medical technology
implan t p re p a ra site tion
The original piezo bone surgery – evidence based!
the PIEZOSURGERY速 technique
Thanks to the controlled three-dimensional ultrasound vibrations, the original PIEZOSURGERY速 technique opens up a new age for osteotomy, osteoplasty and extraction in Implantology, Periodontology, Endodontics and Surgical Orthodontics.
2 I Micrometric cuts
maximum surgical precision and intra-operative sensitivity
I Selective cuts
minimal damage to soft tissue, maximum safety for you and your patients
I Cavitation effect
maximum intra-operative visibility and a blood-free surgical site
medical technology
ÂŽ
PIEZOSURGERY has defined a new definition in bone surgery I It’s simple, stress-free and selective I It increases the quality and success for you and your patients 3
clinical examples Sinus Lift Technique
Extractions
Ridge Expansion Technique
Included Tooth Extraction
4
ORAL SURGERY
IMPLANTOLOGY
Bone Block Harvesting
Implant Site Preparation
Bone Chips Harvesting
I Oral Surgery - Extractions - Bone Graft: Block - Bone Graft: Chips - Endodontic Surgery
I Orthodontic Surgery - Osteotomy and Corticotomy
I Implantology - Sinus Lift Technique - Ridge Expansion Technique - Implant Site Preparation
I Periodontal Surgery - Crown Lengthening Technique - Resective and Regenerative Surgery
medical technology
速
The PIEZOSURGERY technique is indicated for a variety of bone surgery applications
ORTHODONTICS Endodontic Surgery
Orthodontic Surgery
5
PERIODONTAL SURGERY Periodontal Surgery
Crown Lengthening
ultrasound technology
6
THE ULTRASOUNDS
CONTROL
The ultrasounds of the Piezosurgery® unit have been developed specifically for cutting bone tissue and doing minimal damage to the soft tissue. High-frequency oscillations between 24.000 and 29.500 Hz, modulated with a low frequency between 10 and 60 Hz, enable efficient and controlled use and improve the healing of the tissue.
The Piezosurgery® unit is controlled solely by means of an interactive keyboard. Each command is shown on an easy-to-read display. There are two basic programs, BONE and ROOT. In the BONE program, it is possible to adapt the power to any of four levels depending upon bone quality. In the ROOT program, the power can be set to either PERIO or ENDO. It has an automatic feedback system for constant control of the power of the ultrasounds, which can be adjusted in case of need. With this system, any interferences present in the unit, in the handpiece or in the electronics are recognised and highlighted on the display. The CLEAN function is activated by pressing a button and the footswitch together to start the cleaning cycle of the unit’s main tubes.
medical technology
THE SURGICAL TRAY The surgical tray contains all the components necessary for surgery utilizing the Piezosurgery® system.
THE TORQUE WRENCH
THE LIQUID
THE PERISTALTIC PUMP
THE HANDPIECE
The instruments are tightened to the handpiece with the torque wrench. The wrench applies a pre-defined force to obtain optimum energy transmission.
Liquid is drawn from a bag or bottle which hangs from the rod provided. All parts of the unit through which the liquid passes, including the handpiece cord and the handpiece itself, are fully sterilisable.
The sterile tube is simply inserted into the pump which is then closed. The quantity of liquid may be adjusted using the continuous + and – buttons.
The handpiece is connected permanently to the handpiece cord and is sterilised together with it.
The Piezosurgery unit – high performance, safe use ®
7
instruments
OT7
8
EX1
OP3
IM2A
IM3P
OT5
OT1
OT4
OP4
PS1
EL1
PP1
SHARP INSTRUMENTS
SMOOTHING INSTRUMENTS
BLUNT INSTRUMENTS
The sharp edge of the instruments enables gentle and effective treatment of the bony structures.
The smoothing instruments have diamond surfaces enabling precise and controlled work on the bone structures.
Sharp instruments are used in osteotomy whenever a fine and well-defined cut in the bone structure is required.
Smoothing instruments are used in osteotomy when it is necessary to prepare difficult and delicate structures. For example, those preparing for a sinus window or access to a nerve.
Blunt instruments are used for preparing the soft tissue. For example, for elevating the Schneider’s Membrane or for lateralizing nerves.
There are also instruments with sharp edges that are used for implant site preparation, osteoplasty techniques and/or harvesting bone chips.
In periodontology, these tips are used for root planing.
In osteotomy, smoothing instruments are used to obtain the final bone shape.
INSTRUMENTS COLOUR Gold For all instruments used to treat bone. The gold color of the instruments is obtained by applying a coating of titanium nitride to improve the surface hardness which means a longer working life. Steel For all instruments used to treat soft tissue or delicate surfaces such as the roots of teeth.
medical technology
The surgical instruments – specifically invented and clinically tested THE INTRUMENT KITS mectron offers kits of instruments suitable for Piezosurgery® and provides all the instruments required for the various indications. The „Basic Kit” and the „Sinus Lift Kit” are part of the original package.
THE BASIC KIT
THE SINUS LIFT KIT
The fields in which it is used are: I Osteotomy I Osteoplasty I Extraction I Ridge Expansion
The fields in which it is used are: I Preparation of the bone window I Separation of the sinus membrane I Elevation of the sinus membrane
9
science
Electron Microscope Image – Result after the Piezosurgery® Osteotomy
HISTOLOGY RESULTS Comparative studies have demonstrated both the clinical and the histological advantages of the PIEZOSURGERY® procedure.
Bone bur
10
Bone saw
8 years of successful scientific research and clinical studies
PIEZOSURGERY®
REFERENCES Ultrasound in bone surgery
I
I
I
Mazorow HB. Bone repair after experimental produced defects. J Oral Surg 1960; 18: 107-115 I McFall TA, Yamane GM, Burnett GW. Comparison of the cutting effect on bone of an ultrasonic cutting device and rotary burs. J Oral Surg, Anesth & Hosp D Serv 1961; 19: 200-209. I Horton JE, Tarpley TM Jr, Wood LD. The Healing of Surgial Defects in Alveolar Bone Produced with Ultrasonic Instrumentation, Chisel and Rotary Bur. Oral Surg Oral Med Oral Pathol 1975; 39:536-546 I Horton JE, Tarpley TM Jr, Jacoway JR. Clinical Applications of Ultrasonic Instrumentation in the Surgical Removal of Bone. Oral Surg Oral Med Oral Pathol 1981;51:236-242 I Aro H, Kallioniemi H, Aho AJ, Kellokumpu-Lehtinen P. Ultrasonic Device in Bone Cutting. A Histological and Scanning Electron Microscopical Study. Acta Orthop Scand 1981; 52:5-10 I Torella F, Pitarch J, Cabanes G, Anitua E. Ultrasonic Osteotomy for the Surgical Approach of the Maxillary Sinus: A technical note. Int J Oral Maxillofac Implants 1998; 13:697-700
Piezosurgery® in bone surgery I Vercellotti T. Piezoelectric
Surgery in Implantology: A Case Report – A New Piezoelectric Ridge Expansion Technique. Int J Periodontics Restorative Dent 2000; 20:359-365 Vercellotti T, Russo C, Gianotti S. A New Piezoelectric Ridge Expansion Technique in the Lower Arch – A Case Report (online article). World Dentistry 2000; - http://www.worlddent.com/2001/05/articles/vercellotit.xml I Vercellotti T, De Paoli S, Nevins M. The Piezoelectric Bony Window Osteotomy and Sinus Membrane Elevation: Introduction of a New Technique for Simplification of the Sinus Augmentation Procedure. Int J Periodontics Restorative Dent 2001; 21:561-567 I Vercellotti T, Crovace A, Palermo A, Molfetta A. The Piezoelectric Osteotomy in Orthopedics: Clinical and Histological Evaluations (Pilot Study in Animals). Mediterranean Journal of Surg Med 2001; 9:89-95 ® I Vercellotti T, Obermair G. Introduction to Piezosurgery . Dentale Implantologie & Parodontologie. 2003; 7:270-274 I Vercellotti T. La Chirurgia Ossea Piezoelettrica. Il Dentista Moderno. 2003; 5:21-55 I Robiony M, Polini F, Costa F, Vercellotti T, Politi M. Piezoelectric Bone Cutting in multipiece maxillary osteotomies. Technical Note. J Oral Maxillofac Surg. 2004; 62:759-761 I Boioli LT, Vercellotti T, Tecucianu JF. La chirurgie piézoélectrique: Une alternative aux techniques classiques de chirurgie osseuse. Inf Dent 2004; 86 (41): 2887-2893 I Vercellotti T. Technological characteristics and clinical indications of piezoelectric bone surgery. Minerva Stomatol. 2004; 53:207-14 I Lambrecht J. Thomas. Intraorale Piezo-Chirurgie. Schweiz Monatsschr Zahnmed. 1/2004; 114:29-36 I Siervo S, Ruggli-Milic Sascha, Radici M, Siervo P, Jager Kurt. Piezo-elektrische Chirurgie. Eine alternative Methode für die schonende Chirurgie. Schweiz Monatsschr Zahnmed. 4/2004; 114:365-377 I Grenga V, M. Bovi. Piezoelectric Surgery for Exposure of Palatally Impacted Canines. Journal of Clinical Orthodontics. 2004; Volume XXXVIII No.8:446-448 I Cortese G. Struttura implantare a nido d’ape per riabilitare selle atrofiche edentule posteriori. Un approccio chirurgico piezoelettrico. Teamwork. anno VI, 4/2004, 304:309 I Valencia M E, Hernandez R M, Baeza V Solange, Jaramillo K J. Osteotomìas Piezoeléctricas en Cirugìa Ortognatica. Revista de la Facultad de Odontologia. Universidad de Valparaiso. 2004; 3:693-695 I Eggers G, Klein J, Blank J, Hassfeld S. Piezosurgery: an ultrasound device for cutting bone and its use and limitations in maxillofacial surgery. British Journal of Oral Maxillofacial Surgery. 2004; 42(5):451-3 ® I Vercellotti T, Nevins M.L, Kim D.M, Nevins M, Wada K, Schenk R.K, Fiorellini J.P. Osseous Response following Resective Therapy with a Piezosurgery . Int J Periodontics Restorative Dent. 2005; 25:543-549 I
Bovi M. Mobilization of the Inferior Alveolar Nerve with simultaneous implant insertion: A New Technique. A Case Report. Int J Periodontics Restorative Dent 2005; 25:375–383 Troiani C, Russo C, Ballarani G, Vercellotti T. Piezoelectric Surgery: A new reality to cut and manage bone. Maxillo Odontostomatologia – International Journal of Maxillo Odontostomatology – S.I.M.O. 2005; 4(1):23-28 I Vercellotti T. Caracterìsticas tecnològicas e indicaciones clinicas de la cirugìa òsea piezoeléctrica. Revista Mundo Dental. 2005; 26-28 I Schlee M. Ultraschallgestützte Chirurgie – Grundlagen und Möglichkeiten. Zeitschrift für Zahnärztliche Implantologie (JDI) 2005; 21. Jahrgang, Heft 1 (2005) Seite 48-59 ® I Vercellotti T, Obermair G. Introduzione alla Chirurgia Piezoelettrica . Implantologia Dentale. 2005; 2(2):78-82 I Bucking W. Empirisch in der Praxis bewahrt. Die schonende Explantation. Quintessenz. 2005; 56(4):335-341 ® I Chiriac G, Herten M, Schwarz F, Rothamel D, Becker J. Autogenous bone chips: influence of a new piezoelectric device (Piezosurgery ) on chips morphology, cell viability and differentiation. Journal of Clinical Periodontology 2005; 32:994-999 I Gruber R.M, Kramer FJ, Merten HA, Schliephake H. Ultrasonic surgery – an alternative way in orthognathic surgery of the mandible. A pilot study. Int. J. of Oral Maxillofacial Surg. 2005; 34: 590-593 I Schaller BJ, Gruber R, Merten HA, Kruschat T, Schliephake H, Buchfelder M, Ludwig HC. Piezoelectric bone surgery: a revolutionary technique for minimally invasive surgery in cranial base and spinal surgery? Neuro-surgery. Technical notes. 