The “boosted mode” has frequency overmodulation with an increased rate that is most efficient for osteotomy and osteoplasties in surgical procedures, while the “high mode” is less efficient but more helpful in periodontal procedures and bone smoothening. On the contrary side, the “high mode” and the “boosted mode” are characterized by vibrations with higher ultrasonic power and frequency overmodulation, which allows cutting of mineralized tissue. The vibrations produced in the “Low mode” result from average ultrasonic powers, without frequency overmodulation, and allow the operator to perform endodontic procedures. The frequency is usually set between 25 and 29 kHz, which can create micro-oscillations of 60–210 μm amplitude, providing the handpiece with power exceeding 5 W. The Piezoelectric unit also allows for election of modes of operation, which are preset power modes with varying frequencies to match the clinical application. When higher pressure is applied at the tip, it impedes the cutting efficiency of the insert and releases the energy as heat, which is detrimental to the bone as well as adjacent soft tissue. The pressure applied on the insert can also be manually controlled by the operator and can affect the frequency delivered to the target tissue, which in turn affects the cutting efficiency. The main energy unit has an interactive touchpad, which allows the operator to control the frequency of vibrations, power of the unit, and the amount of irrigating or coolant fluid. This, combined with the form of the insert, acts like a micrometric oscillating saw. To create a cutting effect rather than a debriding effect, the vibrations of the insert enter into a resonance with the ceramic chips, which increases the energy output. These inserts can be made of different materials and be coated with titanium or a diamond layer to improve the cutting efficiency. ![]() The working tips of a piezoelectric system used for surgical purposes are interchangeable inserts, which can be of different shapes, sizes, and cutting edges based on the intended clinical applications. This revolutionary tool not only lowers the chance of damage to adjacent vital soft-tissue structures such as nerves and vessels during osteotomies, but also preserves osteocytes, which in turn complements bone healing. ![]() The first use of piezoelectric surgery was for osteotomies by oral and maxillofacial surgeons and later on used for neurosurgical and orthopedic procedures. Although ultrasonic microvibration technology was experimentally used earlier, it was in 1988 that Italian oral surgeon Tomaso Vercellotti developed the first commercially available Mectron® piezoelectric bone surgery unit to cut bone tissue while minimizing the limitations of conventional tools. This phenomenon of deformation when under alternating current creates microvibrations or oscillations of ultrasonic frequency. Inversely, when an electric current is applied across them, they deform. ![]() Piezoelectric effect was first described by Jacques and Pierre Curie in 1880 and involves the appearance of an electric charge across certain crystals when they are under mechanical pressure. The term “piezo” has been derived from the word “Piezien,” which implies pressure in the Greek language.
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