Lifewatch: Dental Bone Surgery

WASHINGTON, D.C. -- Until now, dental bone surgery has meant using a scalpel and stitches to fix problems in your mouth.

Now, the scalpel can be replaced with sound waves and is less scary.

Nancy Lemos was dreading dental surgery to fix a periodontal disease that caused her bone and gum tissue to separate from her tooth.

"When I think of surgery, it's like anything else. I think of cutting. I think of bleeding," said Nancy.

But, none of those would be part of Nancy's surgery, because her cosmetic dentist used a new procedure called piezosurgery.

The new device uses sound waves to cut through bone at 60,000 cycles per second.  The high frequency vibrations work so fast, there's no bleeding or pain.

"Just as an opera singer will sing and crack glass, this is like the opera singer for surgery and it can crack your bone without any pain, without any discomfort, without any bleeding," said Dr. Joseph Kravitz.

The sound waves are programmed to cut bone, without hurting soft tissues, nerves, or vessels.

Nancy is an accomplished PHD, but is still amazed her procedure only took five minutes and went home pain free.

Usually patients who suffer from gum diseases or who have cavities that have crept into the bone are the ones who need this kind of dental bone surgery.


Joseph Kravitz, DDS

The Center for Dental Health

4301 50th Street

Washington, D.C.

(202) 537-7052

BACKGROUND: Traditional surgical procedures for periodontal disease, severe cavities and other dental conditions involves scalpels, risk of nerve damage and post-operative pain. The best way to avoid surgery is to prevent these dental conditions. Periodontal disease is an infection of the tissues that support your teeth. It causes the attachment of the tooth and its supporting tissues to break down. The first stage of periodontal disease is termed gingivitis, and it is a milder and reversible form of the disease that only affects the gums. This first stage may lead to more serious, destructive forms of periodontal disease known as periodontitis. Cavities, another condition that may require dental surgery, are the breakdown of tooth enamel caused ultimately by eating sugars and starches. When a person eats these types of foods, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth, and eventually they break down the enamel and cause a cavity to form. Left untreated, a cavity can destroy your tooth and kill the nerves at its center, which may result in an abscess. An abscess is an area of infection at the root tip that can only be treated through a root canal, surgery or tooth extraction. Both periodontal disease and cavities can be prevented by practicing good oral hygiene.

TRADITIONAL SINUS SURGERY: According to Joseph Kravitz, D.D.S., a prosthodontist at the Center for Dental Health in Washington, D.C., traditional dental surgery is an invasive procedure. "When you do bone or sinus surgery traditionally, is what you have to do is take a scalpel and you cut the gums open, peel them back, so you can see the bone," he told Ivanhoe. The surgery also carries risks. "There's lots of discomfort. There is more chance of infection because it's more invasive, and the patient's face will swell and sometimes there is bruising with that technique."

A NEW WAY TO OPERATE: A new noninvasive procedure is offering an alternative for patients who cringe at the thought of the dentist's office. Piezosurgery is a device that uses 60-thousand-per-second sound waves to cut through dental bone to treat problems associated with periodontal disease and cavities, to aid in dental implant surgery, and to assist with other surgeries like crown lengthening, bone grafts and sinus lifts. It works so quickly, no bleeding or pain is involved. "Through the sound waves, you can program the tool to only cut bone, or only cut a tooth structure, or only cut different tissues in the body," Dr. Kravitz explained. "Based upon the frequency of the wave of the sound, it's selective on the density of the tissue." The instrument received FDA approval for oral procedures in 2005. According to the Compendium of Continuing Education in Dentistry, Piezosurgery offers several advantages over traditional bone surgery.

First, the entry cut is more precise. Second, the cut is safer because the ultrasonic frequency used does not cut soft tissue. Third, the cutting action is less invasive, which results in better healing. "This is one of the best things that dentistry has had come out," Dr. Kravitz said.

Reported by Kristy Ondo