González-García Alberto, Diniz-Freitas Márcio, Somoza-Martín Manuel, García-García Abel
Oral Surgery Department, School of Dentistry, University of Santiago de Compostela, Spain.
Int J Oral Maxillofac Implants. 2008 Sep-Oct;23(5):891-6.
Piezoelectric osteotomy is based on ultrasonic vibration of an osteotomic device that permits precise cutting of bone structures without cutting adjacent soft tissues. To date, however, there have been no studies of the outcome and complications of alveolar distraction for piezoelectric osteotomy versus conventional osteotomy. The present study evaluated piezoelectric versus conventional osteotomy in alveolar distraction.
A retrospective study was performed on all patients of the authors who requested dental implants and who after preliminary evaluation were judged to require alveolar distraction osteogenesis for rehabilitation of edentulous mandibular regions. The distraction was performed using the same distraction system in all cases, but with the osteotomy performed either by conventional techniques using rotary instruments and chisels (conventional osteotomy group, n = 11), or by piezoelectric osteotomy using the Piezosurgery system (Mectron Medical Technology; Carasco, Genoa, Italy; n = 6). The 17 distractions were compared with respect to patient age, patient sex, intra- and postoperative complications, degree of surgical difficulty, postdistraction morphology of the alveolar ridge, and rehabilitation success rate.
Both surgical difficulty (as measured by the number of surgical instruments required) and the incidence of intraoperative complications were significantly lower in the piezoelectric osteotomy group than in the conventional osteotomy group. However, postdistraction morphology of the alveolar ridge (as determined at implant placement) was worse in the piezoelectric osteotomy group than in the conventional osteotomy group (P = .072). The overall rehabilitation success rate was 100% in the conventional osteotomy group versus only 66.7% (4 of 6 cases) in the piezoelectric osteotomy group.
The use of piezoelectric osteotomy in alveolar distraction appears to simplify surgery and reduce the incidence of intraoperative complications. However, results also suggest that piezoelectric osteotomy increases the risk of postoperative and postdistraction complications and reduces the overall rehabilitation success rate.
压电截骨术基于截骨设备的超声振动，可精确切割骨结构而不损伤相邻软组织。然而，迄今为止，尚无关于压电截骨术与传统截骨术在牙槽骨牵张成骨方面的疗效和并发症的研究。本研究评估了压电截骨术与传统截骨术在牙槽骨牵张方面的效果。
对所有要求进行牙种植且经初步评估后被判定需要进行牙槽骨牵张成骨以修复无牙下颌区域的作者的患者进行回顾性研究。所有病例均使用相同的牵张系统进行牵张，但截骨术要么采用使用旋转器械和凿子的传统技术（传统截骨术组，n = 11），要么采用使用压电手术系统（Mectron Medical Technology；意大利热那亚卡拉斯科；n = 6）的压电截骨术。比较了17例牵张病例在患者年龄、患者性别、术中和术后并发症、手术难度程度、牵张后牙槽嵴形态以及修复成功率方面的情况。
压电截骨术组的手术难度（以所需手术器械数量衡量）和术中并发症发生率均显著低于传统截骨术组。然而，压电截骨术组牵张后牙槽嵴的形态（在植入种植体时确定）比传统截骨术组更差（P = 0.072）。传统截骨术组的总体修复成功率为100%，而压电截骨术组仅为66.7%（6例中的4例）。
在牙槽骨牵张中使用压电截骨术似乎简化了手术并降低了术中并发症的发生率。然而，结果也表明压电截骨术增加了术后和牵张后并发症的风险，并降低了总体修复成功率。
