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
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
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