Microvascular free bone flap harvest with piezosurgery.

The piezoelectric bone-cutting device was introduced in orthopedic surgery in the late 1980s as an alternative technique of bone cutting.1 Piezoelectric surgery has been developed to cut bone through ultrasonic microvibrations. The main characteristics of piezoelectric bone-cutting devices are the selective cut of mineralized structures without soft tissue damage, even in the case of accidental contact; a more precise cutting action than with mechanical instruments (ie, saw and bur) thanks to the micrometric vibrations; bloodless field due to the physical phenomenon of cavitation; and low intraoperative overheating of the device.2 The main limitation is represented by the operative time required for the osteotomy, longer than with traditional bone-cutting methods.3 The first use of Piezosurgery in oral and maxillofacial surgery was reported in 2000.4 Since then, it has been increasingly used in a variety of oral surgical procedures. [5], [6] and [7] Because the Piezosurgery device has proved to be a very effective and safe method of bone cutting, at present, its use is spreading in different surgical areas like maxillofacial surgery, otologic surgery, neurosurgery, orthopedics, and hand surgery.8 As regards the maxillofacial skeleton, Piezosurgery has proved to be a valuable tool in orthognathic surgery, orbital surgery, and rhinoplasty. [9], [10] and [11] We present and discuss the use of the piezoelectric bone-cutting device in microvascular free bone flap harvest and contouring for the reconstruction of jawbone defects.