Advanced piezo-ultrasonic surgery in the treatment of complicated cases

Dr.Angelo Troedhan

v.Professor Faculty of Dentistry Health Science University Vientiane

Specialist for cosmetic and reconstructive Maxillofacial Surgery 
Specialist for General Dentistry, Oral Surgery and Implantology

Director of the Center for Facial Esthetics - Vienna

Consiliary Specialist of the Traumatology Department of the Wilhelminen-Hospital of the City of Vienna

Consiliary Specialist of the Hospital "Brothers of Mercy" of the Federal City of Eisenstadt

permanent Specialist of the private clinic "Confraternitaet", Vienna

Assistant Professor Dep. Maxillofacial Surgery Sancti Spiritus / Cuba and the  International University for Medicine Vientiane/Laos

President of the International Academy for Ultrasonic Surgery and Implantology (IAUSI,

Founding Member of the  TKW-Research-Group (Dr. Trödhan, Dr. Kurrek/GER, Dr. Wainwright GER/USA, Co-patent-holder of the INTRALIFT-procedure

Diploma and Certificates:
Implantology next to Nature - IMZ/Frialit-Implantatsystem
Q-Implant-System - Wien
Lag-Screw Osteosynthesis - LKH Salzburg
Laser training Nd:YAG, Erb-YAG, CO2-Laser - Paris
Invisalign  - Düsseldorf
Esthetic Surgery of the Face: Laser and Injectables - Tagesklinik Prof. Hernuss Vienna

since September 2003 permanent Lecturer for Q-Implantat-System (Head of the Training Center Vienna)

Piezotome-surgery enables ultimate precision and atraumaticity in all surgical procedures  related to general oral surgery and bone management. Bone cuts can be performed completely lossless and in many cases without preparation of a mucoperiostal flap and for the first time the surgeon can fully concentrate on the perfect design of the procedure instead of taming rotating instruments.

Beside the precision micromolecular side effects – well known already in general surgery and traumatology – induce healing processes such as angiogenesis and induction of Interleukin-production from the very first bone cut. As a result 50% less postsurgical pain and swelling can be observed. The latest  published results will be presented.

One special application is the vertical alveolar crest split and widening, which  is a well known and accepted method to enable implant insertion into narrow alveolar ridges. Nevertheless the method was highly confined by the lack of surgical tools for a bone-lossless and highly precise vertical osteotomy.

With Piezotome-enabled flapless and bone-lossless crest-splitting and widening surgical tools (CS-Tips) the indication for this procedure can be narrowed down now to alveolar ridges with a width of 1mm.

The hydrodynamic ultrasonic cavitationalsinuslift (HUCSL-INTRALIFT) is currently the most advanced and most atraumatic sinuslift procedure enabled by Piezotome-surgery allowing a scaleable  sinus-membrane detachment  via a 3mm transcrestal approach. The HUCSL-INTRALIFT is applicable in every anatomical situation without exclusion and bears the least risk of iatrogenic membrane perforation enabling the oral surgeon to augment the entire sinus-floor if indicated.

The surgical protocol and the results and a summary of long term radiologically documented cases of a two-year multicentre study are presented resulting in a long term failure risk of the procedure of less than 4 % and post-surgical freedom of any swelling in 80% and pain in 75% .