Department of Oral and Maxillofacial Surgery, Clinique de Espérance, Montegnée, Belgium.
Int J Oral Maxillofac Surg. 2013 Aug;42(8):981-7. doi: 10.1016/j.ijom.2012.12.004. Epub 2013 Jan 8.
The use of a novel ultrasonic osteotome enabled the authors to modify well-established orthognathic osteotomies to more favourably address the anatomy. For this purpose, they utilized a powerful ultrasonic device with tissue-selective cutting characteristics that was originally developed for spinal osteotomies and nerve decompression (BoneScalpel™ by Misonix Inc., Farmingdale, NY, USA). Its straight ultrasonic blade was adapted for dual action, and a soft protective element was added. The product modifications and the related changes regarding maxillary and mandibular osteotomies are explained in detail. A series of 83 patients underwent orthognathic surgery with the BoneScalpel ultrasonic osteotome. All osteotomies within this study group were performed purely ultrasonically and without the auxiliary use of reciprocating saws or rotary burrs. The complications, alveolar nerve impairment and bad splits were assessed. To assess the quality of the lingual osteotomies and pterygomaxillary separation, three-dimensional scanning was performed on 30 patients. In conclusion, the BoneScalpel™ ultrasonic osteotome enabled improved control over orthognathic osteotomies and resulted in significant reductions in the occurrence of nerve impairment and bad splits.
作者使用一种新型的超声骨刀，使他们能够修改已确立的正颌手术，以更有利地解决解剖问题。为此，他们使用了一种具有组织选择性切割特性的强大超声设备，该设备最初是为脊柱切开术和神经减压而开发的（美国纽约州法明代尔的 Misonix 公司的 BoneScalpel™）。其直超声刀片具有双重作用，并添加了柔软的保护元件。详细说明了产品修改以及上颌和下颌切开术的相关变化。83 例患者接受了 BoneScalpel 超声骨刀正颌手术。该研究组中的所有切开术均完全通过超声进行，而不辅助使用往复锯或旋转钻头。评估了并发症，牙槽神经损伤和不良劈裂。为了评估舌侧切开术和翼钩-上颌分离的质量，对 30 例患者进行了三维扫描。总之，BoneScalpel™超声骨刀可提高正颌切开术的控制能力，并显著降低神经损伤和不良劈裂的发生。
