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Users can concentrate on the surgical procedure with peace of mind

Piezomed from W&H facilitates the work of the surgeon with its innovative ultrasound technology. High-frequency microvibrations allow cutting with incredible precision and, in addition, with the so-called cavitation effect you can also ensure an almost blood-free surgical site. In an interview, Andreas Lette, Head of Production Innovation in Oral Surgery and Implantology, spoke about the special features of the device and the additional benefits for the surgeon and patient.

Mr Lette, how is the complete W&H surgical instrument range structured?

W&H has a very long tradition in the field of oral and maxillofacial surgery (OMS) and implantology. The first Elcomed was launched back in 1983, more than 30 years ago. This model 6120 was the beginning of a unique success story. In 1992, the Elcomed 100 set new standards for surgical and implantology motors and Implantmed, launched in 2000, became the benchmark in the field of implantology devices. Today, we can look back at the 6th generation of Elcomed and the 3rd generation of Implantmed – every generation has set new benchmarks in terms of performance and function. The Elcomed/Implantmed range for rotary bone preparation was replaced by the Piezomed for vibrating bone preparation one year ago.

Piezomed

What is the significance of the Piezomed?

Piezomed was our “missing link” in the field of OMS and implantology. Piezomed was the complement to our surgical instrument range and also allowed us to demonstrate our skills in the field of vibrating drives for surgical applications. As such, W&H is one of only a few manufacturers in the world to offer surgical devices for rotary instruments and vibrating systems as well as a complete range of straight and contra-angle handpieces for surgical applications in dentistry.

What research and development work did the project entail?

The foundations for the development of a piezo surgical device were laid as early as 2005. W&H has a very long tradition in the field of motors for rotary preparation, but oscillating systems such as piezo technology were new territory for W&H. In addition, the field of piezo surgery is much more demanding for the surgical device than a piezo oscillating system for the field of oral hygiene. We have succeeded in developing a piezo surgical device specially tailored to the requirements of oral surgery and in doing so to distance ourselves considerably from so-called me-too products. The extraordinary performance and new features are testament today to the successful research and development efforts invested in this product.

What significance does ultrasound technology enjoy in bone surgery?

Thanks to the extremely small movements of the working instruments, the saws can make micrometric cuts, which in turn permit minimally invasive procedures. Another advantage of piezo technology is the cavitation effect. This cavitation effect promotes an almost blood-free treatment site and consequently offers an optimal view of the operating site for excellent surgical control.

Who is Piezomed’s target audience and for what procedures can it be used?

With its great performance, Piezomed is tailored to the requirements of OMS surgeons and implantologists. We are currently in a position to cover practically all indications and are working intensively on expanding our Piezomed instrument portfolio. We are always delighted to receive feedback from our customers.

We are particularly proud to be able to cover the following fields:

  • Bone preparation – from harvesting of bone blocks to alveolar ridge splitting right up to preparation of a lateral bone window for a sinus lift.
  • Mobilization of the membranous lining of the maxillary sinus cavity (Schneiderian membrane) with the use of a unique “elephant foot” with coolant outlets specially arranged on the underside. This guarantees a continuous film of coolant between the membrane and the instrument for optimal cooling and atraumatic preservation of the Schneiderian membrane.
  • Apical resections – from the resection right up to retrograde root canal preparation with diamond-coated instruments.
  • Extraction – atraumatic extraction with periotomes for preservation of the alveoli without damaging the vestibular bone lamellae.
  • Periodontology – root planing and cleaning of the implant surfaces.

The two special B6 and B7 saws are a highlight of the device. Can you please explain them in more detail?

The two special saws are a proprietary development of W&H and truly unique in the dental industry, as they allow incredibly thin cuts of just 0.3 mm. The special design and the fine teeth make it possible to achieve a very high cutting speed.

At the same time, the saws make it possible to plunge directly into the bone. The tooth design and the hardness of the saw blade even allow separation of a tooth at the level of the enamel. The two coolant openings close to where the saws work ensure optimal cooling.

Saw Piezomed
Angled saw with ideal coolant distribution.

Piezomed includes automatic instrument detection. How does this system work and what advantages does it offer?

The automatic instrument detection is a W&H patent and offers the user considerable support during the treatment. Three instrument groups are detected and the corresponding power limits set. This limitation minimizes the risk of overloading an instrument. Within the performance categories, the user has the option of freely adapting three programmes each to meet the requirements, without having to worry about overloading the working instruments. There is no need to consult tables or wonder “What bone quality do I need to set now?”, and as such you can concentrate on the surgical procedure with peace of mind.

The device is minimally invasive and maximally effective. What does that mean exactly?

Minimally invasive, insofar as one can apply the term to a surgical procedure such as harvesting a bone block, refers to the very low oscillation in comparison with rotary instruments, e.g., milling cutters. In turn, maximally effective refers, for example, to the very narrow cut and thus low bone loss. This should be considered in comparison with rotary instruments. Compared with a Lindemann milling cutter, it is possible to avoid at least 1.2 mm of bone loss per cut, which also seems practical for an augmentation, as a bone deficit should not be resolved with an even larger bone deficit.

What advantages do minimally invasive procedures offer for treatment and healing?

Rapid wound healing and reduced postoperative swelling are top priority. These two aspects are important to both the surgeon and the patient, as there is no need for additional postoperative measures such as rinses, irradiation, etc. In addition, the minimally invasive procedure also greatly reduces the risk of soft tissue damage.

Can you tell us a little more about the hygiene and care?

This is yet another field in which we set the benchmark. The Piezomed handpiece with its scratch-resistant surface coating and the motor cable can be thermo washer disinfected and sterilized. Its unique surface coating means it not only supports reprocessing optimally, but the handpiece also boasts amazing resilience and durability. The handpiece tip and the LED illumination module can be removed, which considerably facilitates cleaning. The cleaning of the application instruments was also a matter close to our hearts during development. All the instruments can be reprocessed in instrument trays in an ultrasonic bath. This ensures perfect cleaning of the interior of the coolant channel. Machine reprocessing in a washer and disinfector was also very important to us, which is why we developed special washer and disinfector adaptors. These adapters guarantee machine reprocessing and can be purchased from specialist dealers.

Thank you for your time!

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