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    International Journal of Innovative Science and Research Technology
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    The CUSA is a device of modern periodontal treatment that claims to be a breakthrough in minimal invasion surgical technique

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    Cusa (Cavitron Ultrasonic Surgical Aspirator) “the New Armour of Periodontal Therapy”

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    The CUSA is a device of modern periodontal treatment that claims to be a breakthrough in minimal invasion surgical technique

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    63 views4 pages

    Cusa (Cavitron Ultrasonic Surgical Aspirator) "The New Armour of Periodontal Therapy"

    Uploaded by

    International Journal of Innovative Science and Research Technology
    The CUSA is a device of modern periodontal treatment that claims to be a breakthrough in minimal invasion surgical technique

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 4

    Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology

    ISSN No:-2456-2165

    Cusa (Cavitron Ultrasonic Surgical Aspirator)


    “The New Armour of Periodontal Therapy”
    Dr. Ankita sharma1, Dr. Shailendra S. Chauhan2, Dr. Aditya Sinha3, Dr. Satendra sharma4,
    Dr. Vineeta gupta5, Dr. Gaurav singh6, Dr. Ritu Agrawal7
    MDS1,6,7, Prof. and Head of Department2, Reader3,4,5.

    Abstract:- The CUSA is a device of modern periodontal The flap's preservation of interdental space while
    treatment that claims to be a breakthrough in minimal lowering vertical release permits adhesion and maturation
    invasion surgical technique. While repairing a ship's with little harm, and primary purpose wound closure enables
    propeller in 1916, scientist Lord Rayleigh discovered the the regeneration of periodontal tissue.
    effect of cavitation. This device, like others, uses low
    frequency ultrasonic radiation to dissect or split tissues In this context, further current research that defines and
    with low fibre content. Ultrasonic pulses in the 23 kHz contrasts the effectiveness of the minimally invasive
    range are used to create cavitations in tissue a hollow 3 nonsurgical method (MINST) and the minimally invasive
    mm tip vibrating at 23,000 times per second delivers this surgical approach is necessary. Extensive subgingival
    mechanical energy. debridement is the aim of MINST while keeping the
    preoperative gingival architecture, making a small incision,
    CUSA is a surgical device that was developed for and delicately manipulating the soft and hard tissues to
    ophthalmology but has since gained widespread encourage the creation of a stable blood clot by spontaneous
    acceptance in a number of medical disciplines, including filling of the infrabony defect3, 4.
    neurosurgery, general surgery, gynaecology, urology, and
    neurotology. This equipment cause, Biofilm disruption CUSA was originally designed for ophthalmological
    and cell stimulation for non-surgical treatment of surgery, but it has since gained widespread acceptance in a
    infrabony defects, as well as ultrasonic debridement and variety of medical disciplines, including neurosurgery,
    flapless therapy, are said to be effective. general surgery, gynaecology, urology, neurotology, and,
    most recently dentistry5-6 (figure: 1). A well-known medical
    Using this aspirator increases safety and quality tool called the Cavitron ultrasonic surgical aspirator (CUSA)
    while decreasing operational time. There are no known is utilised for many different conditions, the most frequent of
    contraindications, but there are financial and personal which being liver illness and neurosurgery. Cell stimulation
    constraints. As a result, this strategy appears to be a and biofilm eradication have both been successfully
    viable option for improving non-surgical minimally accomplished with CUSA. CUSA's capacity to disrupt,
    invasive therapeutic procedures. rupture, and aspirate granulation tissue is claimed to increase
    the size and stability of blood clots when used for nonsurgical
    Keywords:- Cavitron Ultrasonic Surgical Aspirator, Pocket healing of infrabony lesions7.
    Depth, Non-Surgical Periodontal Therapy, Infrabony Defects

    I. INTRODUCTION

    Deep periodontal pockets, which are associated with


    infrabony abnormalities, have been linked to an increase in
    periodontal disease and tooth loss.

    The flap design preserves interdental space while


    reducing vertical release, which allows for adhesion and
    maturation with minimal damage, and primary intention
    wound closure allows for periodontal tissue regeneration. The
    development of membranes and biological mediators, such as Fig: 1 Cavitron Ultrasonic Surgical Aspirator (CUSA)
    bone substitutes, was once the main focus of researchers'
    interest in tissue regeneration. However, with the advent of In 1916, when looking at a ship's propeller's damage,
    minimally invasive surgical techniques, this interest has Lord Rayleigh learned about cavitations’ effects. He deduced
    recently shifted to tissue management to produce better that the structural damage was brought on by a tiny water jet
    results (MIS) 1, 2. stream produced by the bursting bubbles. A similar idea may
    be utilised to produce a cavitation effect utilising high-speed
    mechanical waves in non-elastic medium like water. All cells
    are killed when this phenomenon is used on tissues high in
    water content, like the liver, while collagen-rich structures,

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    Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology
    ISSN No:-2456-2165
    such blood arteries and nerves, which are low in water
    content, are retained. According to the researchers, a little jet Ultrasonic waves are sound waves with frequencies greater
    formed as a result of the bubbles collapsing. than 20,000 Hz.

