title: Maxillary Segmental Micro Osteotomy: A Human Cadaver Study on the Efficacy of the Technique.
abstract: OBJECTIVE
  Ultrasonic bone cutting was recently introduced as a feasible alternative to the conventional tools of cranio-maxillofacial surgery because it offers improved precision and safety.This study examined the feasibility of minimally invasive orthodontic or preprosthetic surgery using a piezosurgery device for latero-posterior maxillary segmental osteotomy.
  
  
  METHODS
  Four fresh cadaveric heads were obtained for this study. Maxillary posterior osteotomy was performed using piezoelectric surgery. To preserve the vascular supply, only 1 vestibular incision was made during surgery. The Mectron Piezosurgery unit is a multipurpose device that uses micrometric ultrasonic piezoelectric vibrations with a variable frequency and cutting energy. The strategy for maxillary osteotomy included 1 horizontal osteotomy, 2 vertical osteotomies, and 1 palatal osteotomy performed transantrally without incision of the mucoperiosteum. The osteotomies were performed using a piezodevice (OT7-type inserts: 0.55 and 0.35 mm). In total, 1 horizontal cut (3 mm above the roots of the teeth), 2 vertical bone cuts, and 1 palatal osteotomy were made without incision of the palatal mucoperiosteum.Gentle dissection of the buccal fat pad was used to promote the healing of hard and soft tissues in the osteotomized zone.
  
  
  RESULTS
  No damage to soft tissues, including the palatal mucosa, occurred. The buccal fat pad was mobilized easily without requiring an additional incision. The osteotomic sites were linear and clean in the palatal aspect. The integrity of the vascular network was maintained because of the lack of damage to the palatal mucosa. No chisels were used during the osteotomies.
  
  
  CONCLUSIONS
  This cadaveric study shows the feasibility of using piezosurgery for segmental maxillary osteotomy. This report outlines a new and simple application of segmental maxillary micro-osteotomy.
authors.affiliation: *Department of Medical and Biological Science, University of Udine, Udine †Verona, Italy ‡Padova, Italy §Department of Biomedical, Surgical, Dental Sciences, IRCCS Galeazzi Orthopaedic Institute, University of Milan, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Robiony
authors.forename: Federico
authors.initials: F
authors.lastname: Gelpi
authors.forename: Marco
authors.initials: M
authors.lastname: Finotti
authors.forename: Tiziano
authors.initials: T
authors.lastname: Testori
mesh_terms: D005240:Feasibility Studies; D006801:Humans; D008437:Maxilla / Q000601:surgery; D063166:Maxillary Osteotomy / Q000295:instrumentation* / Q000379:methods*; D008866:Microsurgery / Q000295:instrumentation* / Q000379:methods*; D008953:Models, Anatomic; D059745:Piezosurgery / Q000295:instrumentation* / Q000379:methods*