The Effect of Irrigation Temperature on Bone Healing

Abstract

Objective: Osteotomies, performed by rotational instruments, can cause temperature rise on the bone and elevated temperature can disrupt the bone healing. When the osteotomies are performed for the insertion of miniscrews, the bone healing disruption may cause stability loosening or failures. Saline irrigation is mostly used for the prevention of the heat generation during osteotomy.Purpose: The purpose of this study was to evaluate the effect of the saline irrigation temperature on bone healing.Material and Method: Standardized drilling and miniscrew placement was performed in the tibias of 18 Sprague Dawley rats with rotating bur uncooled, cooled with 25°C and 4°C saline irrigations. After the 21 days, the difference in healing was observed between the uncooled and cooled groups.Results: Although there was no statistically significant difference between the group irrigated with 25°C and 4°C saline for newly bone formation, osteoblasts were seen more active and bone marrow was more dynamic in group 4°C than group 25°C. There is no disadvantage to use 25°C, but it may be better to use 4°C for rapid healing.

The effect of load on heat production, thermal effects and expenditure of time during implant site preparation – an experimental ex vivo comparison between piezosurgery and conventional drilling

“…(25 and 4°C) in irrigation does still not show statistically significant differences in new bone formation (Isler et al 2011), whereas the global cooling of the heads seemed to impact on temperature development and thus on potentially new bone formation. The higher temperatures arising when using the piezosurgical instrument may be explained by significantly higher durations for the implant site preparation compared with both of the conventional styles, the spiral and the trephine bur, and all loads applied.…”

Effect of surgical drill guide and irrigans temperature on thermal bone changes during drilling implant sites - thermographic analysis on bovine ribs

“…However, when choosing a temperature of the irrigans in the clinical setting, the effect of cooled saline on nerves, vessels or other structures should also be considered 20 . Histological data 21 have shown higher osteoblast activity and greater increase in bone marrow dynamics when implant sites are drilled under saline at 4°C compared to 25°C. Rapid bone healing associated with the use of cooled saline has also been documented histomorphometrically, although irrigans temperature did not have any impact on the amount of newly formed bone 21 .…”

Physical Stimulations for Bone and Cartilage Regeneration

“…Low-level laser therapy (LLLT) with proper doses and output powers was also reported to stimulate cellular metabolism, increase protein synthesis, and subsequently enhance bone regeneration [131]. Temperature could rise in a surgical operation like osteotomies and the elevated temperature could disrupt the bone healing [132]. Heat generation during osteotomy is one of the important factors influencing the development of osseointegration [133].…”