Piezosurgery: A safe technique for inferior alveolar nerve mobilization in surgical correction of hemimandibular hyperplasia—Review of the literature and case report

INTRODUCTION: Piezoelectric bone surgery is a relatively new alternative for bone-related procedures in oral and maxillofacial surgery. It represents an innovative technique as it offers the maxillofacial surgeon the opportunity to make precise bone cuts without damaging any soft tissue and providing a blood less surgical field. Correction of facial asymmetries is still a major problem in need of an adequate solution. Neurosensory damage to the inferior alveolar nerve can be an adverse effect of surgical correction of hemimandibular hyperplasia. In this case report, piezoelectric cutting device was used to treat a hemimandibular hyperplasia with inferior alveolar nerve preservation. PRESENTATION OF CASE: A 21-year-old female presented with lower facial a symmetry which was started when she was 16 years. Clinical and radiographic examination were done, the patient was diagnosed with hemimandibular hyperplasia. Bone scan revealed normal condylar activity. Piezoelectric device was used to split the lower border cortical plate where the inferior alveolar neurovascular bundle was found within the hyperplastic lower border. After dissection of the neurovascular bundle from the canal; resection to the inner border of the mandible continued. Inferior alveolar neurovascular bundle was secured safely on the lateral border of the mandible and wound closed. Patient had symmetrical facial appearance. Inferior alveolar nerve was intact intra-operatively and the patient didn’t report any parasethesia with 6 months follow up. CONCLUSION: The use of a piezoelectric device provides surgical results that would not be possible with traditional instruments, not only for the patient's benefit but also for the surgeon’s.