    II. CAVITATION

    Vaporization of a liquid is referred to as cavitation. It enters


    the phase when exposed to lower pressures at a steady
    temperature.
    In a liquid, boiling happens when the pressure is
    dropped rather than when the temperature is raised. When the
    probe-tip retracts with appropriate amplitude and frequency,
    creating shock waves, gas bubbles suspended in a fluid,
    released into the environment, or trapped at a solid surface Fig: 4 ultrasonic sound wave frequencies
    expand and collapse on the negative side of a pressure cycle. IV. ASPIRATION
    This is known as cavitation (figure: 2).
    Aspiration is a sucking motion used to draw something in or
    out.
    Depending on how it is used, this term can have two different
    meanings.
    • Aspiration can refer to the act of breathing in a foreign
    object. Aspiration can also refer to a medical procedure that
    removes harmful or incorrectly placed substances from the
    body.
    Suction is essentially the aspiration of a gas or fluid by
    lowering the air pressure over its surface, typically through
    mechanical means or a negative pressure device.
    Fig: 2 showing cavitation effect
    V. THE CAVITRON ULTRASONIC SURGICAL
    III. ULTRASOUND ASPIRATOR (CUSA)
    Audible Frequency Range: 20 Hz —- 20,000 Hz Infrasonic A Cavitron ultrasonic surgical aspirator (CUSA) is used
    waves are sound waves with frequencies less than 20 Hz. by neurosurgeons to "cut out" brain tumors while sparing
    healthy tissue. Tissue cavitations are produced using the
    Cavitron ultrasonic surgical aspirator (CUSA) equipment
    using ultrasonic pulses in the 23 kHz range. A 3 mm hollow
    tip that vibrates at 23,000 times per second carries this
    mechanical energy. The complete apparatus is equipped with
    an aspirator and an irrigator to remove tissue debris.

    Fig: 3 infrasonic sound wave frequencies

    Fig: 5 surgical aspirator Fig: 6 component of CUSA probe

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    Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology
    ISSN No:-2456-2165
    VI. COMPONENTS OF CUSA PROBE IX. EFFECT OF DIFFERENT FREQUENCIES

    Three holy elements make up the CUSA investigation: The powerful 24 kHz hand piece fragments even the
    most difficult, fibrous, and calcified tumors, whereas the
    An apparatus that transforms electrical energy into small 35 kHz hand piece is useful during procedures requiring
    mechanical vibrations is a transducer. The transducer is precision, tactile feedback, and delicate control. The hand
    composed of a stack of nickel alloy plates. A magnetic field piece can be tailored to the consistency, location, and depth
    created by a coil wrapped around the plates moves the plates of the targeted tissue for each procedure.
    mechanically by around 300 microns.

    The connecting body mechanically transmits the


    transducer's movements to the surgical tip. The transducer's
    vibration motion is also amplified by it.

    Surgical hint: Contacts the tissue while simultaneously


    completing the motion amplification. As a result, there is
    sufficient motion amplification since the tip is relatively
    lengthy in relation to its diameter.

    VII. PIEZOELECTRICTRANSDUCER

    Ultrasonic waves are produced and detected using a


    piezoelectric transducer. It is a quartz crystal that converts
    electrical oscillations (sound) into mechanical vibrations
    (sound).

    Fig: 8 Effect Of Different Frequencies

    X. SUCTION AND IRRIGATION

    The CUSA has a self-contained suction capability for


    removing fragmented tissue and irrigation fluid. In the CUSA
    operation, suction and irrigation serve three functions:

    1. It attracts tissue to the vibrating tip, causing tip/tissue


    coupling.
    2. It keeps debris from irrigation and fragmentation away
    Fig: 7 Piezoelectric Transducer from the surgical site.
    3. Irrigation fluid flows capillary around the outside of the
    VIII. MECHANICS OF CUSA vibrating tip to keep it cool.
    The CUSA console supplies alternating current (24 or 3
    kHz) to the hand piece. The current flowing through the coil
    in the hand piece creates a magnetic field.

    A transducer or nickel alloy laminations are then excited


    by the magnetic field, resulting in oscillating motion
    (vibration) along the transducer laminated structure's long
    axis.

