional osteotomy devices. The aim of the present study was to carry out morphological comparison of the bone surface using conventional osteotomy techniques in comparison to the rather new ultrasonic osteotomy technique by means of a reflected-light microscopic examination.
Following the sacrifice of 12 rabbits, 24 standardized bone samples were removed from the skull. The osteotomy devices used were a rotating instrument (Lindemann bur), an oscillating micro-saw, and an ultrasonic osteotomy device (Piezosurgery) with insert tips OT6 and OT7. The times needed for osteotomy were measured. The bone surfaces were examined using a reflected-light microscope with a magnification of 40x and 100x.
Osteotomy with Piezosurgery is significantly more time consuming than osteotomy with conventional methods (p<0.05). Following osteotomy with the ultrasonic device, the reflected-light microscopic examinations of the unmodified bone samples revealed typical bone structure of the calvaria, including compacta externa, diploe and compacta interna. On the contrary, following osteotomy with the conventional devices, the diploe structure presented distinct modifications. The cancellous spaces were filled with bone debris, and the cancellous structure was demolished. The samples prepared by the micro-saw technique showed a superficially condensed and grooved surface.
In the present study, well-defined differences were observed following osteotomy with conventional devices and osteotomy with the ultrasonic device. The integrity of the bony structure observed after the ultrasonic technique could benefit the bone healing process. Further studies dealing with the bone healing process after using different osteotomy techniques are recommended.
新型超声截骨技术(压电外科手术)是传统截骨器械的一种替代方法。本研究的目的是通过反射光显微镜检查,对传统截骨技术与相对较新的超声截骨技术的骨表面进行形态学比较。
在处死12只兔子后,从颅骨上取下24个标准化骨样本。使用的截骨器械包括旋转器械(林德曼钻)、振荡微型锯和带有OT6和OT7插入尖端的超声截骨器械(压电外科手术)。测量截骨所需时间。使用放大倍数为40倍和100倍的反射光显微镜检查骨表面。
压电外科手术截骨比传统方法截骨耗时显著更长(p<0.05)。使用超声器械截骨后,未处理的骨样本的反射光显微镜检查显示出颅盖骨的典型骨结构,包括外板、板障和内板。相反,使用传统器械截骨后,板障结构出现明显改变。松质间隙充满骨碎片,松质结构被破坏。微型锯技术制备的样本显示表面致密且有沟槽。
在本研究中,观察到传统器械截骨和超声器械截骨后存在明确差异。超声技术后观察到的骨结构完整性可能有利于骨愈合过程。建议进一步研究不同截骨技术后的骨愈合过程。