In surgical dentistry, trauma to the gums and bone tissue is possible when working with them. The patient may experience pain during such manipulations. The advent of the piezo scalpel in dental practice has made it possible to perform surgical interventions painlessly, bloodlessly, safely and with high precision. Due to the effect of ultrasonic waves on bone tissue, manipulations are carried out with special care.
Technically complex surgical interventions - tooth extraction, cyst extraction, bone and gum grafting - are difficult to complete using classical methods. Pain, tissue burns, and bleeding are possible. The bur, due to rotating movements, does not provide the desired accuracy of tissue cutting. The advent of the piezo scalpel made it possible to perform operations without pain and very accurately. A gentle effect is exerted on the tooth and the surrounding bone and soft tissue, which makes complex operations more comfortable.
At the innovative dental clinic "Implantmaster" in Moscow, operations performed with a piezo scalpel are performed by highly qualified specialists. Our doctors constantly improve their professional skills and knowledge, attend office courses and seminars. Patients can always count on receiving quality treatment. We are able to solve complex problems in the fastest possible time and satisfy the needs of even the most demanding patients, setting loyal prices for the services provided.
Next, you will learn about what piezosurgery and the piezoscalpel apparatus are. We will tell you in detail about the advantages of using a piezo scalpel. We will introduce you to the indications and contraindications for surgical intervention with this device.
What is piezosurgery and when is it used?
Piezosurgery (non-contact surgery) is the latest method of surgical operations based on ultrasound. The procedure is performed with a piezo scalpel - an ultrasonic knife that produces vibrations, thanks to which the effects on oral tissues are carried out as carefully and accurately as possible. This is a more modern alternative to well-known surgical removal techniques in dentistry; the piezo scalpel makes it possible to abandon burs and bone drills.
Indications for piezosurgery:
- removal of teeth (also “eights”);
- adding bone before implantation (taking bone chips for the preparatory stage for implantation);
- removal of cysts, granulomas;
- sinus lift surgery (thickening of the bottom of the maxillary sinus);
- interventions that require special precision - opening the mandibular nerve, extracting tumors.
The piezo scalpel requires high professionalism from the doctor to work with it. At our Implantmaster clinic, all specialists improve and improve their skills at seminars and master classes.
Description of the piezo scalpel and its characteristics
The VarioSurg LED ultrasonic surgical system from NSK (made in Japan) is a new generation piezo scalpel. Thanks to the increased cutting ability and precision of titanium nitride tips, piezosurgery is the first choice for complex procedures. The tip has dual LEDs.
The device has 3 operating modes:
- Surg (surgical);
- Endo (endodontic);
- Perio (periodontal).
There is a pulsating mode, as well as the ability to choose from 9 programs and different attachments. The unique structure of the VarioSurg LED ultrasound device makes it indispensable when working with bone tissue. With the VarioSurg LED piezo scalpel, wisdom tooth removal becomes safe, painless and as comfortable as possible for the patient. The presence of feedback functions and automated power settings ensures highly effective surgical operations - sinus lifting, periodontal and endodontic surgery, orthodontics. The piezo scalpel adapts to the surface being treated. The VarioSurg handpiece has integrated LED optics, increasing efficiency and ensuring visibility of the surgical field.
The use of ultrasound technologies in surgery protects tissues from overheating, which reduces the likelihood of osteonecrosis and damage. The question “does it hurt to remove teeth with a piezo scalpel?” does not occur in patients, thanks to the gentle operating mechanisms of the device used in the clinic and the professionalism of Implantmaster specialists.
NSK is constantly striving for development. Its technological modifications are constantly evolving. Piezo scalpel is a technologically advanced model. It makes the treatment procedure safer and minimizes surgical intervention.
The tip of the Japanese VarioSurg system simultaneously performs two important functions:
- Produces ultrasonic vibrations;
- In real time, it analyzes the reaction of tissues to the influence of attachments and the doctor during manipulations.
The piezo scalpel has a pulse mode that facilitates tooth extraction of any complexity. This mode creates a perforation effect that cuts through the dense jawbone. Easy and precise manipulation in this mode reduces the operation time .
The presence of a feedback function ensures control of the operating parameters of the ultrasound generator during the procedure. Based on the information received from the nozzles, the feedback maintains the output power at the required level. Continuous supply of the appropriate power for each procedure is possible.
Main characteristics of the VarioSurg LED device:
- Great power;
- LED optics;
- 3 operating modes;
- pulsation function;
- 9 types of software (Surg x 5, Endo x 2, Perio x 2);
- automatically programmed cleaning and adjustment;
- various types of attachments (with titanium nitride coating).
