Split-crest and immediate implant placement with ultrasonic bone surgery (piezosurgery): 3-year follow-up of 180 treated implant sites.
OBJECTIVE
To report and evaluate ultrasonic bone surgery (USBS), also known as piezosurgery, in split-crest procedures with immediate implant placement at 3 years of follow-up.


METHODS
Sixty-one split-crest procedures were performed, and 180 implants were placed in 43 patients. Initial ridge width varied between 1.5 and 5.0 mm (mean 3.3 +/- 0.7 mm). Bone density was type I (11.1%), type II (27.8%), type III (28.9%), and type IV (32.2%). The USBS device worked with a 20 to 32 kHz vibrating frequency and 90 W peak power.


RESULTS
Mean split length was 14.8 +/- 10.8 mm; mean final ridge width was 6.0 +/- 0.4 mm. At second-stage surgery, five of 180 implants failed to osseointegrate (2.8%), all in the maxilla. Also at second-stage surgery, the success rate of the implants placed simultaneously to the split crest performed with USBS was 97.2% overall, 95.1% in the maxilla and 100% in the mandible. No loaded implant failed during the 3-year follow-up; respective success rates were unchanged.


CONCLUSIONS
USBS is predictable to perform split-crest procedures, without risk of bone thermonecrosis; it decreases the risk of soft tissue alteration. Bone-cutting efficiency was satisfactory with the present USBS device because of its elevated ultrasonic vibrating power, especially in soft type IV bone.
Blus
Cornelio
C
Department of Odonto-Stomatology Sciences, University of Cagliari, Cagliari, Italy; Private Practice, Torino, Italy. corblus@hotmail.com
Szmukler-Moncler
Serge
S
Vozza
Iole
I
Rispoli
Lorena
L
Polastri
Carolina
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation / Q000379:methods*; D015519:Bone Density / Q000502:physiology; D001857:Bone Matrix / Q000637:transplantation; D001861:Bone Regeneration / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D016348:Osseointegration / Q000502:physiology; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods*
C077540:Bio-Oss; D018786:Bone Substitutes; D015921:Dental Implants; D008903:Minerals