Bertossi Dario, Lucchese Alessandra, Albanese Massimo, Turra Matteo, Faccioni Fiorenzo, Nocini Pierfrancesco, Rodriguez Y Baena Ruggero
From the *Maxillo Facial Department, University of Verona, Verona; †Department of Morphology, Surgery and Experimental Medicine, School of Dentistry, University of Ferrara, Italy; ‡Dentistry Department, University of Verona, Verona; and §Department of Clinico Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, Pavia, Italy.
J Craniofac Surg. 2013;24(5):1763-6. doi: 10.1097/SCS.0b013e31828f1aa8.
The aim of the study was to compare in a randomized controlled clinical trial the use of the piezoelectric osteotomy as an alternative to the conventional approach in terms of surgery time, intraoperative blood loss, cut quality, nerve injury, and costs.One hundred ten patients who had orthognathic surgery procedures with bimaxillary osteotomy were divided into 2 groups: group A was treated with a piezosurgery device, and group B, with a reciprocating saw and bur.The piezosurgical bone osteotomy permitted individualized cut designs. The surgical time in group A was reduced, with a mean for the mandibular osteotomy (1 side) between 3 minutes 31 seconds and 5 minutes 2 seconds, whereas in group B, the surgical time was between 7 minutes 23 seconds and 10 minutes 22 seconds. The surgical time in group A for the Le Fort I osteotomy was between 5 minutes 17 seconds and 7 minutes 55 seconds in group A and between 8 minutes 38 seconds and 15 minutes 11 seconds in group B. All patients in group A had a low blood loss (<300 mL) versus patients of group B who had a medium to high blood loss (medium loss: 400 mL, high loss: >500 mL). Inferior alveolar nerve sensation was retained in 98.2% of group A versus 92.7% in group B at 6 months postoperative testing.Piezoelectric osteotomy reduced surgical time, blood loss, and inferior alveolar nerve injury in bimaxillary osteotomy. Absence of macrovibrations makes the instrument more manageable and easy to use and allows greater intraoperative control with higher safety in cutting in difficult anatomical regions.
本研究的目的是在一项随机对照临床试验中，比较压电截骨术与传统方法在手术时间、术中失血量、截骨质量、神经损伤和成本方面的差异。110例行双颌截骨正颌手术的患者被分为两组：A组采用压电手术设备治疗，B组采用往复锯和牙钻治疗。压电手术截骨术允许进行个性化的截骨设计。A组的手术时间缩短，下颌骨截骨术（一侧）平均时间在3分31秒至5分2秒之间，而B组的手术时间在7分23秒至10分22秒之间。A组Le Fort I截骨术的手术时间在5分17秒至7分55秒之间，B组在8分38秒至15分11秒之间。A组所有患者失血量低（<300 mL），而B组患者失血量为中至高（中度失血：400 mL，高度失血：>500 mL）。术后6个月测试时，A组98.2%的患者保留了下牙槽神经感觉，B组为92.7%。压电截骨术减少了双颌截骨术中的手术时间、失血量和下牙槽神经损伤。无宏观振动使该器械更易于操作和使用，并在解剖结构复杂的区域切割时能实现更高的术中控制和更高的安全性。