    A connected surgical tip receives vibrations from the


    transducer via a metal connecting body. Fig: 9 Suction and Irrigation device

    When the vibrating tip makes contact with tissue, it Studies8, 9 have shown that surgical and nonsurgical
    divides cells (fragmentation). Numerous magnetostrictive interventions both improved CAL increase and PD reduction.
    hand pieces with various frequencies and tip configurations However, certain studies back up the authors' initial theory;
    are compatible with the CUSA system. in particular, using minimally invasive techniques to
    nonsurgical therapy may result in better outcomes than using
    a conventional nonsurgical strategy10. Another study looked
    at a novel flapless technique to enhance debridement

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    Volume 7, Issue 7, July – 2022 International Journal of Innovative Science and Research Technology
    ISSN No:-2456-2165
    outcomes. As a result, we began our research a year after [6]. Desinger K, Liebold K, Helfman J, Stein T, Müller T. A
    FMUD and conducted SPT11 sessions after that. new system for a combined laser and ultrasound
    application in neurosurgery. Neurological Research.
    Following a chronic periodontitis process, the major 1999; 21:84-88.
    goal was to remove old and capsulated granulation tissue, [7]. B. J. O’Daly, E. Morris, G. P. Gavin, J. M. O’Byrne, and
    allowing the defects to have an appropriate and stable new G. B. McGuinness, “High-power low-frequency
    blood clot as a consequence of a nonsurgical technique. The ultrasound: a review of tissue dissection and ablation in
    surgical aspirator is the best tool for this application because medicine and surgery,” Journal of Materials Processing
    it can aspirate and fragment tissue with the capacity to reach Technology, vol. 200, no. 1–3, pp. 38–58, 2008.
    all regions of the defect12. [8]. L. J. Heitz-Mayfield, L. Trombelli, F. Heitz, I.
    Needleman, and D. Moles, “A systematic review of the
    XI. CONCLUSION effect of surgical debridement vs non-surgical
    debridement for the treatment of chronic periodontitis,”
    The effects and interactions of the following five Journal of Clinical Periodontology, vol. 29, no. 3, pp.
    variables are involved in surgical aspiration: 92–102, 2002.
    • Hand piece operating frequency [9]. L. J. Heitz-Mayfield, “How effective is surgical therapy
    • Tip cross-sectional area at the tissue contact site compared with nonsurgical debridement?”
    • Tip stroke amplitude Periodontology, vol. 37, no. 1, pp. 72–87, 2000.
    • Tissue type [10]. F. V. Ribeiro, R. C. Casarin, M. A. Palma, F. H. J´unior,
    • Suction level E. A. Sallum, and M. Z. Casati, “Clinical and patient-
    cantered outcomes after minimally invasive non-
    Overall, the use of ultrasonic aspiration increases safety, surgical or surgical approaches for the treatment of
    decreases operating time, improves quality, and allows for intrabony defects: a randomized clinical trial,” Journal
    selective surgery. of Periodontology, vol. 82, no. 9, pp. 1256–1266, 2011.
    [11]. N. Claffey, B. Loos, B. Gantes, M. Martin, and J.
    There are no known side effects. Egelberg, “Probing depth at re-evaluation following
    There are only constraints (financial, personal, etc. initial periodontal therapy to indicate the initial response
    to treatment,” Journal of Clinical Periodontology, vol.
    The flapless approach, on the other hand, was identified 16, no. 4, pp. 229–233, 1989.
    as a promising method for enhancing, and in secondary care, [12]. B. J. O’Daly, E. Morris, G. P. Gavin, J. M. O’Byrne, and
    the results obtained with nonsurgical therapy, while causing G. B. McGuinness, “High-power low-frequency
    less morbidity than any other surgical technique and ultrasound: a review of tissue dissection and ablation in
    providing patient satisfaction. Future randomized control medicine and surgery,” Journal of Materials Processing
    studies are required to better explain the potential of this Technology, vol. 200, no. 1–3, pp. 38–58, 2008.
    approach and its various application strategies.

    REFERENCES

    [1]. S. K. Harrel, “A minimally invasive surgical approach


    for periodontal regeneration: surgical technique and
    observations,” Journal of Periodontology, vol. 70, no.
    12, pp. 1547– 1557, 1999.
    [2]. P. Cortellini, “Minimally invasive surgical techniques in
    periodontal regeneration,” Journal of Evidence-based
    Dental Practice, vol. 12, no. 3, pp. 89–100, 2012.
    [3]. F. V. Ribeiro, R. C. Casarin, M. A. Palma, F. H. J´unior,
    E. A. Sallum, and M. Z. Casati, “Clinical and patient-
    cantered outcomes after minimally invasive non-
    surgical or surgical approaches for the treatment of
    intrabony defects: a randomized clinical trial,” Journal
    of Periodontology, vol. 82, no. 9, pp. 1256–1266, 2011.
    [4]. L. Nibali, D. Pometti, T. T. Chen, and Y. K. Tu,
    “Minimally invasive non-surgical approach for the
    treatment of periodontal intrabony defects: a
    retrospective analysis,” Journal of Clinical
    Periodontology, vol. 42, no. 9, pp. 853–859, 2015.
    [5]. Brock M, Ingwersen I, Roggendorf W. Ultrasonic
    aspiration in neurosurgery. Neurosurg Rev. 1984;
    7:173-177.

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