In vitro comparison of the effect of piezosurgery and conventional bone preparation technique on intraosseous heat generation

Abstract

The aim of this in vitro study was to compare the effect of sagittal saw handpiece with a piezoelectric device on the rise in intraosseous temperature and on the preparation time.
100 native pieces of pork ribs were cut either with S-8 S handpiece connected to Elcomed surgical motor (W&H) (n = 30)
or with B6 insert connected to Piezomed (W&H) using continuous movement (n = 30) or with B6 using short breaks to perform intermittent cutting (n = 30). The rest were cut either by S-8 S (n = 5) or by B6 (n = 5) both applied by permanent pressure. The intraosseous temperature was measured by K-type thermocouple connected to digital thermometer placed in the bone 1 mm away of the cutting line. The heat generated and the time of the complete cutting were recorded.
In S-8 S group the temperature never rose above 47oC. Using the B6 with permanent movement the critical temperature was reached in 16.2 ± 3.53% of the cases while taking breaks decreased the results to 2.6 ± 0.96% (p < 0.001). In no cases the temperature elevation above 47oC lasted more than 60 sec. Applying the B6 by permanent pressure resulted in heat up to 90.3oC.
Our results suggest that piezoelectric device could use safely according to the factory instructions, however further reduce of heat load could be achieved if the intermittent cutting motion combined with short-time cooling periods.