.: ORİJİNAL ARAŞTIRMA
Histopathological, Histochemical and Histomorphometrical Investigation of the Effects of Different Piezosurgery Tools on Tissues: Experimental Study
Farklı Piezocerrahi Aletlerinin Dokular Üzerine Olan Etkisinin Histopatolojik, Histokimyasal ve Histomorfometrik Olarak İncelenmesi: Deneysel Çalışma
Turkiye Klinikleri J Dental Sci. 2023;29(2):243-53
doi: 10.5336/dentalsci.2023-95763
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Piezoelectric surgical instruments are widely used in medicine and dentistry. Devices with new features are produced day by day and offered to surgeons. The aim of this study is to evaluate the effects of new and old generation piezosurgery instruments and conventional rotary hand tools on bone after osteotomy histopathologically, histochemically and histomorphometrically. Material and Methods: In the parietal bones of 12 rabbits, bone defects with a diameter of 8 mm were created with two different piezosurgery tools and a conventional rotary tool. Animals were sacrificed on the 7th and 21st days and evaluated histopathologically, histochemically and histomorphometrically the amounts of new bone formation, sequestration, connective tissue, fibrin and cartilage and percentages of full-empty area in the total area. Results: In the histopathological examinations, the least sequestra formation was observed in the new generation piezosurgery group. In the histomorphometric analysis, it was determined that there was a statistically significant difference between the mean of new bone and total area measurements in all groups on the 7th day (p0.05). Conclusion: As a result of the histopathological evaluation, it was determined that filling (both bone and connective tissue) in the defect areas in the new generation piezosurgery group was higher in the short term follow up compared to other groups, but there was no significant difference between the groups in the midterm follow up.
Keywords: Bone healing; oral and maxillofacial surgery; osteotomy; piezoelectric surgery; rabbit
Objective: Piezoelectric surgical instruments are widely used in medicine and dentistry. Devices with new features are produced day by day and offered to surgeons. The aim of this study is to evaluate the effects of new and old generation piezosurgery instruments and conventional rotary hand tools on bone after osteotomy histopathologically, histochemically and histomorphometrically. Material and Methods: In the parietal bones of 12 rabbits, bone defects with a diameter of 8 mm were created with two different piezosurgery tools and a conventional rotary tool. Animals were sacrificed on the 7th and 21st days and evaluated histopathologically, histochemically and histomorphometrically the amounts of new bone formation, sequestration, connective tissue, fibrin and cartilage and percentages of full-empty area in the total area. Results: In the histopathological examinations, the least sequestra formation was observed in the new generation piezosurgery group. In the histomorphometric analysis, it was determined that there was a statistically significant difference between the mean of new bone and total area measurements in all groups on the 7th day (p0.05). Conclusion: As a result of the histopathological evaluation, it was determined that filling (both bone and connective tissue) in the defect areas in the new generation piezosurgery group was higher in the short term follow up compared to other groups, but there was no significant difference between the groups in the midterm follow up.
Keywords: Bone healing; oral and maxillofacial surgery; osteotomy; piezoelectric surgery; rabbit
ÖZET
Amaç: Piezoelektrik cerrahi aletleri tıpta ve diş hekimliğinde oldukça yaygın olarak kullanılmaktadır. Günbegün yeni özelliklere sahip cihazlar üretilmekte ve piyasaya sürülmektedir. Bu çalışmanın amacı; yeni ve eski nesil piezocerrahi aletleri ile konvansiyonel döner el aletinin osteotomi sonrası kemik üzerindeki etkilerini histopatolojik, histomorfometrik ve histokimyasal olarak değerlendirmektir. Gereç ve Yöntemler: On iki adet tavşanın parietal kemiklerinde, 2 farklı piezocerrahi aleti ve geleneksel bir döner alet ile 8 mm çapında kemik defektleri oluşturuldu. Hayvanlar 7 ve 21. günlerde sakrifiye edilerek; histopatolojik, histokimyasal ve histomorfometrik olarak yeni kemik oluşumu, sekestr, bağ doku, fibrin ve kartilaj miktarları ile toplam alan içerisindeki dolu-boş alan yüzdeleri değerlendirildi. Bulgular: Histopatolojik incelemelerde, en az sekestr oluşumu yeni nesil piezocerrahi grubunda gözlendi. Histomorfometrik analizde, 7. günde tüm gruplarda yeni kemik oluşum miktarı ile toplam alan ölçümleri arasında istatistiksel olarak anlamlı fark olduğu belirlendi (p0,05). Sonuç: Piezoelektrik cerrahi cihazlarını konu alan birçok çalışmada, piezocerrahi aletlerinin kemik doku iyileşmesinde daha üstün olduğu tespit edilmiştir. Bu çalışmada da histopatolojik, histomorfometrik ve histokimyasal değerlendirme sonucunda yeni nesil piezocerrahi grubunda defekt bölgelerindeki kemik dolumunun (hem kemik hem de bağ doku) kısa dönem takipte eski nesil piezocerrahi ve konvansiyonel döner alet gruplarına göre daha yüksek olduğu, ancak uzun dönem takipte gruplar arasında anlamlı fark olmadığı belirlenmiştir.
