Sharmishta, G (2016) Efficiency of Piezoelectric Vs Conventional Bur Osteotomy in Orthognathic Surgery. Masters thesis, Ragas Dental College and Hospital, Chennai.
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Abstract
PURPOSE: The main objective of this study was to evaluate and compare the effects of piezosurgery device with those of the conventional rotary instruments in orthognathic surgery in terms of blood loss, pain, swelling and paraesthesia. PATIENTS AND METHODS: A split mouth prospective clinical study was designed. Twelve patients with dento-facial deformities who had to undergo bimaxillary orthognathic surgical procedures were included in the study. In all the twelve patients the right side osteotomies were performed using the conventional rotary instruments and the left side osteotomies were performed using the piezosurgery unit. Intra-operative blood loss and post-operative pain, swelling and nerve impairment were the parameters that were evaluated and the outcomes of all these parameters were compared between the two groups. RESULTS: On comparison between the piezosurgery and the conventional bur osteotomies, there was an average blood loss of 245.83 ml Vs 403.75 ml intra-operatively with a statistically significant (p = 0.001) reduction in the blood loss in the piezosurgery group than in conventional rotary group. Post-operatively, pain started to subside at a shorter interval of time with a statistically significant value of p = 0.02 (Wong Baker Faces Pain Rating Scale) & p = 0.01 (Numeric Pain Scale) by 3rd day and the nerve impairment was significantly reduced in the piezosurgery side than the conventional bur side both subjectively as well as objectively. But there were no significant differences in the post-operative swelling in either of the study groups. CONCLUSION: Piezosurgery is a safer and minimally invasive procedure causing lesser post-operative discomfort to the patient and also increases patient’s compliance. It helped in achieving precise and geometric osteotomy cuts and improved the vision at the site of surgery during the procedure. It reduced the amount of intra-operative blood loss, post-operative pain and nerve impairment significantly. Clinically post-operative bone healing was unimpeded. Even though the time taken for the osteotomies especially in dense bone using piezosurgery is longer and the cost of the inserts is higher, it gave better treatment outcomes when compared to the other traditional mechanical tools. Also it’s a great tool that can be used by a beginner while performing procedures in critical anatomic areas. Hence we recommend that piezosurgery can be used for routine orthognathic surgical procedures especially in close proximity to the vital structures with great safety and minimal injury along with the other traditional tools.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Piezosurgery, Conventional bur osteotomy, Orthognathic surgery, Blood loss, Swelling, Pain, Nerve impairment. |
| Subjects: | DENTAL > Oral and Maxillofacial Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 21 Sep 2021 03:43 |
| Last Modified: | 21 Sep 2021 03:43 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/18058 |
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