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Comparative Histological Evaluation Of Bone Healing Following Piezotome And Osteotome Techniques For Potential Applications In Rhinoplasty
Summary
Scientists tested a newer tool (piezoelectric device) versus the traditional hammer-and-chisel-like tool (osteotome) for breaking nasal bones during nose jobs, using sheep as a model. The piezo tool made cleaner, less messy cuts right after surgery, but by three months later, both methods healed the bone equally well. This suggests the newer technology may make surgery gentler in the short term, but patients shouldn't expect better long-term healing results from it alone.
PURPOSE: Rhinoplasty is a technically demanding procedure in which the precision of osteotomy creation directly influences both cosmetic and functional outcomes. Traditional osteotomes often produce uncontrolled fracture lines and soft tissue trauma. Piezoelectric devices have been introduced as an alternative, offering selective cutting of mineralized tissue while sparing surrounding soft tissue structures. Although the clinical benefits of this approach have been well documented, the biological processes underpinning this technique have been largely unexplored. The present study aimed to compare the histologic changes in bone regeneration and long-term healing outcomes within piezotome- and osteotome-induced nasal bone defects in a highly translational, pre-clinical model. METHODS: Bilateral osteotomies were created on the nasal bone of skeletally mature sheep (n=12 sheep) using: (i) a piezoelectric bone-cutting system (Piezotome CUBE, BioHorizons, Hoover, AL, USA) or (ii) a traditional osteotome. Euthanasia was performed at either 3- or 12-weeks post-operatively (n=6 defects per group per time point), and samples were collected and processed for qualitative and semi-quantitative histological analysis. RESULTS: Histological analysis at 3-weeks post-operatively revealed limited bone ingrowth with inflammatory infiltrate, followed by substantial bone regeneration in both groups by 12 weeks (Figure 1) . Osteotome-treated sites displayed irregular margins and bone debris, while piezotome-treated defects demonstrated cleaner margins and less bony fragmentation. Despite qualitative differences, semi-quantitative scoring of new bone formation showed no statistically significant differences in healing between devices at 3 weeks ( p = 0.500) or 12 weeks ( p = 0.125). CONCLUSION: These findings suggest that although piezoelectric osteotomies may offer advantages in intraoperative precision and early postoperative morbidity, long-term bone regeneration appears comparable to that achieved with conventional osteotomes.© 2026. Plastic Surgery Research Council | All rights reserved |*Source: https://ps-rc.org/meeting/Program/2026/90.cgi*