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General Category => Functional Surgery Questions => Topic started by: grahams on January 27, 2013, 11:55:37 AM

Title: Piezosurgery technique
Post by: grahams on January 27, 2013, 11:55:37 AM
Surprised to see no discussion of 'piezosurgery' on this forum.  It's apparently a relatively new technique developed in the last few years which uses ultrasound to cut the bone rather than traditional saw techniques.

The supposed benefits are that it doesn't harm soft tissue and is less likely to upset the nerves — so that means feeling back in your face within days, no nerve damage, less swelling/bruising and ultimately back to work more speedily — 2 weeks as opposed to 6 weeks!

Some leading surgeons charge a lot of money for it, but I've also seen many do it at a reasonable price.

Unfortunately, where I am in the UK they appear to be behind the times, but the technique is practised in Europe and the US.

Has anyone had experience of it?  Or are they looking into it?  Seems like the technology to go for, unless I'm missing something.
Title: Re: Piezosurgery technique
Post by: Lazlo on January 27, 2013, 01:21:28 PM
I'd be interested to know more about this. I consulted with a top Max fac surgeon who is also a chair of maxillofacial surgery at a university and is a researcher. He told me they were currently doing research into finding a laser to do the cutting for jaw surgery and they had just identified the right laser and that were about were about 5-7 years away from it's adoption, that was 3 years ago by the way, so maybe it's out.  Do you actually know of a maxillofacial surgeon who is using this technique?
Title: Re: Piezosurgery technique
Post by: Lazlo on January 27, 2013, 01:22:09 PM
Surprised to see no discussion of 'piezosurgery' on this forum.  It's apparently a relatively new technique developed in the last few years which uses ultrasound to cut the bone rather than traditional saw techniques.

The supposed benefits are that it doesn't harm soft tissue and is less likely to upset the nerves — so that means feeling back in your face within days, no nerve damage, less swelling/bruising and ultimately back to work more speedily — 2 weeks as opposed to 6 weeks!

Some leading surgeons charge a lot of money for it, but I've also seen many do it at a reasonable price.

Unfortunately, where I am in the UK they appear to be behind the times, but the technique is practised in Europe and the US.

Has anyone had experience of it?  Or are they looking into it?  Seems like the technology to go for, unless I'm missing something.

do you know of any max fac surgeon using it? please post the info
Title: Re: Piezosurgery technique
Post by: Lazlo on January 27, 2013, 01:46:10 PM
wow this technology has the potential to actually revolutionize the results you can get. I wonder why we haven't seen it's application and adoption in max fac --it's been around for several years!!!??

any ideas?

http://www.ijoms.com/article/S0901-5027(10)00506-0/abstract (http://www.ijoms.com/article/S0901-5027(10)00506-0/abstract)

http://www.joms.org/article/S0278-2391(05)00873-6/abstract (http://www.joms.org/article/S0278-2391(05)00873-6/abstract)
Title: Re: Piezosurgery technique
Post by: Lazlo on January 27, 2013, 01:49:22 PM
seems we are just around the corner from it's use --here's a workshop for max facs to learn how to use the device from sept. of this year.

it's kind of exciting actually because it seems like it would be really useful for all sorts of more complex craniofacial surgeries involving sensitive areas around the orbits etc.. Man ten years from now things are going to be awesome.

http://www.piezosurgery.com/fileadmin/user_upload/PIEZOSURGERY_medical/PDF/EACMFS_program.pdf (http://www.piezosurgery.com/fileadmin/user_upload/PIEZOSURGERY_medical/PDF/EACMFS_program.pdf)
Title: Re: Piezosurgery technique
Post by: Lazlo on January 27, 2013, 01:56:17 PM
well...premature enthusiasm,

brochure indicates it's not used for mandibular or lefort advancements...yet, only things like extractions etc. but it is used for distraction osteogenesis interestingly...

http://www.mentoroms.com/files/2012/08/Piezosurgery-brochure.pdf (http://www.mentoroms.com/files/2012/08/Piezosurgery-brochure.pdf)
Title: Re: Piezosurgery technique
Post by: Heavyweight on January 27, 2013, 03:02:22 PM
I think Dr. Hernandez in Spain uses this technique. I'm guessing a few more surgeons in Europe and Korea do so as well.
Title: Re: Piezosurgery technique
Post by: Lazlo on January 27, 2013, 03:34:53 PM
I think Dr. Hernandez in Spain uses this technique. I'm guessing a few more surgeons in Europe and Korea do so as well.


what gives you that idea? i can't find a single site indicating orthagnathic surgery is performed with this device.
Title: Re: Piezosurgery technique
Post by: Heavyweight on January 28, 2013, 11:40:31 AM

what gives you that idea? i can't find a single site indicating orthagnathic surgery is performed with this device.

It's right on his website. Sailer uses it as well. I'm assuming the same is true of Dr. Park in Korea.
Title: Re: Piezosurgery technique
Post by: Lazlo on January 28, 2013, 11:52:40 AM
It's right on his website. Sailer uses it as well. I'm assuming the same is true of Dr. Park in Korea.

oh thanks, i missed that i guess. obviously the outcome of one's surgery is still dependent on the skill and aesthetic eye of the surgeon, but it does seem the use of this device can significantly minimize nerve damage as well as allow the surgeon greater precision....  i wonder why our top dog surgeons such as schendel, a/g etc. don't use it (or at least it's not advertised...)
Title: Re: Piezosurgery technique
Post by: Heavyweight on January 28, 2013, 12:58:21 PM
According to this study, 98% of patients who had piezosurgery had no nerve damage vs 84% of those who had conventional surgery: http://www.ncbi.nlm.nih.gov/m/pubmed/18629552/ (http://www.ncbi.nlm.nih.gov/m/pubmed/18629552/)

