Ultrasonic osteotomy as a new technique in craniomaxillofacial surgery

Ultrasound osteotomy is a new surgical technique used in dentistry to section hard tissues without damaging adjacent soft tissues. It was hypothesized that this could also be useful in craniofacial and orthognathic surgery. An ultrasonic device was employed in the following craniofacial surgical procedures: 144 Le Fort I osteotomies, 140 palatal expansions after Le Fort I osteotomies and 140 bilateral sagittal osteotomies; 2 Le Fort III osteotomies for treatment of Crouzon syndrome in two patients; 12 cases of unicortical calvarial bone grafting; removal of superior orbital roof in 25 cases of craniofaciostenosis; removal of external wall of the orbit in 10 cases of orbital cavity tumour; removal of anterior and posterior walls of the frontal sinuses in four cases of orbital cavity tumour. Integrity of soft tissues and surgical time were evaluated. Functional results were good without any soft-tissue damage being observed, but the overall operative time was increased. Ultrasound osteotomy is a new technical procedure that is advantageous for bone cutting in multiple situations, with minimal to no damage in adjacent soft tissues such as brain, palatal mucosa and the inferior alveolar nerve.