BACKGROUND: The ultrasonic vibrations from the piezoelectric knife may amplify the natural response to surgical injury. This may lead to different clinical and biological outcomes when using the piezoelectric knife versus a surgical bur to create selective cortical penetrations for alveolar ridge augmentation surgeries. The first aim of this study was to analyze the differences in bone graft healing when selective cortical penetrations are created with a surgical bur and with a piezoelectric knife. The second aim of this pilot study was to see if enhanced new bone formation during bone regeneration procedures can be achieved with the use of a piezoelectric knife versus the conventional bur or onlay grafting techniques utilizing deep learning, a subset of machine learning.
MATERIALS & METHODS: he project was approved by the Boston University Medical Center Institutional Animal Care and Use Committee (IACUC). Twenty, 9-10 week male Sprague Dawley rats, weighing approximately 300g, were used in this study. The rats were randomly divided into three groups: Xenograft, Alloplast, and Collagen. These groups were further divided by surgical technique: Bur, Piezo, and Onlay. For the Bur and Piezo groups, four equally-spaced selective cortical penetrations were made prior to bone graft stabilization. Three rats served as controls (Control group). Microcomputed tomography scans (µCT) were acquired for each sample, containing approximately 1,000 slices of data each. After 28 days of healing the volumes of and density of the newly formed bone were extracted and analyzed for each group. This was achieved with an innovative deep learning algorithm designed for multi-level segmentation and regional feature detection utilizing convolutional neural networks (CNN).
RESULTS: Microcomputed tomography (µCT) of our samples yielded very localized, high-resolution scans of our surgical samples. The innovative deep learning algorithm was able to reliably produce highly accurate, unbiased segmentations of our samples. This study demonstrated that new bone formation was possible with all nine of the tested surgical techniques, however the differences were not statistically significant. Selective cortical penetrations with a piezoelectric knife (PIEZO) resulted in significantly more “cortical-like” new bone formation at 28 days.
CONCLUSION: Within the limitations of this preliminary study, it is possible to conclude that the piezoelectric knife is a valid alternative to conventional carbide burs when making selective cortical penetrations prior to bone grafting surgery. Additionally, our deep learning algorithm successfully segmented thousands of slices of data and allowed for the calculation of porosity and new bone volume in our samples.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/44838 |
| Date | 05 July 2022 |
| Creators | Exarchos, Elias A. |
| Contributors | Ohira, Taisuke, Dibart, Serge |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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