Anahtar Kelimeler: Kemik iyileşmesi; oral ve maksillofasiyal cerrahi; osteotomi; piezoelektrik cerrahi; tavşan
Amaç: Piezoelektrik cerrahi aletleri tıpta ve diş hekimliğinde oldukça yaygın olarak kullanılmaktadır. Günbegün yeni özelliklere sahip cihazlar üretilmekte ve piyasaya sürülmektedir. Bu çalışmanın amacı; yeni ve eski nesil piezocerrahi aletleri ile konvansiyonel döner el aletinin osteotomi sonrası kemik üzerindeki etkilerini histopatolojik, histomorfometrik ve histokimyasal olarak değerlendirmektir. Gereç ve Yöntemler: On iki adet tavşanın parietal kemiklerinde, 2 farklı piezocerrahi aleti ve geleneksel bir döner alet ile 8 mm çapında kemik defektleri oluşturuldu. Hayvanlar 7 ve 21. günlerde sakrifiye edilerek; histopatolojik, histokimyasal ve histomorfometrik olarak yeni kemik oluşumu, sekestr, bağ doku, fibrin ve kartilaj miktarları ile toplam alan içerisindeki dolu-boş alan yüzdeleri değerlendirildi. Bulgular: Histopatolojik incelemelerde, en az sekestr oluşumu yeni nesil piezocerrahi grubunda gözlendi. Histomorfometrik analizde, 7. günde tüm gruplarda yeni kemik oluşum miktarı ile toplam alan ölçümleri arasında istatistiksel olarak anlamlı fark olduğu belirlendi (p0,05). Sonuç: Piezoelektrik cerrahi cihazlarını konu alan birçok çalışmada, piezocerrahi aletlerinin kemik doku iyileşmesinde daha üstün olduğu tespit edilmiştir. Bu çalışmada da histopatolojik, histomorfometrik ve histokimyasal değerlendirme sonucunda yeni nesil piezocerrahi grubunda defekt bölgelerindeki kemik dolumunun (hem kemik hem de bağ doku) kısa dönem takipte eski nesil piezocerrahi ve konvansiyonel döner alet gruplarına göre daha yüksek olduğu, ancak uzun dönem takipte gruplar arasında anlamlı fark olmadığı belirlenmiştir.
Anahtar Kelimeler: Kemik iyileşmesi; oral ve maksillofasiyal cerrahi; osteotomi; piezoelektrik cerrahi; tavşan
REFERANSLAR:
- Chacon GE, Bower DL, Larsen PE, McGlumphy EA, Beck FM. Heat production by 3 implant drill systems after repeated drilling and sterilization. J Oral Maxillofac Surg. 2006;64(2):265-9. [Crossref] [PubMed]
- Queiroz TP, Souza FA, Okamoto R, Margonar R, Pereira-Filho VA, Garcia Júnior IR, et al. Evaluation of immediate bone-cell viability and of drill wear after implant osteotomies: immunohistochemistry and scanning electron microscopy analysis. J Oral Maxillofac Surg. 2008;66(6):1233-40. [Crossref] [PubMed]
- Schaller BJ, Gruber R, Merten HA, Kruschat T, Schliephake H, Buchfelder M, et al. Piezoelectric bone surgery: a revolutionary technique for minimally invasive surgery in cranial base and spinal surgery? Technical note. Neurosurgery. 2005;57(4 Suppl):E410; discussion E410. [Crossref] [PubMed]
- Gruber RM, Kramer FJ, Merten HA, Schliephake H. Ultrasonic surgery--an alternative way in orthognathic surgery of the mandible. A pilot study. Int J Oral Maxillofac Surg. 2005;34(6):590-3. [Crossref] [PubMed]
- 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(6):543-9. [PubMed]
- Robiony M, Polini F, Costa F, Zerman N, Politi M. Ultrasonic bone cutting for surgically assisted rapid maxillary expansion (SARME) under local anaesthesia. Int J Oral Maxillofac Surg. 2007;36(3):267-9. [Crossref] [PubMed]
- 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(4):536-46. [Crossref] [PubMed]
- Vercellotti T. Piezoelectric surgery in implantology: a case report--a new piezoelectric ridge expansion technique. Int J Periodontics Restorative Dent. 2000;20(4):358-65. [PubMed]
- Sherman JA, Davies HT. Ultracision: the harmonic scalpel and its possible uses in maxillofacial surgery. Br J Oral Maxillofac Surg. 2000;38(5):530-2. [Crossref] [PubMed]
- Labanca M, Azzola F, Vinci R, Rodella LF. Piezoelectric surgery: twenty years of use. Br J Oral Maxillofac Surg. 2008;46(4):265-9. [Crossref] [PubMed]