Removal technology
Stages of the procedure using the example of an incompletely erupted wisdom tooth:
- Diagnosis of contraindications.
- The patient is given local anesthesia.
- An ultrasonic “scalpel” is used to peel off the gum tissue to free the surgical field.
- The tooth is carefully defragmented using ultrasound (without pain, pressure or touching the equipment to the tissue).
- The tooth elements are easily removed from the socket along with the roots.
- The mucous membrane is returned to its place, and stitches are applied if necessary.
Our team of doctors
Maxillofacial surgeon, Implantologist
Bocharov Maxim Viktorovich
Experience: 11 years
Orthopedist, Neuromuscular dentist
Stepanov Andrey Vasilievich
Experience: 22 years
Orthopedic dentist
Tsoi Sergey Konstantinovich
Experience: 19 years
Endodontist, Therapist
Skalet Yana Alexandrovna
Experience: 22 years
Endodontist, Therapist, Orthopedist
Varvyanskaya Anastasia Andreevna
Experience: 6 years
Dentist-orthodontist
Enikeeva Anna Stanislavovna
Experience: 3 years
Advantages of surgery performed with a piezo scalpel
The main advantages of the technique highlighted by professional dentists:
- Atraumatic. There may be no bleeding during manipulations. This technique is completely suitable for working in hard-to-reach areas. For patients with vascular pathologies who are indicated for wisdom teeth removal, a piezo scalpel is the best solution.
- Accelerated rehabilitation. Compared to a conventional operation with a scalpel, the piezo scalpel causes minimal damage to tissue with ultrasound. Patients recover quickly and without discomfort.
- Antibacterial action. Ultrasound manipulation has an antiseptic effect and in the future you can do without taking antibiotics. The risk of infection and complications in the oral cavity is reduced. Immediately after ultrasound exposure, it can be implanted. This operation is allowed for pregnant and lactating women without risks to the child’s health (when removal cannot be avoided).
- Direction of action. The device works purposefully under the supervision of a surgeon. The thickness of the required cut is determined by the nozzle used. Precision in handpiece control is achieved effortlessly, due to the instant start of the ultrasonic generator. Its work is based on a selective principle so that only the bone tissue of the jaws is exposed, and soft tissues are not affected.
- Painless. Ultrasound waves do not cause any sensations, because they do not affect nerve endings. For pain relief, local anesthesia is sufficient.
- Comfort. The patient’s recovery occurs many times faster and without discomfort due to minimal vibrations. The cutting part of the nozzle makes minimal translational movements. Thanks to VarioSurg, the number of clinical cases that can be treated under local anesthesia has increased. The system is also convenient for the doctor - an extensive view of the surgical field due to powerful LED optics. An easily controlled, balanced handpiece is included with the VarioSurg ultrasound system. The precision of manipulation reaches a new level, and there is no muscle tension in the doctor’s hand. The doctor has the opportunity to control the tip clearly and smoothly. The surgeon will be able to work with both the right and left hand, which means it becomes possible to perform high-precision operations in hard-to-reach or hidden areas of the oral cavity. Reducing the doctor’s emotional stress when working with the system, and therefore the patient’s trust, optimizes the receipt of a high-quality result. The patient will not ask the question: “Does tooth extraction with a piezo scalpel hurt?”, because the doctor’s confidence and the latest technologies of the VarioSurg system will help to perform the operation quickly, comfortably and safely.
- Time saving and efficiency. The bone tissue is cut clearly and completely; partial cuts with uneven edges are excluded. The time frame for operations performed with a piezo scalpel is significantly shorter compared to conventional surgical procedures. Ultrasound waves help reduce the time of manipulation by 2 times. The reduction in surgical time occurs because there is no need to pay careful attention to the soft structures in the mouth. The number of manipulations aimed at raising the periosteum with special instruments (its traumatization) is minimized.
It is necessary to highlight two nuances of piezosurgery:
- High price. The price of tooth extraction with a piezo scalpel is relatively high compared to conventional surgical procedures.
- Advanced training for doctors . To be allowed to perform tooth extraction operations using the ultrasound method, the dentist must complete the necessary certification courses.
The procedure is very popular and demonstrates high productivity. It has a favorable result that can be predicted. Implantmaster patients leave positive reviews about tooth extraction with a piezo scalpel.
