title: Piezosurgery versus conventional osteotomy in orthognathic surgery: a paradigm shift in treatment.
abstract: The aim of the study was to compare in a randomized controlled clinical trial the use of the piezoelectric osteotomy as an alternative to the conventional approach in terms of surgery time, intraoperative blood loss, cut quality, nerve injury, and costs.One hundred ten patients who had orthognathic surgery procedures with bimaxillary osteotomy were divided into 2 groups: group A was treated with a piezosurgery device, and group B, with a reciprocating saw and bur.The piezosurgical bone osteotomy permitted individualized cut designs. The surgical time in group A was reduced, with a mean for the mandibular osteotomy (1 side) between 3 minutes 31 seconds and 5 minutes 2 seconds, whereas in group B, the surgical time was between 7 minutes 23 seconds and 10 minutes 22 seconds. The surgical time in group A for the Le Fort I osteotomy was between 5 minutes 17 seconds and 7 minutes 55 seconds in group A and between 8 minutes 38 seconds and 15 minutes 11 seconds in group B. All patients in group A had a low blood loss (<300 mL) versus patients of group B who had a medium to high blood loss (medium loss: 400 mL, high loss: >500 mL). Inferior alveolar nerve sensation was retained in 98.2% of group A versus 92.7% in group B at 6 months postoperative testing.Piezoelectric osteotomy reduced surgical time, blood loss, and inferior alveolar nerve injury in bimaxillary osteotomy. Absence of macrovibrations makes the instrument more manageable and easy to use and allows greater intraoperative control with higher safety in cutting in difficult anatomical regions.
authors.affiliation: From the *Maxillo Facial Department, University of Verona, Verona; †Department of Morphology, Surgery and Experimental Medicine, School of Dentistry, University of Ferrara, Italy; ‡Dentistry Department, University of Verona, Verona; and §Department of Clinico Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, Pavia, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Bertossi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lucchese
authors.forename: Massimo
authors.initials: M
authors.lastname: Albanese
authors.forename: Matteo
authors.initials: M
authors.lastname: Turra
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Faccioni
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Nocini
authors.forename: Ruggero
authors.initials: R
authors.lastname: Rodriguez Y Baena
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D020220:Facial Nerve Injuries / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D063168:Mandibular Osteotomy / Q000379:methods*; D063166:Maxillary Osteotomy / Q000379:methods*; D061646:Operative Time; D059745:Piezosurgery / Q000379:methods*; D016896:Treatment Outcome