[Development and clinical application of ultrasonic osteotomy in dentistry]

Ultrasonic osteotomy is a new technique for osseous surgery utilizing an innovative ultrasonic surgical apparatus. Oral surgeons have started using this newly developed ultrasonic bone scalpel when performing precise osteotomies. This technique is known as piezosurgery also and has found wide applications in dental and medical specialities. Numerous protocols including conventional diamond round bur, safe scraper, rongeur pliers and gouge shaped bone chisel have been proposed to simplify osteotomy and osteoplasty in bone surgery before this technique was created. But only ultrasonic osteotomy could reach high levels of precision and safety as compared to those instruments. Ultrasonic osteotomy device is characterized by piezoelectric ultrasonic vibrations of a frequency of 25-29 kHz and a range between 60-200 microm. Due to low-frequency ultrasonic vibration, the device precisely cuts bone without cutting soft tissue even in case of accidental contact. It also maintains a blood-free site during cutting bone. This technique was first used in sinus floor elevation for bony window osteotomy and sinus membrane elevation. After several years, this technique is utilized in more and more dental indications such as ridge expansion, maxillary sinus floor elevation, harvesting of bone graft, extraction and socket debridement for the installation of immediate-loaded implants, extraction of third molars, periodontal surgery, cyst exeresis and inferior alveolar nerve transposition. It's also reported in hand surgery, cranial osteoplasty and segmental maxillary Le Fort osteotomy. Ultrasonic osteotomy is different from the conventional techniques utilized and proved to be a safe and useful technique in bone surgery.