Ultrasonic Piezosurgery Reduces Pain and Swelling

A new study shows that the use of ultrasonic piezosurgery equipment reduces trauma, pain, and swelling compared to conventional bone surgery.

Researchers at the University of Naples Federico II (Italy) conducted a study in 40 patients who underwent genioplasty for chin anomalies, with the intention of comparing postoperative complications using ultrasonic piezosurgery instruments instead of traditional rotating drills. The patients were randomly assigned to either of the two procedures, with the main outcomes of the study being pain, healing, and complications from one to 15 days after surgery.

The results showed lower pain scores for patients undergoing piezosurgery, although the difference was significant only on the third and seventh day following surgery. Paresthesia was observed in all patients in both groups up to 15th postoperative day, mainly due to nerve stretching. But at six months sensation was normalized for all patients, and pain and swelling were completely resolved as well. The study was published in the March 2016 issue of the Journal of Craniofacial Surgery.

“Piezosurgery may be a viable alternative to traditional osteotomy technique, as it reduces the degree of inflammation, pain, swelling, and morbidity, improving satisfaction and patient comfort,” concluded senior author Gilberto Sammartino, MD, DDS, and colleagues of the department of oral surgery. “Bone undergoes less stress during surgery. Pain and discomfort were minimal compared to the traditional technique, especially in the immediate postoperative period of healing.”

Piezoelectric bone surgery is a process that utilizes ultrasonic vibrations to cut hard tissue, while leaving soft tissues untouched by the process. The ultrasonic frequency is modulated to 29 kHz, a low frequency that enables the cutting of the mineralized structures alone. The power is adjusted from 2.8 to 16 watts, with preset power settings for various types of bone density. The tip itself vibrates within a range of 60–200 µm, which allows clean cutting with precise incisions.

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University of Naples Federico II