Thermal changes observed at implant sites during internal and external irrigation

Abstract

In the preparation of osseointegrated dental implant sites, the use of bone drilling with conventional external irrigation has been shown to be thermally non-injurious to bovine bone, when employed as a model for dental implantology. The use of internal irrigation drilling systems is promoted on the basis of improved delivery of coolant to the bone/drill interface, which should subsequently improve local debridement and cooling, and therefore reduce thermal insults to the bone. The aim of this bovine model study was to compare the temperatures that were generated with external and internal irrigation systems during bone preparation for dental implants. A constant drill load of 1.7 kg was applied throughout the drilling procedures via a drilling rig. The burs that were used for both irrigation methods were a 2 mm twist drill for cutting the channel and a 3.25 mm drill for trephining this channel. The principal recorded parameter was the change in temperature generated via the drilling procedure. The 2 mm twist drills produced a maximum change in temperature of only 3.0 degrees C and 3.1 degrees C for the internal and external irrigation systems, respectively. Maximum changes for the 3.25 mm drills were 1.34 degrees C and 1.62 degrees C, respectively. Using the t-test, no statistical benefit was observed for one irrigant delivery system over the other. The clinical benefit of using the more expensive internal irrigation systems is therefore deemed unjustifiable, on the grounds that these systems do not appear to reduce the thermal challenge to the bone over and above that of simple flood irrigation.

Avaliação Microscópica de Fragmentos Ósseos Obtidos por Diferentes Métodos de Osteotomia e de Irrigação

“…A perfuração e trepanação são procedimentos que ocorrem durante a preparação do implante dental, podendo causar danos mecânicos e térmicos que que são obstáculos importantes para o processo de reparo inicial 11 . Além do trauma mecânico, as brocas cirúrgicas causam uma injúria térmica ao tecido ósseo cortado; esse aumento na temperatura tem sido o fator mais prejudicial.…”

“…A osteotomia ou o corte do tecido ósseo pode ser realizado por diversos métodos, alguns utilizados com uma maior frequência, como as brocas ou fresas cirúrgicas em alta e baixa rotação, e outros utilizados mais seletivamente, como o cinzel e as serras para osso; mais recentemente, o laser de alta potência foi introduzido como método alternativo para osteotomias 4,5 . Muitos fatores têm sido considerados na produção de calor durante a osteotomia, dentre eles estão incluídos a velocidade da broca 6,7 , espessura da cortical óssea 8 , força da broca 9 , profundidade e desenho da broca 9,10 , diâmetro da broca 10 e irrigação 11 . A busca por definições de uma técnica segura de osteotomia, que estabeleça um melhor prognóstico cirúrgico, motivou a realização desta pesquisa, que teve como objetivo avaliar o melhor método de osteotomia (caneta de alta rotação ou motor de implante a 1500 rpm) e o melhor método de irrigação (manual ou realizada por bombas peristálticas de motor cirúrgico) para obtenção de peças ósseas em coelhos.…”

Biological Evaluation of Implant Drill Made from Zirconium Dioxide

“…Quality and quantity of bone surrounding implants and primary stability of implants are important elements for the establishment of osseointegration, which is essential for implant success 1. At the same time, inflammation control and acceleration of bone healing after cavity preparation play a pivotal role in implant therapy.…”

“…At the same time, inflammation control and acceleration of bone healing after cavity preparation play a pivotal role in implant therapy. In this regard, minimal bone damage upon cavity preparation would help to improve success rate, and it has been noted that external irrigation during implant cavity formation results in less heat and damage to surrounding bone 1, 2…”

In-vitro experimental analysis and numerical study of temperature in bone drilling

“…Recent reviews on bone-drilling process briefly presented mechanics of bone drilling and associated postoperative complications [7,9]. One of the important factors reducing bone temperature during drilling operations is saline irrigation (cooling) [7,10,11]. The use of internal or external cooling with saline solution can also reduce friction between the drill and the drilled bone and helps in keeping the drilling track clear of bone debris and prevents flutes of the drill bit from clogging.…”