Key Factors for Success in Implantology and GBR

This lecture reviews the scientific background of Piezotome-surgery, synthetic bonegrafts and PRF. Some of the other topics covered here are: the physiology of bone healing, the leading role of periosteum, and the physiology of osseointegration. Clinical cases are presented supporting the 3 surgical techniques espoused by the lecturer. Traditionally, osseous surgery has been performed by either manual or motor-driven instruments. Piezosurgery is a newer technique for osteotomy and osteoplasty that utilizes ultrasonic vibration which allows clean cutting with precise incisions.

For a good review of Piezosurgery in Implantology, see [Clin Cosmet Investig Dent. 2015 Nov 11;7:115-24](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4646478/) where the authors conclude:

Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible…Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient…The slightly longer amount of time required if the piezoelectric tool is used for cutting large or extensive bone volumes is acceptable, keeping in mind the overall advantages of precise cutting…. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies.1

**References** 1\. Clin Cosmet Investig Dent. 2015; 7: 115–124., [Piezosurgery in implant dentistry](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4646478/) Stefan Stübinger, et al.

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