title: Evaluation of surgically assisted rapid maxillary expansion with piezosurgery versus oscillating saw and chisel osteotomy - a randomized prospective trial.
abstract: BACKGROUND
  Ultrasonic bone-cutting surgery has been introduced as a feasible alternative to the conventional sharp instruments used in craniomaxillofacial surgery because of its precision and safety. The piezosurgery medical device allows the efficient cutting of mineralized tissues with minimal trauma to soft tissues. Piezoelectric osteotome has found its role in surgically assisted rapid maxillary expansion (SARME), a procedure well established to correct transverse maxillary discrepancies. The advantages include minimal risk to critical anatomic structures. The purpose of this clinical comparative study (CIS 2007-237-M) was to present the advantages of the piezoelectric cut as a minimally invasive device in surgically assisted, rapid maxillary expansion by protecting the maxillary sinus mucosal lining.
  
  
  METHODS
  Thirty patients (18 females and 12 males) at the age of 18 to 54 underwent a surgically assisted palatal expansion of the maxilla with a combined orthodontic and surgical approach. The patients were randomly divided into two separate treatment groups. While Group 1 received conventional surgery using an oscillating saw, Group 2 was treated with piezosurgery. The following parameters were examined: blood pressure, blood values, required medication, bleeding level in the maxillary sinus, duration of inpatient stay, duration of surgery and height of body temperature.
  
  
  RESULTS
  The results displayed no statistically significant differences between the two groups regarding laboratory blood values and inpatient stay. The duration of surgery revealed a significant discrepancy. Deploying piezosurgery took the surgeon an average of 10 minutes longer than working with a conventional-saw technique. However, the observation of the bleeding level in the paranasal sinus presented a major and statistically significant advantage of piezosurgery: on average the bleeding level was one category above the one of the remaining patients.
  
  
  CONCLUSIONS
  This method of piezoelectric surgery with all its advantages is going to replace many conventional operating procedures in oral and maxillofacial surgery.
  
  
  BACKGROUND
  CIS 2007-237-M.
authors: Department of Cranio-Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str, 1, Hannover, 30625, Germany. rana.majeed@mh-hannover.de
authors: Majeed
authors: M
authors: Rana
authors: Nils-Claudius
authors: NC
authors: Gellrich
authors: Madiha
authors: M
authors: Rana
authors: Jozsef
authors: J
authors: Piffkó
authors: Wolfgang
authors: W
authors: Kater
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical; D001794:Blood Pressure; D001833:Body Temperature Regulation; D004867:Equipment Design; D005260:Female; D005858:Germany; D006801:Humans; D007902:Length of Stay; D008297:Male; D008437:Maxilla / Q000601:surgery*; D063166:Maxillary Osteotomy / Q000009:adverse effects / Q000295:instrumentation*; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D010155:Palatal Expansion Technique / Q000009:adverse effects / Q000295:instrumentation*; D017060:Patient Satisfaction; D059745:Piezosurgery / Q000009:adverse effects / Q000295:instrumentation*; D011446:Prospective Studies; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers