title: In vivo assessment of bone healing following Piezotome® ultrasonic instrumentation.
abstract: OBJECTIVE
  This pilot study evaluated the molecular, histologic, and radiographic healing of bone to instrumentation with piezoelectric or high speed rotary (R) devices over a 3-week healing period.
  
  
  METHODS
  Fourteen Sprague-Dawley rats (Charles River Laboratories International, Inc., Wilmington, MA, USA) underwent bilateral tibial osteotomies prepared in a randomized split-leg design using Piezotome® (P1) (Satelec Acteon, Merignac, France), Piezotome 2® (P2) (Satelec Acteon), High-speed R instrumentation, or sham surgery (S). At 1 week, an osteogenesis array was used to evaluate differences in gene expression while quantitative analysis assessed percentage bone fill (PBF) and bone mineral density (BMD) in the defect, peripheral, and distant regions at 3 weeks. Qualitative histologic evaluation of healing osteotomies was also performed at 3 weeks.
  
  
  RESULTS
  At 1 week, expression of 11 and 18 genes involved in bone healing was significantly (p < .05) lower following P1 and P2 instrumentation, respectively, relative to S whereas 16 and 4 genes were lower relative to R. No differences in PBF or BMD were detected between groups within the osteotomy defect. However, significant differences in PBF (p = .020) and BMD (p = .008) were noted along the peripheral region between P2 and R groups, being R the group with the lowest values. Histologically, smooth osteotomy margins were present following instrumentation using P1 or P2 relative to R.
  
  
  CONCLUSIONS
  Piezoelectric instrumentation favors preservation of bone adjacent to osteotomies while variations in gene expression suggest differences in healing rates due to surgical modality. Bone instrumented by piezoelectric surgery appears less detrimental to bone healing than high-speed R device.
authors.affiliation: Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Reside
authors.forename: Eric
authors.initials: E
authors.lastname: Everett
authors.forename: Ricardo
authors.initials: R
authors.lastname: Padilla
authors.forename: Roger
authors.initials: R
authors.lastname: Arce
authors.forename: Patricia
authors.initials: P
authors.lastname: Miguez
authors.forename: Nadine
authors.initials: N
authors.lastname: Brodala
authors.forename: Ingeborg
authors.initials: I
authors.lastname: De Kok
authors.forename: Salvador
authors.initials: S
authors.lastname: Nares
mesh_terms: D000818:Animals; D015519:Bone Density; D015870:Gene Expression; D010012:Osteogenesis; D010027:Osteotomy / Q000295:instrumentation*; D059745:Piezosurgery / Q000295:instrumentation*; D010865:Pilot Projects; D051381:Rats; D017207:Rats, Sprague-Dawley; D060888:Real-Time Polymerase Chain Reaction; D013977:Tibia / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology*; D055114:X-Ray Microtomography
keywords: Piezoelectric surgery; Piezotome; gene expression; histology; microCT