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Is Ultrasonic Bone Scalpel Useful in Le Fort I Osteotomy?
Ahmet Emin Demirbas1, Suheyb Bilge2, Selin Celebi3
1Assistant Professor and Department Head, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Melikgazi, Turkey.
Purpose:
Safety and precision are 2 main goals in research to improve bone cutting in maxillofacial surgery. The aim of this prospective clinical study was to analyze the outcomes using an ultrasonic bone scalpel versus a piezoelectric surgical device and the conventional technique in a Le Fort I osteotomy.
Materials And Methods:
We designed a prospective, randomized, single-blind cohort study. The predictor variables were the devices used to perform the Le Fort I osteotomy, divided into 3 groups: 1) ultrasonic bone scalpel (BoneScalpel; Misonix, Farmingdale, NY), 2) piezoelectric surgical device, and 3) conventional technique (Lindeman burr and reciprocal saw). The primary outcome of the study was cutting time, whereas secondary outcomes were length of the procedure, total blood loss, intraoperative complications, and postoperative edema. Other variables of interest were age and gender. Data were analyzed using 1-way analysis of variance and the Kruskal-Wallis test.
Results:
The study sample was composed of 34 patients with a mean age of 21.5 years, and 63.3% of patients were women. The mean cutting time (P < .001) and length of the procedure (P = .012) were significantly shorter with the bone scalpel than with the other types of surgery. The ultrasonic bone scalpel showed a significant reduction in intraoperative blood loss of up to 45% compared with the piezoelectric surgical device and the conventional technique (P = .038).
Conclusions:
The results of this study suggest that the ultrasonic bone scalpel is an effective ultrasonic bone-cutting instrument in a Le Fort I osteotomy as evidenced by the significant decrease in the cutting time, intraoperative blood loss, and postoperative edema compared with the other techniques.