- Basheer SA, Govind RJ, Daniel A, Sam G, Adarsh VJ, Rao A. Comparative study of piezoelectric and rotary osteotomy technique for third molar impaction. J Contemp Dent Pract. 2017;18(1):60-4. [Crossref] [PubMed]
- Patil C, Jadhav A, K R, Bhola N, Borle RM, Mishra A. "Piezosurgery vs bur in impacted mandibular third molar surgery: Evaluation of postoperative sequelae". J Oral Biol Craniofac Res. 2019;9(3):259-62. [Crossref] [PubMed] [PMC]
- Nehme W, Fares Y, Abou-Abbas L. Piezo-surgery technique and intramuscular dexamethasone injection to reduce postoperative pain after impacted mandibular third molar surgery: a randomized clinical trial. BMC Oral Health. 2021;21(1):393. [Crossref] [PubMed] [PMC]
- Rossi D, Romano M, Karanxha L, Baserga C, Russillo A, Taschieri S, et al. Bimaxillary orthognathic surgery with a conventional saw compared with the piezoelectric technique: a longitudinal clinical study. Br J Oral Maxillofac Surg. 2018;56(8):698-704. [Crossref] [PubMed]
- Pearce AI, Richards RG, Milz S, Schneider E, Pearce SG. Animal models for implant biomaterial research in bone: a review. Eur Cell Mater. 2007;13:1-10. [Crossref] [PubMed]
- Dodde R 2nd, Yavuzer R, Bier UC, Alkadri A, Jackson IT. Spontaneous bone healing in the rabbit. J Craniofac Surg. 2000;11(4):346-9. [Crossref] [PubMed]
- Selçuki M, Özdemir S. Kalvaryum'un embriyolojik gelişimi [Embryological development of the calvarium]. Türk Nöroşir Derg. 2017;27(3):231-3. [Link]
- Namli H, Erdogan Ö, Gönlüşen G, Kahraman OE, Aydin HM, Karabag S, et al. Vertical bone augmentation using bone marrow-derived stem cells: an in vivo study in the rabbit calvaria. Implant Dent. 2016;25(1):54-62. [Crossref] [PubMed]
- Arpağ OF, Damlar I, Altan A, Tatli U, Günay A. To what extent does hyaluronic acid affect healing of xenografts? A histomorphometric study in a rabbit model. J Appl Oral Sci. 2018;26:e20170004. [Crossref] [PubMed] [PMC]
- Anesi A, Ferretti M, Cavani F, Salvatori R, Bianchi M, Russo A, et al. Structural and ultrastructural analyses of bone regeneration in rabbit cranial osteotomy: Piezosurgery versus traditional osteotomes. J Craniomaxillofac Surg. 2018;46(1):107-18. [Crossref] [PubMed]
- Ma L, Stübinger S, Liu XL, Schneider UA, Lang NP. Healing of osteotomy sites applying either piezosurgery or two conventional saw blades: a pilot study in rabbits. Int Orthop. 2013;37(8):1597-603. [Crossref] [PubMed] [PMC]
- Hoigne DJ, Stübinger S, Von Kaenel O, Shamdasani S, Hasenboehler P. Piezoelectric osteotomy in hand surgery: first experiences with a new technique. BMC Musculoskelet Disord. 2006;7:36. [Crossref] [PubMed] [PMC]
- Esteves JC, Marcantonio E Jr, de Souza Faloni AP, Rocha FR, Marcantonio RA, Wilk K, et al. Dynamics of bone healing after osteotomy with piezosurgery or conventional drilling - histomorphometrical, immunohistochemical, and molecular analysis. J Transl Med. 2013;11:221. [Crossref] [PubMed] [PMC]
- Ma L, Mattheos N, Sun Y, Liu XL, Yip Chui Y, Lang NP. Wound healing of osteotomy defects prepared with piezo or conventional surgical instruments: a pilot study in rabbits. J Investig Clin Dent. 2015;6(3):211-20. [Crossref] [PubMed]
- Maurer P, Kriwalsky MS, Block Veras R, Vogel J, Syrowatka F, Heiss C. Micromorphometrical analysis of conventional osteotomy techniques and ultrasonic osteotomy at the rabbit skull. Clin Oral Implants Res. 2008;19(6):570-5. [Crossref] [PubMed]
- Sortino F, Pedullà E, Masoli V. The piezoelectric and rotatory osteotomy technique in impacted third molar surgery: comparison of postoperative recovery. J Oral Maxillofac Surg. 2008;66(12):2444-8. [Crossref] [PubMed]
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