Piezoelectric surgery is a relatively new option for osteotomies using an ultrasound device. Piezosurgery was developed in response to the need to reach major levels of precision and intraoperative safety in bone surgery, if compared to that available traditional manual and motorized bone cutting instruments. Accuracy and selectivity for hard tissues make it superior to conventional rotating instruments, especially where area of interest is adjacted to nerves, maxillary sinus and blood vessels. The piezoelectric surgery device is applied to preimplantologic surgery including: bony window osteotomy in sinus lift, atraumatic tooth extraction, ridge split technique, bone blocks and bone chips harvestig, osteoplasty, distraction osteogenesis and elevation of Schneiderian´s membrane. The use of piezoelectric device in implant site preparation according to different scientific studies shows high success rate, maintaining bone vitality and promoting implant osseointegration. The main advantages of piezoeletric surgery are: precise cutting, preservation of soft tissue, less vibration and noise, better visibility in the surgical field and signifiacantly reduced blood loss. Some of disadvantages are longer operative time, lower efficincy in hard compact bone and potential temperature rise in hard tissue. Piezosurgery according to various scientific studies appears to be an advanced and conservative tool if compared with conventional drills and instruments.