## 1 Introduction  
Bone healing is a contemporary topic that is becoming more and more interesting due to its clinical implications [1, 2]. Traditional osteotomy devices, such as conventional rotary osteotomes or reciprocating saws, have always been used for bone surgery. However, the use of these mechanical devices entails disadvantages, including bone overheating, bone fragmentation, formation of a'smear layer' during osteotomy, and damage to adjacent tissues [3; 4]. The piezoelectric bone-cutting osteetome was first introduced in orthopedic surgery in the late 1980s as an alternative bone-cutting instrument [5]. In oral, maxillofacial, vertebral, and hand surgery, as well as neurosurgery and aesthetic and reconstructive surgery, there is an increasing demand for precise and safe bone-cutting techniques [3; 4]. Minimally invasive surgery is important to provide faster healing and to allow the preservation of delicate bony structures and adjacent soft tissues [6]. In recent years, significant steps have been made toward improving osteotomy devices and techniques. Among them, the development of ultrasound-based osteotomes has been a game-changer. Ultrasonic bone surgery, also called 'piezoelectric bone surgery', or simply 'piezosurgery', is a micrometric selective technique that uses a defined ultrasonic frequency, in a range between 24 kHz and 32 kHz, thus allowing a selective cut of bone [7; 8]. Its mechanism of action is based on the ability of certain ceramics and crystals to deform when crossed by an electric current, resulting in micro-vibration at ultrasonic frequency [9]. The tip of piezosurgical devices cuts selectively mineralized tissues without cutting soft tissues, thereby limiting the risk of damage to blood vessels and nerves during bone surgery, which is essential in craniofacial surgery [10]. In order to introduce ultrasonic bone surgery in daily clinical practice, many studies have been performed, especially in the field of translational medicine. In fact, preclinical and clinical studies, combined with in vitro studies, have shown that piezosurgery produces clean and precise osteetomies with smooth surfaces and decreased bleeding [10; 11]. These are key aspects, especially in those fields where precise and safe osteotomy cutting surfaces can also have an aesthetical impact on the result, such as oral, maxillacial, and plastic surgical interventions. For these reasons, the use of piezosurgery has become the mainstay of pre-prosthetic and implant surgery. The presence of tips with different sizes and shapes determines excellent versatility, allowing the use of piezosurgery in several surgical fields [12; 13]. Maximillary sinus floor elevation is a common application, as the sparing of bone tissue plays a key role in the success of this intervention [14]. Another frequent surgical intervention improved by the use of piezosurgery is bone grafting, where the reduction in bone damage during the harvesting phase allows the obtaining of tissue of higher quality [15]. Also interventions requiring high precision have benefited from this new technology, such as bone ridge augmentation and removal of fractured implants. The versatility of piezoelectric tips can help in implant site preparation in atrophic jaws because of an accurate site preparation with sparing of bone, maxillary sinus, and inferior alveolar nerve [16]. Moreover, precise mandibular implant site preparation using piezosurgery can be combined with pre-operative deep learning-based mandibular canal segmentation [17; 18; 19; 1]. Finally, piezosurgery improved the safety of extreme interventions, such as inferior alveolar nerve lateralization, with a substantial impact on patients' postoperative quality of life [20]. All of these qualities have also been clinically demonstrated. For example, [PERSON] et al. evaluated the outcomes of alveoloplasty performed with piezosurgery compared with a classical technique with bone rongeur and bone file [21]. [PERSON] et al.