PIEZOSURGERY: A versatile tool in periodontology and oral implantology


  • Bharath Chandra college of dental sciences, davangere, karnataka
  • Narayan Walavalkar N college of dental sciences
  • Shobha Praksh college of dental sciences






Ultrasonic, Piezoelectric, Osteotomies


Piezosurgery is a relatively a new technique of bone surgery, that is recently gaining popularity in implantology, periodontics and oral surgery. Piezoelectric ultrasonic vibrations are utilized to perform precise and safe osteotomies. Becauseof its highly selective and accurate nature, with its cutting effect exclusively targeting hard tissue, its use may be extended to more complex oral surgical procedures, as well as to other interdisciplinary problems. It can be used for selective cutting of bone depending on bone mineralization, without damaging the adjacent soft tissue (e.g. vessels, nerves or mucosa), providing a clear visibility in the operating field, and cutting with sensitivity without the generation of heat. So this review discusses the equipment, mechanism of action biological effects on bone, indications, contraindications, advantages and disadvantages of this new technology.


[1] Bains VK, Mohan R, Bains R. Application of ultrasound in periodontics: Part II. J Indian SocPeriodontol 2008; 12:55‑61.https://doi.org/10.4103/0972-124X.44096.

[2] Carr M. Ultrasonics. Access, 1999, 2-8.

[3] Deepa D, Jain G, Bansal T. Piezosurgery in dentistry. J Oral Res Rev 2016;8:27-31.https://doi.org/10.4103/2249-4987.182487.

[4] González‑García A, Diniz‑Freitas M, Somoza‑Martín M, García‑García A. Ultrasonic osteotomy in oral surgery and implantology. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 2009; 108:360-7.https://doi.org/10.1016/j.tripleo.2009.04.018.

[5] Grenga V, Bovi M. Piezoelectric surgery for exposure of palatally impacted canines. J ClinOrthod. 2004;38:446. [PubMed: 15333962].

[6] Happe A. Use of a piezoelectric surgical device to harvest bone grafts from the mandibular ramus: Report of 40 cases. Int J Periodontics Restorative Dent 2007; 27:241-9.

[7] HaydarpasaTeachingHospital, Department of Oral Surgery and Oral Medicine, GulhaneMilitary Medical Academy, Istanbul, Turkey.

[8] Hema S, Kranti K, Sameer Z. Piezosurgery in periodontology and oral implantology. J Indian SocPeriodontol 2009; 13(3):155-156.https://doi.org/10.4103/0972-124X.60229.

[9] Horton JE, Tarpley TM Jr., Wood LD. The healing of surgical defects in alveolar bone produced with ultrasonic instrumentation, chisel, and rotary bur. Oral Surg Oral Med Oral Pathol 1975; 39:536-46.https://doi.org/10.1016/0030-4220(75)90192-9.

[10] JaishreeTukaramKshirsagar, Premkumar K, Yashodha SR, Nirmmal Maria T. Piezosurgery: Ultrasonic bone surgery in periodontics and oral implantology- Review. International Journal of Applied Dental Sciences 2015; 1(5): 19-22.

[11] Labanca M, Azzola F, Vinci R, Rodella LF. Piezoelectric surgery: Twenty years of use. Br J Oral MaxillofacSurg 2008; 46:265-9.https://doi.org/10.1016/j.bjoms.2007.12.007.

[12] Marie Grace Poblete-Michel, Jean-Francois Michel.Clinical Success in Bone Surgery with UltrasonicDevices. Quintessence Publishing Company.Incorporated, 2009.

[13] Palti A, Hoch T. A concept for the treatment of various dental bone defects. Implant Dent. 2002;11:73–8. [PubMed: 11915549]https://doi.org/10.1097/00008505-200201000-00017.

[14] PenarrochaDiago M, Ortega Sanchez B, Garcia Mira B. Evaluation of healing criteria for success after periapical surgery. Med Oral Patol Oral Cir Bucal. 2008; 13:E143-7.

[15] Preti G, Martinasso G, Peirone B,NavoneR, ManzellaC, Muzio G, et al. Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus adrilltechnique: A pilot study in minipigs. J Periodontol 2007; 78:716-22.https://doi.org/10.1902/jop.2007.060285.

[16] Rashad A, Sadr‑Eshkevari P, Weuster M, Schmitz I, Prochnow N, Maurer P. Material attrition and bone micromorphology after conventional and ultrasonic implant site preparation. Clin Oral Implants Res 2013; 24Suppl A100:110-4.

[17] Robiony M, Polini F, Costa F, Vercellotti T, Politi M. Piezoelectric bone cutting in multipiece maxillary osteotomies: Technical Note. J Oral Maxillofac Surg. 2004;62:6.https://doi.org/10.1016/j.joms.2004.01.010.

[18] Seshan H, Konuganti K, Zope S. Piezosurgery in periodontology andoral implantology. J Indian SocPeriodontol 2009; 13:155-6.https://doi.org/10.4103/0972-124X.60229.

[19] Sherman JA, Davies HT. Ultracision: the harmonic scalpel and its possible uses in maxillofacial surgery. Br J Oral Maxillofac Surg. 2000; 38:530-2.https://doi.org/10.1054/bjom.2000.0502.

[20] Sohn DS, Ahn MR, Lee WH, Yeo DS, Lim SY. Piezoelectric osteotomy for intraoral harvesting of bone blocks. Int J Periodontics Restorative Dent 2007; 27:127-31.

[21] Stelzle F, Frenkel C, Riemann M, Knipfer C, Stockmann P, Nkenke E. The effect of load on heat production,thermal effects and expenditure of time during implant site preparation - an experimental ex vivo comparison between peizosurgery and conventional drilling. Clin Oral Implants Res, 2012.

[22] Stübinger S, Kuttenberger J, Filippi A, Sader R, Zeilhofer HF. Intraoral piezosurgery: Preliminary results of a new technique. J Oral MaxillofacSurg 2005; 63:1283-7.https://doi.org/10.1016/j.joms.2005.05.304.

[23] Swyeta Jain Gupta, VivekGautam, Amit Gupta. Piezosurgery – a revolutionary approach in periodontal surgeries. Int J Dent Health Sci 2015; 2(5):1205-1221.

[24] Vercellotti T, Paoli SD, Nevins M. The PiezoelectricBony Window Osteotomy and Sinus MembraneElevation: Introduction of a New Technique forSimplification of the Sinus Augmentation Procedure. IntJPerio Rest Dent. 2001; 21:561-67.

[25] Vercellotti T, Nevins ML, Kim DM, Nevins M, Wada K, Schenk RK, et al. Osseous response following resective therapy with piezosurgery. Int J Periodontics Restorative Dent 2005; 25:543-9.

[26] Wallace SS, Mazor Z, Froum SJ. Scheinderian membrane perforation rate during sinus elevation using Piezosurgery: Clinical results of 100 consecutive cases. Int J Periodontics Restorative Dent. 2007; 27:5.

[27] Walmsley AD, Laird WR, Williams AR. Dental plaque removal by cavitational activity during ultrasonic scaling. J ClinPeriodontol. 1988; 15:539-43.https://doi.org/10.1111/j.1600-051X.1988.tb02126.x.

[28] Yaman Z, Suer BT. Piezoelectric surgery in oral and maxillofacial surgery. Annals of Oral and Maxillofacial Surgery. 2013; 1(5):1-9.https://doi.org/10.13172/2052-7837-1-1-399.

View Full Article: