Author Topic: My first consultation with Alfaro  (Read 5551 times)

kavan

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Re: My first consultation with Alfaro
« Reply #15 on: April 28, 2021, 05:58:43 PM »
Here's a great intro video where he shows the device can do surgery on an egg--cut through the shell without damaging the soft tissue of the egg.  https://www.youtube.com/watch?v=ZRMAqi1xWu8&ab_channel=GBAesthetics
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kavan

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Alfaro is INNOVATOR using Piezosurgery® device. Others are the INVENTORS.
« Reply #16 on: April 29, 2021, 07:11:11 PM »
Literally every surgeon I've talked to claims they pioneered piezosurgery...

There indeed can be a NUMBER of pioneers or INNOVATORS who come up with techniques used with a DEVICE.

I did some research on this to distinguish between the 'inventor' and the 'pioneers'/innovators.
There are MANY pioneers/innovators, Alfaro is indeed one of them. The inventor is the one who gets the PATENT on the device. Although the inventor would also be a pioneer. Alfaro isn't listed as the patent holder/inventor.  Assignee: Piezosurgery, Inc.
Inventors: Tomaso Vercellotti, Fernando Bianchetti, Domenico Vercellotti

I referred to the following article: Piezosurgery in implant dentistry
https://www.dovepress.com/piezosurgery-in-implant-dentistry-peer-reviewed-fulltext-article-CCIDE#r_ref66 and looked for the KEY pieces of info within it.

" In 2001, the Piezosurgery® was introduced, a tool that combines the ultrasound and the piezo effect. 9" That tells me that 'Piesosurgery' is actually a TRADE MARK.

Then I go down to the credits in the bibliography and look for number 9. It lists:

9 Vercellotti T, Crovace A, Palermo A, Molfetta A. The piezoelectric osteotomy in orthopedics: clinical and histological evaluations (pilot study in animals). Mediterranean J Surg Med. 2001;9:89–95.

That tells me one of those names is likely to be the Inventor. Knowing that Piezosurgery® is a TRADEMARK and INVENTORS are usually assigned by a company to invent something, I find that it's owned by 'Piezosurgery INC' a corporation which is company owned by/associated with a company named 'mectron'.

After that, I find the PATENT on it and hence the INVENTORS:

Surgical device for bone surgery
Patent number: 8002783
Abstract: A surgical device (1) for bone surgery including a body (2) able to be gripped by the user and a tip (3) mounted at the head of the body and set in vibration at a modulated ultrasonic frequency to operate on bone tissue, the surgical device (1) being particularly suitable for oral surgical procedures such as bone sampling, excision of cysts, third molar extraction, preparation of alveolar sites, creation of an opening into the maxillary sinus (Caldwell Luc), elevation of the maxillary sinus by the crestal route and orthopedic and neurosurgical procedures such as osteoplasty, ostectomy and osteotomy.
Type: Grant
Filed: December 12, 2007
Date of Patent: August 23, 2011
Assignee: Piezosurgery, Inc.
Inventors: Tomaso Vercellotti, Fernando Bianchetti, Domenico Vercellotti

So, Alfaro isn't actually the 'inventor' of the device with TRADEMARK; Piezosurgery®

Perhaps he used the term loosely, something got lost in the translation or meant to say he was the INNOVATOR of a TECHNIQUE using the device. The article most certainly lists Alfaro as COMBINING it with an ENDOSCOPE:

"The piezosurgery technique can also be combined with endoscopic assistance for corticotomies. 66"

Looking at listing #66 in the bibliography:

66. Hernández-Alfaro F, Guijarro-Martínez R. Endoscopically assisted tunnel approach for minimally invasive corticotomies: a preliminary report. J Periodontol. 2012;83:574–580.

"CONCLUSIONS
The authors present a simple yet effective technique
to achieve rapid orthodontic tooth movement. A
tunnel approach through one to three buccal vertical
incisions per arch is used to minimize soft-tissue
debridement and periodontal risks. Endoscopic assistance is useful to design and perform the corticotomies
and to select the sites needing bone augmentation.
The preservation of root integrity is further maximized with the use of piezosurgical instruments.
Compared to traditional corticotomies, the procedure
has manifest advantages in surgical time, technical
complexity, patient morbidity, and periodontium
preservation."

So, Alfaro indeed is a PIONEER of a technique used with the device (and has TONS of journal articles) and an INNOVATOR using the device. The article CREDITS him in the bibliography. But the actual inventor/s of the TRADEMARK device he uses called Piezosurgery® are different people.


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GJ

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Re: My first consultation with Alfaro
« Reply #17 on: April 29, 2021, 08:59:27 PM »
Exactly. I used "innovator" specifically for that reason. None claim they invented it, but they all hint they sort of did...(innovator). Lol.
Millimeters are miles on the face.

kavan

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Re: My first consultation with Alfaro
« Reply #18 on: April 30, 2021, 08:36:20 AM »
Exactly. I used "innovator" specifically for that reason. None claim they invented it, but they all hint they sort of did...(innovator). Lol.

Indeed, the correct word would be 'innovator' for combining other modalities (endoscope) with the device for minimum invasive surgery. It's really an amazing technology to be put to use in surgery though because it acts on principle of specific frequency levels targeting selected tissue and not harming the surrounding tissue.
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GJ

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Re: My first consultation with Alfaro
« Reply #19 on: April 30, 2021, 09:23:02 AM »
Indeed, the correct word would be 'innovator' for combining other modalities (endoscope) with the device for minimum invasive surgery. It's really an amazing technology to be put to use in surgery though because it acts on principle of specific frequency levels targeting selected tissue and not harming the surrounding tissue.

Agree. I had it with my surgery, and I had next to zero nerve damage.

I think some of this, though, depends where the nerve is and where the cut is. Like I mentioned, Dr. G said some surgeons very knowingly "sacrifice the nerve" as in they look at it and have it in hand, and make the cut knowing it will result in damage. Their justification is that it has to be done to do the surgery as they want. I don't know...isn't the first principle "do no harm"?
Millimeters are miles on the face.

kavan

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Re: My first consultation with Alfaro
« Reply #20 on: April 30, 2021, 11:49:06 AM »
Agree. I had it with my surgery, and I had next to zero nerve damage.

I think some of this, though, depends where the nerve is and where the cut is. Like I mentioned, Dr. G said some surgeons very knowingly "sacrifice the nerve" as in they look at it and have it in hand, and make the cut knowing it will result in damage. Their justification is that it has to be done to do the surgery as they want. I don't know...isn't the first principle "do no harm"?

Then perhaps Dr. G is referring to surgeons using 'buzz saws' (medical equivalent of such) and other type tools that can sacrifice the nerves when needing to cut through an area. That is not the case when a selective frequency is specific to cutting bone but not the right frequency to cut through or damage other soft tissue. In fact, if they press on the piezo tool too much, the vibrations stop and they can't cut with it.  Watch the video I linked to where the doctor does surgery on an EGG. It demonstrates the basic principle of using selective frequencies to cut through hard stuff but not damage the soft stuff in the process.
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eglantine

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Re: My first consultation with Alfaro
« Reply #21 on: May 01, 2021, 09:11:57 AM »
@GJThanks a lot again for your replies !

"(have you had extractions, or did anyone recommend them ever?"
By extraction you mean the fact of extracting a tooth ? Alfaro mentioned it would be necessary but I never had one so far (except wisdom teeth).

Could you maybe recommend some surgeons that you believe to be good ones ? I've heard of Arnett Gunson Pelo...

I'm very shocked with what you said about surgeons cutting nerves voluntarily !
You said that yourself had "next to zero nerve damage": what light damage did you have ?

Thanks a lot again for your help !!


eglantine

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Re: My first consultation with Alfaro
« Reply #22 on: May 01, 2021, 09:19:53 AM »
@Kagan Thank you very much for all the informations you give me and for your time !!

I've read the links and your posts on Piezosurgery. It makes things much clearer and it is very interesting for me to learn more about these technique.
And it is very reassuring as my biggest fear is nerve damage.

Can I ask you if you have any opinion on Alfaro and if maybe you could suggest surgeons that are known for their good results ? As I said in another post I've noted the names of Gunson, Arnett, Pelo...

Again thanks a lot for your help !

GJ

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Re: My first consultation with Alfaro
« Reply #23 on: May 01, 2021, 09:25:30 AM »
You said that yourself had "next to zero nerve damage": what light damage did you have ?

I don't think I had any damage, but my chin feels a slightly weird so maybe some very light damage there. I can't even tell for sure.

In my instance, that was not a big deal. But it is for many people. They say 10%, but I would say the odds of damage are higher. Piezosurgery does seem to help.

Be careful with extractions. Run any final plan by the forum.
Millimeters are miles on the face.

eglantine

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Re: My first consultation with Alfaro
« Reply #24 on: May 01, 2021, 09:27:44 AM »
@Gadwins Thank you very much for your reply =) !
I didn't think of that (that nerve damage could have different definitions for different people) and it certainly does make sense. I will ask questions more specifically in the future as you advice...

I didn't know anything about the law in Germany or in Spain. It sure makes a difference knowing these contexts...

Alfaro said I could ask him more questions by email which I have (but I haven't received any reply yet). I think I'll stick to that instead of scheduling another consultation. I would rather have a consultation with another surgeon to have a second medical opinion on my case. If you have any surgeon that you could recommend, it would be very helpful !

eglantine

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Re: My first consultation with Alfaro
« Reply #25 on: May 01, 2021, 09:30:48 AM »
I don't think I had any damage, but my chin feels a slightly weird so maybe some very light damage there. I can't even tell for sure.

In my instance, that was not a big deal. But it is for many people. They say 10%, but I would say the odds of damage are higher. Piezosurgery does seem to help.

Be careful with extractions. Run any final plan by the forum.

10% is indeed a lot ! I'm glad it's not a big deal for you !
Why should I be careful with extrations ? Thanks for the warning anyways !

I'm sorry my English is quite bad and I don't understand this sentence "Run any final plan by the forum."

kavan

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Re: My first consultation with Alfaro
« Reply #26 on: May 01, 2021, 01:37:25 PM »
@Kagan Thank you very much for all the informations you give me and for your time !!

I've read the links and your posts on Piezosurgery. It makes things much clearer and it is very interesting for me to learn more about these technique.
And it is very reassuring as my biggest fear is nerve damage.

Can I ask you if you have any opinion on Alfaro and if maybe you could suggest surgeons that are known for their good results ? As I said in another post I've noted the names of Gunson, Arnett, Pelo...

Again thanks a lot for your help !

Well, I think that my participation as it relates to opinions is best when I can give focus to basic scientific principles and aesthetic relationships. Being a graduate of one of the best scientific institutions in the world and also having studied art/aesthetic theory at another renowned university, my academic inclination is more in the venue of shedding light on that kind of topic matter. I mean I'm happy to confirm that Alfaro is using an advanced technology where he does have some 'bragging rights' as to his use and success with it since your questions revolved around that in part. So, my 'opinion' as to Alfaro was to buttress factual relationships having to do with the technology he was using and also the differentiation between 'Inventor' and 'Innovator'. So, I guess I can say my opinion on Alfaro is that he likes to 'toot his horn'. But then again, he CAN and I'm in no position to hold his feet to the fire because he does.

I'll also say that another practice you named; Arnett/Gunson (Arnett is retired) is known for balancing aesthetics with scientific principles behind function. But I need to disclose and perhaps veer away from the appearance that I am recommending a doctor or conveying; 'This is the one for you' (or anyone else who might assume that) when I name doctors. So, the act of my naming surgeons can give appearance  JSF is promoting them or be interpreted as conveying: 'Here's the one/s for you.' or that they are the 'right' ones for every person reading the mention of a name. Hence, personally, I veer away from suggesting surgeons although I have no issue with others doing so.

 
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eglantine

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Re: My first consultation with Alfaro
« Reply #27 on: May 03, 2021, 03:42:29 PM »
@Kavan Thanks for giving some background :) The informations you gave me about the technique used by Alfaro was very interesting !

" balancing aesthetics with scientific principles behind function. "
my English is too bad and I don't understand the meaning... Does he privilege aesthetic at the detriment of function ?

" JSF is promoting them or be interpreted as conveying: '"

Of course, I would never take it like that ! I just believe that you have heard of many surgeons and that maybe you have an idea of the statistics of good experience reported for each one, and which surgeons seem to be the best... Of course, I am fully responsible of the surgeon I choose to meet. It just helps saving a lot of time to know that such one is reputated for doing a bad job or that this one has mostly good reviews from former patients...


kavan

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Re: My first consultation with Alfaro
« Reply #28 on: May 03, 2021, 03:56:44 PM »
@Kavan Thanks for giving some background :) The informations you gave me about the technique used by Alfaro was very interesting !

" balancing aesthetics with scientific principles behind function. "
my English is too bad and I don't understand the meaning... Does he privilege aesthetic at the detriment of function ?

" JSF is promoting them or be interpreted as conveying: '"

Of course, I would never take it like that ! I just believe that you have heard of many surgeons and that maybe you have an idea of the statistics of good experience reported for each one, and which surgeons seem to be the best... Of course, I am fully responsible of the surgeon I choose to meet. It just helps saving a lot of time to know that such one is reputated for doing a bad job or that this one has mostly good reviews from former patients...

Your English is very good. Now the 'balancing aesthetics with scientific principles behind function' would have to do with what he calls 'FAB' which is 'Face, Airway and Bite'. So, your bite and airway are the functional things and the face is the Aesthetic thing and the goal is to BALANCE them.

Alfaro and Gunson are frequently mentioned on here. There is a section of the board called 'Surgeon Leads'. So, you might want to try that for more names than the 2 you've already found.
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eglantine

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Re: My first consultation with Alfaro
« Reply #29 on: May 04, 2021, 02:07:26 AM »
Thanks a lot for all your help :) !
I'm going to look at this section !