Mills, drills, burs and low-frequency oscillating saws were the only tools for bone-cutting for a long time and their use rarely questioned on their biological and physiological effects on bone. With the emergence of new technologies in bone-cutting - such as lasers and piezoelectric cutting devices - more and more experimental and clinical studies shed light on the differences in the bone healing-cycle when traditional instrumentation is compared to these new technologies.

A search in medical and biomedical databases was performed and molecular-biologic, micromorphologic, histologic, experimental and comparative clinical studies were selected for a systematic review and meta-analysis.

Experimental and clinical results then were summarized and compared against each other by their micromorphologic, histologic, biologic and clinical effects resulting in a comparative overview with significant impact on the clinicians’ daily routine-work in basic oral surgery, bone-augmentation-surgeries and implantology.

Evidence-based knowledge currently  suggests piezoelectric surgical tools for bone-cutting to provide the highest clinical precision, the least procedural bone-loss, and an improved bone-healing, defining the new Gold-Standard in cutting bone. Various new surgical techniques such as ultrasonic transcrestal sinuslift, atraumatic crest-split, subperiostal tunnel-technique and other newly developed surgical techniques in oral implantology will be presented as clinical case-demonstrations.