Review: Maria
The wisdom tooth tormented me for 4 years, always getting worse at the wrong time, and never erupted. I read horror films about how such operations are carried out - they cut out the gums, saw out pieces of the impacted figure eight, imagined a bloody crumb in the mouth, and... every time I put off going to the dentist, washing down my tears of pain with nimesil. Then the esthetician dentist, where I do whitening, told me about ultrasound. For me, the nightmare ended before it even began! It all took 15 minutes, this is due to freezing time. They showed two terrible pieces of the tooth, and it had already begun to deteriorate under the gums, and separately two long crooked roots. I rinsed with an antiseptic for 3 days, they didn’t even prescribe an antibiotic. I recommend it to anyone who is afraid of tooth extraction and suffers pain.
Contraindications to the use of a piezo scalpel
Despite the fact that operations performed with a piezo scalpel are technologically effective. Ultrasound manipulations have certain contraindications that should definitely be taken into account.
This equipment is not used in certain cases:
- Cardiovascular diseases;
- oncological diseases;
- the presence of systemic diseases - diabetes, hepatitis, tuberculosis, HIV.
- reduced immunity;
- diseases of the respiratory system (asthma, emphysema);
- disorders of the central nervous system (mental disorders);
- presence of a pacemaker.
Pros and cons of piezosurgery compared to the mechanical method
Disadvantages of the mechanical method:
- A large portion of the jaw bone is removed to provide access to the surgical site;
- high risk of perforation of the root canal walls;
- Removal of unerupted and incorrectly positioned teeth is a technically complex operation. Prolonged hospitalization and rehabilitation may be required;
- it is impossible to predict the occurrence of possible complications;
- significant thinning of the walls of the teeth during preparation;
- there is a possibility of the spread of microbial flora;
- the final result of treatment depends on the doctor’s manual skills;
- overheating of tissues is possible;
- the risk of developing inflammatory processes in the postoperative period is very high.
Key features of working with a piezo scalpel:
- a compact tip and a large number of attachments help to reach hard-to-reach places, minimally affecting the surrounding tissue;
- the movements of the ultrasonic tip are strictly targeted “back and forth”, so there is no risk of creating perforation;
- complex tooth extractions are performed at a time, and hospitalization is not required;
- the development of complications is unlikely;
- attachments of various shapes and sizes help minimize the impact on surrounding tissues;
- ultrasonic vibrations create an antimicrobial effect;
- additional water cooling with water allows you to regulate the degree of thermal effect on the hard tissues of the tooth;
- after surgery, rehabilitation does not take much time and occurs without complications;
- the antibacterial effect that appears on surrounding tissues prevents the development and spread of inflammatory processes during and after manipulations;
- Gentle ultrasound intervention simplifies the future implantation process.
How is dental treatment performed?
A multifunctional ultrasound device is used for piezosurgical treatment. It has several attachments for different manipulations. The device is high-precision, every doctor’s action is as precise as possible, the incisions are thin, and the bone is processed without damaging surrounding tissues.
During treatment, local anesthesia is administered, and hard tissues are dissected using ultrasound. During the operation, tissues are disinfected (due to the properties of ultrasonic waves), due to which they are quickly restored after the intervention.
Recommendations for surgery performed with a piezo scalpel
Immediately after surgical ultrasound intervention, you must adhere to the following recommendations:
- Eating should be delayed until the anesthetic wears off. There is a high probability of soft tissue damage when chewing a bolus of food. Also, food debris can get into the fresh socket and cause an inflammatory process, which will complicate postoperative rehabilitation.
- Correction of diet. After the manipulations, the patient should limit the intake of solid foods, salted, peppered and pickled foods. In the first days, it is best to eat soft foods and purees. You should also drink more plain water.
- Do not disturb the hole. In the first 2 days, a blood clot forms in the socket area. It is not recommended to touch the hole and the site of the operation with your hands, or put your tongue there. Regeneration processes should not be disrupted. Rinsing, compresses and baths are also undesirable. Teeth should be brushed gently with a mechanical brush, and it is better not to touch the fresh socket.
- Avoid temperature changes. Visiting a sauna, bathhouse, or solarium can lead to increased bleeding in the socket.
Author:
Disadvantages of existing methods
Existing methods of tooth extraction have several disadvantages:
- Traumaticity.
- Possibility of tooth damage, formation of fragments that are difficult to remove.
- There is a possibility of damage to bone tissue during problematic removal, which can subsequently lead to difficulties with implantation.
- There may be a complication in the form of inflammation of regional lymph nodes.
- Inevitable damage to soft tissues, long healing period.