2005; Operative Neurosurgery 57: suppl. 4 I Boioli L.T, Etrillard P, Vercellotti T, Tecucianu JF. Piézochirurgie et aménagement osseux préimplantaire. Greffes par apposition de blocs d’os autogène avec prélèvement ramique. Implant 2005; 11(4):261-274 I Vercellotti T. La Chirurgia Piezoelettrica. Tecnica di rialzo del seno mascellare. 2005; 14:245-255. I T. Testori, R. Weinstein, S. Wallace. La Chirurgia del Seno Mascellare e le alternative terapeutiche. Edizioni Acme. 2005. I Geha H, Gleizal A, Nimeskern N, Beziat J.L. Sensitivity of the Inferior Lip and Chin following Mandibular Bilateral Sagittal Split Osteotomy Using Piezosurgery. Plast. Reconstr. Surg. 2006; 118(7):1598-1607. I Stubinger S, Robertson A, Zimmerer S. K, Leiggener C, Sader R, Kunz C. Piezoelectric Harvesting of an Autogenous Bone Graft from the Zygomaticomaxillary Region: Case Report. Int J Periodontics Restorative Dent. 2006; 26:453-457 I Vercellotti T, Pollack A S. The New Bone Surgery Device: Sinus Grafting and Periodontal Surgery. Compend Contin Educ Dent. 2006 May;27(5):319-25. I Sivolella S, Berengo M, Scarin M, Mella F. Martinelli F. Autogenous particulate bone collected with a piezo-electric surgical device and bone trap: a microbiological and histomorphometric study. Archives of Oral Biology. 2006; 51(10): 883-891 I Vercellotti T, Nevins M, Jensen Ole T. Piezoelectric Bone Surgery for Sinus Bone Grafting. 2006; 23:273-279. The Sinus Bone Graft, Second Edition. Edited by Ole T. Jensen, Quintessence books I Geha A. H.J, Gleizal A, Nimeskern N, Béziat J-L. Sensitivity of the Inferior Lip and Chin following Mandibular Bilateral Sagittal Split Osteotomy Using Piezosurgery. Plast. Reconstr. Surg. 2006; 118(7) 1598-1607. I Gleizal A, Li Shuli, Pialat J-B, Béziat J-L. Transcriptional expression of calvarial bone after treatment with low-intensity ultrasound: An in vitro study. Ultrasound Med Biol. 2006; 32(10):1569-1574, ® ® I Beziat J-L, T. Vercellotti, Gleizal A. Qu’est-ce que la Piezosurgery ? Intérêt en Chirurgie cranio-maxillofaciale. A propos de deux ans d’expérience. (What is Piezosurgery , Two-years experience in craniomaxillofacial surgery). Revue de Stomatologie et Chir Maxillofaciale. 2007; 108(2):101-107 I Béziat J-L, Béra,J-C, Lavandier B, Gleizal A. Ultrasonic osteotomy as a new technique in craniomaxillofacial surgery. International Journal of Maxillo-facial Surgery. 2007; Mar 21 I Gleizal A, Béra J-C, Lavandier B., Béziat J-L. Piezoelectric osteotomy: a new technique for bone surgery – advantages in craniofacial surgery. Childs Nerv Syst . 2007; 5: 509-513
medical technology Mission: teach, disclose the Piezosurgery® procedure and improve the surgical technique in many specialities by: Basic course (a one day and half workshop/hands-on): This will be an opportunity to obtain a fast learning curve and learn about each aspect of piezoelectric bone surgery from the basic principals to the deep knowledge of each instrument and the variety of applications where Piezosurgery® can be used. Also the practical workshop/ hands-on on animal skulls gives each participant practical experience. The attendants will receive the „Authorized Piezosurgery® Certificate” at the and of the course. Piezosurgery Academy Palazzo Negrotto Cambiaso Advanced course: Specialists in the field develop Via Portobello, 12 – 16039 Sestri Levante (GE) monographic courses for each speciality – Sinus Ph.: +39 0185 42968 lift, Root Extraction, Ridge Expansion, Bone Graft, Fax: +39 0185 401186 Orthodontic Surgery – though theory, surgical proe-mail: european.academy@piezosurgery.com tocols and hands-on on animal skulls.