Does Schendel use piezosurgery?
Title: Re: Piezosurgery technique
Post by: pekay on January 28, 2013, 01:10:11 PM
I'm pretty sure that the Department of Oral and Maxillofacial Surgery in Boston lead by Dr Kaban uses this
Title: Re: Piezosurgery technique
Post by: Lazlo on January 28, 2013, 03:24:36 PM
According to this study, 98% of patients who had piezosurgery had no nerve damage vs 84% of those who had conventional surgery: http://www.ncbi.nlm.nih.gov/m/pubmed/18629552/ (http://www.ncbi.nlm.nih.gov/m/pubmed/18629552/)

Does Schendel use piezosurgery?

wow, yeah that's significant...i hope schendel does, you should ask him...
Title: Re: Piezosurgery technique
Post by: pekay on January 29, 2013, 06:45:25 AM
according to Prof. Sailer's website he ONLY uses the piezosurgery technique
Title: Re: Piezosurgery technique
Post by: bbonte on February 24, 2013, 09:23:51 AM
Surprised to see no discussion of 'piezosurgery' on this forum.  It's apparently a relatively new technique developed in the last few years which uses ultrasound to cut the bone rather than traditional saw techniques.
[b
I have been the MECTRON piezo for BSO since a few years, now start using the more powerfull MISONIX for LeFort I, SARPE and BSO, less bleeding definitely and there should be less injury to the nerves from literature.
Dr Bonte MD DDS PhD


[/b]
The supposed benefits are that it doesn't harm soft tissue and is less likely to upset the nerves — so that means feeling back in your face within days, no nerve damage, less swelling/bruising and ultimately back to work more speedily — 2 weeks as opposed to 6 weeks!

Some leading surgeons charge a lot of money for it, but I've also seen many do it at a reasonable price.

Unfortunately, where I am in the UK they appear to be behind the times, but the technique is practised in Europe and the US.

Has anyone had experience of it?  Or are they looking into it?  Seems like the technology to go for, unless I'm missing something.
Title: Re: Piezosurgery technique
Post by: Bone Guy on May 09, 2013, 10:33:36 AM
Piezosurgery by Mectron is popular in the United States.   www.piezosurgery.us (http://www.piezosurgery.us)

Oral surgeons using it include Craig Misch, Michael Pikos, Joel Rosenlicht, Cris Viozzi, Ole Jenson, Peter Moy, Martin Chin and Dan Cullum.

There are different versions available from Piezosurgery by Mectron such as: Piezosurgery 3, Piezosurgery Touch and the Piezosurgery Medical System (hospital operating rooms)
.
Title: Re: Piezosurgery technique
Post by: Lazlo on May 09, 2013, 10:55:48 AM
I asked Dr. Keller about piezosurgery. He actually said he's tried it, doesn't like it. He said it takes longer to use, is not as precise and in the right hands a good sharp tool is much better than the piezosurgery. He said a few of the max facs at mayo have used it but they usually go back to the using sharp tools. Said it doesn't really make much of a difference with regards to nerve damage either. Don't know if he's just set in his ways and old school, or if he's right.
Title: Re: Piezosurgery technique
Post by: Lazlo on May 09, 2013, 10:57:27 AM
fyi: I kept pronouncing it p-i-e-z-o-surgery as if it was some kind of italian thing, apparently it's pronounced fizosurgery, lol

schendel uses it correct?
Title: Re: Piezosurgery technique
Post by: pumukka on May 10, 2013, 03:49:22 PM
I find it hard to find which ones use it here in Europe, It's not like most announce it on their website that if they even have it as most top surgeons dont need to advertise them selfs and just by word of mouth they are very busy.

Do you guys know anyone else apart from Dr Alfaro who uses it?
Title: Re: Piezosurgery technique
Post by: pekay on May 11, 2013, 08:08:30 AM
I asked Dr. Keller about piezosurgery. He actually said he's tried it, doesn't like it. He said it takes longer to use, is not as precise and in the right hands a good sharp tool is much better than the piezosurgery. He said a few of the max facs at mayo have used it but they usually go back to the using sharp tools. Said it doesn't really make much of a difference with regards to nerve damage either. Don't know if he's just set in his ways and old school, or if he's right.

I heard the exact and I mean the exact same thing from a surgeon here

i guess the is no way around avoiding the whole perma lower lip numbness  >:(

Title: Re: Piezosurgery technique
Post by: pekay on May 11, 2013, 10:12:22 AM
Pekay, who is the other surgeon who has the same opinion as him? How much experience he had with Piezo? Im asking because this is been a determinant factor in deciding who to choose for the next surgery. If more people say Piezo doesn't make a difference I will ignore it

Dr Pitta, he is a Brazilian surgeon. I don't know how experienced he is with the Piezo technique but he doesn't like it.

Are you certain that you need revision surgery? How old are you and where are you located?
Title: Re: Piezosurgery technique
Post by: molestrip on August 13, 2014, 08:42:16 PM
I've been looking into this technique as well. I contacted the company and they gave me Dr Viozzi's name as well. I sent him an email to see if he'd comment on the piezo technique but got no reply :( I asked my local surgeon about it and he didn't think it was interesting but didn't say why specifically. He mentioned that he has the tool and uses it for other operations.

I met with Li and Gunson as well. I didn't ask specifically about piezo but I got the impression that they don't like to be on the bleeding edge, a respectable position. If you go with something very new like this, you want to be sure you use a surgeon who has a lot of experience with it. I would say at least a few hundred surgeries and at least 2-3 years.