Bone micromorphology and material attrition after sonic, ultrasonic and conventional osteotomies

Background/Aim: Osteotomy as the first step in surgery, provides access to the field and its application could influence the outcome. Nowadays, the conventional burr reduction is being challenged by newer sonic and ultrasonic methods. We investigated the bone structural integrity and metal attrition residues both in bone and the irrigation fluid. Materials and Methods: Bovine ribs were cut using three methods. Bone cuts were studied using Environmental Scanning Electron Microscopy (ESEM) for tissue discrepancies and Scanning Electron Microscopy/Energy Dispersion X-Ray Microanalysis (SEM/EDX) for organic and inorganic debris. Results: Better preservation of bone architecture was seen in piezo and sono surgery while metal attrition was not conclusive (p>0.05). Unlike in bone analyses, both bur and ultrasonic osteotomies showed statistically significant higher median inorganic detection per analysis (p=0.021 and p=0.037, respectively). Conclusion: Sono and piezo surgery proved to be less invasive while attrition properties were the same.