[Mandibular donor site healing after bone graft harvesting in cleft patients: a comparative study of rotary bur and piezoelectric osteotomy techniques].

OBJECTIVE

To evaluate mandibular donor site healing after cortical bone graft harvesting in cleft patients, comparing outcomes of osteotomies performed with rotary burs and piezosurgery.

MATERIAL AND

METHODS

Fifty-three patients (64 bone grafting procedures) were included. Autogenous grafts were harvested from the mandibular body using either a rotary bur (n=43) or a piezoelectric device (n=21). Healing was assessed by CT 5-24 months postoperatively using a 4-grade scale. Statistical analysis employed the Shapiro-Wilk test, Mann-Whitney U test, and Spearman correlation (p<0.05).

RESULTS

Mean healing scores were 3.7±0.6 for the rotary group and 2.1±1.0 for the piezosurgery group (p<0.01). No significant correlation was found between postoperative time and healing (r=0.11 and -0.37, respectively). In the piezosurgery group, patients older than 13-14 years demonstrated reduced bone regeneration and higher outcome variability.

CONCLUSION

Piezosurgery did not improve bone healing at the mandibular donor site and was associated with slower regeneration compared with rotary osteotomy. Rotary burs provided more stable and predictable results. The advantages of piezoelectric surgery appear primarily technical rather than biological.