Ultrasonic Surgery Reduces Pain, Swelling After Genioplasty

For patients undergoing genioplasty, the use of ultrasonic piezosurgery equipment reduces trauma, pain, and swelling, compared with traditional surgical drills, according to a study published in the Journal of Craniofacial Surgery.

“Piezosurgery may be a viable alternative to traditional osteotomy technique, as it reduces the degree of inflammation, pain, swelling, and morbidity, improving satisfaction and patient comfort,” wrote Gilberto Sammartino, MD, University of Naples Federico II, Naples, Italy, and colleagues.

The researchers compared complications after genioplasty performed using piezosurgery devices or traditional rotating drills. Piezosurgery is a relatively new approach that uses ultrasonic energy, rather than conventional surgical instruments, for cutting of bone.

“Several studies have demonstrated that bone healing using piezosurgery is more rapid than other techniques using drills or burs, thanks to a lower inflammatory bone response,” the authors wrote.

The study included 40 patients scheduled for genioplasty, as a primary procedure or after corrective jaw surgery. Patients were randomised to undergo genioplasty using either ultrasonic piezosurgery instruments or traditional drills. Pain, healing, and complications were compared from 1 to 15 days after surgery.

The results showed lower pain scores for patients undergoing piezosurgery, although the difference was significant only on the third and seventh day after surgery. Swelling also seemed to be reduced with piezosurgery, compared with cutting drills.

Both groups had reduced feeling in the chin area throughout the first 15 days after surgery, mainly due to nerve stretching. By 6 months, sensation normalised within 6 months for all patients in both groups. Pain and swelling were completely resolved as well.

Previous studies have shown that piezosurgery leads to better control of the inflammatory bone response induced by surgery, and less cell damage leading to increased bone remodelling after surgery.

“Bone undergoes less stress during surgery and thus less pain and swelling postoperatively, which is in agreement with the results found in our trial,” the authors wrote. “Pain and discomfort were minimal compared to the traditional technique especially in the immediate postoperative period of healing.”

SOURCE: Wolters Kluwer Health