title: Benefits of using the ultrasonic BoneScalpel™ in temporomandibular joint reconstruction.
abstract: OBJECTIVE
  The main objective of this retrospective study is to analyze and report on our operative experiences and outcomes using the ultrasonic BoneScalpel™ (BoneScalpel) versus a conventional reciprocating saw (RecipSaw) for the purpose of completing the osteotomies in total temporomandibular joint reconstruction (TJR) surgery.
  
  
  METHODS
  23 consecutive patients presented with a diagnosis of either degenerative joint disease (n = 23), a failing autogenous TJR (n = 1), heterotrophic bone formation (n = 1) or a subcondylar fracture (n = 1) for a total of 26 joints that received a TJR. 13 unique TJR surgeries employed the use of the BoneScalpel to perform the osteotomies and 13 used the RecipSaw.
  
  
  RESULTS
  There was a 49% reduction in the average volume of blood loss in the BoneScalpel group compared to the RecipSaw group (130cc vs. 268cc, p ≤ 0.004), unpaired t-test). For the other variables it was observed that there were more favorable clinical results using the BoneScalpel but without statistically significant differences given the small sample size relative to the prevalence of the outcome that was being measured.
  
  
  CONCLUSIONS
  Use of the BoneScalpel in TMJ reconstruction is overall safer and results in less blood loss compared to surgeries employing the use of the conventional RecipSaw for completing osteotomies.
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco, CA, USA.
authors.forename: Rebeka
authors.initials: R
authors.lastname: Silva
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco, CA, USA.
authors.forename: Rishi
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Biomedical Sciences for Health, Functional Anatomy Research Center (FARC), Universita degli Studi di Milano, Milano, Italy; SST Dental Clinic, Segrate, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Tartaglia
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco, CA, USA. Electronic address: stephen.connelly2@va.gov.
authors.forename: Stephen
authors.initials: S
authors.lastname: Connelly
mesh_terms: D000328:Adult; D000368:Aged; D020220:Facial Nerve Injuries; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007902:Length of Stay; D008297:Male; D008438:Maxillary Artery / Q000293:injuries; D008576:Meningeal Arteries / Q000000981:diagnostic imaging / Q000293:injuries; D008875:Middle Aged; D061646:Operative Time; D010027:Osteotomy / Q000295:instrumentation*; D019651:Plastic Surgery Procedures / Q000295:instrumentation; D012189:Retrospective Studies; D013704:Temporomandibular Joint / Q000098:blood supply / Q000000981:diagnostic imaging / Q000294:innervation / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery
keywords: Blood loss; Reconstruction; Temporomandibular; Ultrasonic instruments