Bone Surgery: The Clinical Applications

To point out, Piezoelectric units provide clinicians with the ability to cut the mineralized tissue selectively. The units’ low kHz frequency allows the soft tissue to “move” with the vibrating insert, thus preventing incision or damage to soft tissue. With higher ultrasonic frequencies, this tandem movement does not occur, resulting in the incision or other damage to soft tissue. Obviously, this “selective cutting action” is very desirable in bone surgery. For example, with piezoelectric bone surgery, dentists can create a lateral sinus window access without cutting the Schneiderian membrane.



Bone Surgery (Also known as Piezosurgery) technology has been used in periodontology and implantology for over 2 decades. Piezosurgery is a relatively new technique for osteotomy and osteoplasty that utilizes ultrasonic vibration.

How does it work?

As an illustration, the ultrasonic (or ultrasound) frequency is a frequency above the audible range for humans, usually above 20 kHz. In dental applications, the frequencies used range from 24 to 36kHz, the frequency range capable of cutting mineralized tissue.

In short, an ultrasonic surgery device is essentially an ultrasound machine with modulated frequency and a controlled tip vibration range.
By taking advantage of its settings and tips gives precise bone shaving, rasping, cutting. Moreover, Bone Surgery devices are useful for drilling while preserving the surrounding soft tissues.

In brief, with piezoelectric ultrasonics, the frequency is created by driving an electric current from a generator over piezoceramic rings.

For this reason, the resulting movement from the deformation of the rings sets up a vibration in a transducer and/or amplifier, which creates the ultrasound output.

The handpiece tip also called an insert, receives these waves. Consequently, the longitudinal movement results in the cutting of osseous tissue by the microscopic shattering of the bone.  As can be seen, a typical bone surgery unit is similar to an implant drilling system with a control panel, an irrigant, and a handpiece with wire/tubing.

Micro Vibrations

In particular, another characteristic of Piezosurgery units is the micro-vibration of the inserts. As a result, these micro-vibrations allow clinicians to make precise and narrow bone incisions, with cuts as small as 0.5 mm to 0.7 mm. The surgeon also benefits from good tactile sensation. In contrast, bone saws and dental drills do not have this level of control, precision, and tactile sensation.

In fact, not only do clinicians need to apply greater force with many rotary instruments but also there is a partial or complete loss of control of some parts of the cutting surface at any given time. This loss of control can result in damage to underlying structures, especially soft tissue, such as nerves and the sinus membrane in dentistry.

The micro-vibrations and selective cutting action, therefore, result in greater patient safety.

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