Mandibular Ridge Expansion: Piezosurgery® Technique versus Traditional Oral Surgery - a case report

OBJECTIVES: To compare, from a clinical and radiographic point of view, the healing conditions of the mandibular bone after a ridge expansion obtained through either traditional oral surgery or Piezosurgery®. CASE PRESENTATION: A male patient of 57 year of age has undergone a bilateral mandibular ridge expansion through traditional ostectomy, on one side of the mandible, and Piezosurgery®, on the other side of the mandible, preliminary to the insertion of oral implants. In both cases, the mandibular split crest allows the bone to split into respectively two plates: one buccal and one oral. The resulting space between the two plates, which has been filled with autogenous bone chips, has ideal regenerative and implant-integrating conditions, since the augmentation material is surrounded by bone tissue and has two directional blood vessel supplies that help a fluid cells migration. Following a healing period of three months, and after having obtained a computed tomography scan to verify t

OBJECTIVES: To compare, from a clinical and radiographic point of view, the healing conditions of the mandibular bone after a ridge expansion obtained through either traditional oral surgery or Piezosurgery®. CASE PRESENTATION: A male patient of 57 year of age has undergone a bilateral mandibular ridge expansion through traditional ostectomy, on one side of the mandible, and Piezosurgery®, on the other side of the mandible, preliminary to the insertion of oral implants. In both cases, the mandibular split crest allows the bone to split into respectively two plates: one buccal and one oral. The resulting space between the two plates, which has been filled with autogenous bone chips, has ideal regenerative and implant-integrating conditions, since the augmentation material is surrounded by bone tissue and has two directional blood vessel supplies that help a fluid cells migration. Following a healing period of three months, and after having obtained a computed tomography scan to verify the horizontal increase in bone tissue at the level of the two mandibular ridges, the patient has undergone a second surgery to insert the oral implants. RESULTS: This case confirms the already well-established intra-operative advantages of ultrasonic osteotomy, which are as it follows: visibility of the surgical field, precise control of cuts, and above all, low risk to adjacent soft tissue. Additionally, for the patient, the piezosurgery tecnique is less traumatic during the surgery. Finally, by comparing the two ridge expansions and their healing conditions, it has been evident that the ultrasonic osteotomy allows a better and swifter clinical healing of both the soft and hard tissues after surgery. CONCLUSION: Piezosurgery® (piezoelectric bone surgery) is a promising, meticulous, and soft tissue sparing, system for bone cutting based on ultrasonic micro-vibrations. It was developed in 1988 by the Italian oral surgeon Dr. Tommaso Vercellotti to overcome the limits of traditional instrumentation in oral bone surgery, by modifying and improving conventional ultrasound technology. The preservative nature on the structure of the bone and on the viability of cells of this technique is important in regenerative surgery.