A Piezo element will not produce a tone by itself. The older mechanical buzzers used a switch and coil rather like a relay but the switch was in series with the coil and normally closed. When voltage was applied, the current flowed through the switch, energized the coil and opened the switch. Without power, the coils magnetic field collapsed, the switch closed again and started the cycle over again. A diaphragm was attached to the switch to make the sound of of it opening and closing louder.
In modern electronic buzzers there is usually a piezo element and a small transistor oscillator. The oscillator pulses voltage across the piezo elelment making it flex back and forth to produce the sound. The casing and outlet hole is tuned to the oscllator frequency to make it resonate and sound louder.
Brian.