W&H's Piezomed device utilizes innovative ultrasound technology to facilitate precise and minimally invasive bone cutting for dental surgeons. It was developed to complement their existing surgical product range and addresses the need for a piezoelectric device. Significant research was required to develop it given the demanding precision required. The automatic instrument detection system and ability to precisely cut bone make it useful for a variety of dental procedures.

1. CATEGORY
90 AUSTRALASIAN DENTIST
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.
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.
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 what procedures can it be
used for?
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
Users can concentrate
on the surgical procedure
with peace of mind
PROFILE

2. CATEGORY
92 AUSTRALASIAN DENTIST
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.
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 hygiene and care of the
instrument?
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.
For more information
contact A-dec on 1800 225 010
or visit: www.WH.com
PROFILE
Angled saw with ideal coolant distribution.