www.piezosurgery.com THE INVENTION „The PIEZOSURGERY® has been developed in order to overcome the limits of precision and intraoperatory safety existing in traditional bone cutting instruments.“ Tomaso Vercellotti, MD, DDS
11
TECHNICAL SPECIFICATIONS Dimensions (LxWxH) Weight Working frequency Output levels
340 x 210 x 150 mm 3.5 kg 24.000 – 29.500 Hz adjustable to 6 output levels: ROOT Mode
Delivery rate of the peristaltic pump Power supply Power supply voltage
Max. power absorbed Warranty
ENDO output PERIO output
BONE Mode
QUALITY1 output QUALITY2 output QUALITY3 output SPECIAL output
with the „Root” outputs with the „Bone” outputs 0–100 ml per min. 15–100 ml per min. connection to the power supply is sufficient 230 Vac ± 10 % 50/60 Hz 115 Vac ± 10 % 50/60 Hz (optional) 100 Vac ± 10 % 50/60 Hz (optional) 70 W unit 2 years, handpiece and handpiece cord 1 year
medical technology
”Devi Plaza”, #3, 9th 'D' Cross HBR Layout, Ring Road Bangalore - 560043 Karnataka, INDIA tel +91 80 41608672 fax +91 80 41608671 info@mectronindia.com
mectron Dental (India) PVT LTD
mectron.suisse@mectron.com
Le Clos, 43 1346 Les Bioux SUISSE tel +41 21 8454682 fax +41 21 8454714
mectron Suisse Uniline Dental Service
ul. Wybickiego 1/49a 31-261 Kraków POLAND tel +48 12 632 19 27 fax +48 12 632 89 9 www.fmdental.pl biuro@fmdental.pl
mectron Poland FM Produkty Dla Stomatologii
mectron.france@mectron.com
3706 rue de Franche Comté 39220 Bois d’Amont FRANCE tel +33 3 84609853 fax +33 3 84609637
mectron France Surgytech Sarl
Zemlianoi Val 2/50 KV. 31 105 064 Moscow RUSSIA tel +7 495 626 5455 fax +7 495 917 9931 www.anas.ru info@anas.ru
mectron Russia ANAS LTD
www.incotrading.net incotrading@incotrading.net
C° Hormigueras, 119 28031 Madrid ESPAÑA tel +34 91 3807490 fax +34 91 3036863
mectron España Incotrading S.A.
100 Matawan Road, Suite 400 Matawan, New Jersey 07747 USA tel +1 732 335 3433 fax +1 732 335 3667 www.piezosurgery.us info@piezosurgery.us
United States Piezosurgery® Inc.
Waltherstr. 80/2001 51069 Köln DEUTSCHLAND tel +49 221 492015 0 fax +49 221 492015 29 www.rocker-narjes.com www.mectron.de info@mectron.de
mectron Deutschland Vertriebs GmbH
The original piezo bone surgery – evidence based!
mectron s.p.a. via Loreto, 15/A 16042 Carasco (Ge) ITALIA tel +39 0185 35361 fax +39 0185 351374 www.mectron.com mectron@mectron.com
mectron s.p.a. ©
0092en-10/07