Piezoelectric Device Versus Conventional Osteotomy Instruments in the Comparison of Three Different Bone Harvesting Methods: An Istomorphometric, Phonometric, and Chronometric Evaluation

Purpose: This study was conducted to compare the bone cutting performance of the piezoelectric device with traditional drills in terms of cut execution time, environmental noise produced, surface morphology characteristics, and residual cell vitality of the bone samples. Materials and Methods: Two fresh pig jaws were obtained from a local slaughterhouse, and nine bone samples with a standard size (1 cm3) were harvested from each jaw: three using piezosurgery, three with a multiblade bur mounted on a surgical handpiece, and three with a diamond bur mounted on a high-speed handpiece, for a total of 18 samples. Two samples for each harvesting method were examined by scanning electron microscope (SEM), observing four surfaces per sample. For each surface observed, a count of the intertrabecular spaces was performed, and each space was evaluated as completely, partially, or unfilled by debris. Four samples per sampling method were examined by cell culture to evaluate residual cell vitality after cutting. The execution time of each osteotomy was measured with a stopwatch. The environmental noise was measured, at two different distances, with a phonometer. Results: At SEM analysis, piezosurgery osteotomies showed 66% of totally free intertrabecular spaces on the cutting surface, statistically significantly higher than those on the multiblade bur (33%) and diamond bur (12%) cutting surfaces (P .0005). Bone samples harvested with piezosurgery also demonstrated faster cell proliferation. Finally, piezosurgery generated less environmental noise, though it required longer cutting time. Conclusion: Piezoelectric technology is a valid alternative to rotating burs for osteotomy, demonstrating higher bone cell viability and a precise and silent, though slower, cut. Keywords: bone graft, histomorphometric, piezosurgery, surgery