Odontogenic abscesses represent one of the most frequent and challenging conditions in pet rabbits, with a clinical course often complicated by osteomyelitis and osteonecrosis. The unique dental physiology of lagomorphs, characterized by continuously growing teeth and delicate craniofacial bone architecture, makes surgical management particularly complex. Traditional approaches using rotary instruments or manual luxators require the application of significant force, which increases the risk of iatrogenic mandibular or maxillary fractures, thermal necrosis of bone margins, and delayed healing. Piezoelectric surgery offers a minimally invasive and highly selective alternative. This technology relies on ultrasonic microvibrations that cut only mineralized tissues such as bone and teeth, while sparing soft tissues. The cavitation effect generated during irrigation produces antibacterial action, reduces intraoperative bleeding through microcoagulation, and maintains a clear surgical field. These properties allow atraumatic osteotomies and osteoplasties, precise dental extractions without force, and preservation of vascularized bone margins, thereby reducing postoperative pain and accelerating tissue regeneration.
A clinical parallel can be drawn from human oral surgery, where piezoelectric devices have become indispensable in the treatment of mandibular osteonecrosis. In advanced cases of odontogenic abscesses in rabbits, where osteomyelitis and osteonecrosis are also present, this analogy supports the use of piezoelectric surgery as a preferred tool. The ability to selectively remove infected and necrotic bone while preserving viable structures makes it an excellent option for complex or recurrent cases that otherwise carry a poor prognosis. The described technique involves extraoral access to the affected region, atraumatic bone removal with dedicated piezoelectric inserts, and extraction of diseased teeth without forceful manipulation. Intraoral suturing prevents orocutaneous fistula formation, while marsupialization facilitates drainage and granulation.
A key adjunct to surgical treatment is ultrasonic wound debridement (UWD), performed with the same piezoelectric unit by switching to specific programs and inserts. UWD applies low-frequency ultrasonic oscillations that selectively emulsify necrotic tissue while preserving granulation tissue and stimulating angiogenesis. Cavitation phenomena further enhance antibacterial activity by disrupting bacterial biofilm and promoting the release of growth factors. In the postoperative management of abscess cavities, UWD accelerates healing, reduces the number of required anesthetic events, and is often well tolerated without pharmacological restraint. Clinical application in rabbits has shown reduced recurrence rates, improved wound hygiene, and faster resolution compared with conventional mechanical debridement. By combining extraoral piezoelectric extractions with postoperative UWD, a comprehensive and minimally invasive treatment protocol can be achieved. This dual application of the same technology ensures continuity of care: precise surgical removal of infected dental and bony structures, followed by targeted and atraumatic management of residual infection. In conclusion, piezoelectric extraoral dental extraction represents a safe and effective method for managing odontogenic abscesses in rabbits, while ultrasonic wound debridement provides a powerful adjunctive therapy to optimize postoperative recovery. Together, these approaches mirror the successful integration of piezoelectric surgery in human oral and maxillofacial medicine, highlighting its role as an indispensable tool in the treatment of osteomyelitis and osteonecrosis secondary to advanced dental disease in rabbits.
References
Paesano, Francesco & Laganà , Tiziana. (2025). Piezoelectric Surgery and Oral Cavity Disorders in Small Mammals. Veterinary Clinics of North America: Exotic Animal Practice. 10.1016/j.cvex.2025.04.005.
