The effect of heating during dental implant drilling and osteonecrosis (original) (raw)

Heat Generated by Dental Implant Drills During Osteotomy—A Review

The Journal of Indian Prosthodontic Society, 2014

Statementof problem: Osseointegration is the more stable situation and results in a high success rate of dental implants. Heat generation during rotary cutting is one of the important factors influencing the development of osseointegration. Purpose: To assess the various factors related to implant drills responsible for heat generation during osteotomy. Materials and Methods: To identify suitable literature, an electronic search was performed using Medline and Pubmed database. Articles published in between 1960 to February 2013 were searched. The search is focused on heat generated by dental implant drills during osteotomy. Various factors related to implant drill such effect of number of blades; drill design, drill fatigue, drill speed and force applied during osteotomies which were responsible for heat generation were reviewed. Titles and abstracts were screened, and literature that fulfilled the inclusion criteria was selected for a full-text reading. Results: The initial literature search resulted in 299 articles out of which only 70 articles fulfils the inclusion criteria and were included in this systematic review. Many factors related to implant drill responsible for heat generation were found. Successful preparation of an implant cavity with minimal damage to the surrounding bone depends on the avoidance of excessive temperature generation during surgical drilling. Conclusion: The relationship between heat generated and implant drilling osteotomy is multifactorial in nature and its complexity has not been fully studied. Lack of scientific knowledge regarding this issue still exists. Further studies should be conducted to determine the various factors which generate less heat while osteotomy such as ideal ratio of force and speed in vivo, exact time to replace a drill, ideal drill design, irrigation system, drill-bone contact area.

Thermal osteonecrosis and bone drilling parameters revisited

Archives of Orthopaedic and Trauma Surgery, 2008

Introduction During the drilling of the bone, the temperature could increase above 47°C and cause irreversible osteonecrosis. The result is weakened contact of implants with bone and possible loss of rigid fixation. The aim of this study was to find an optimal condition where the increase in bone temperature during bone drilling process would be minimal. Materials and methods Influence of different drill parameters was evaluated on the increase of bone temperature. Drill diameters were 2.5, 3.2 and 4.5 mm; drill speed 188, 462, 1,140 and 1,820 rpm; feed-rate 24, 56, 84 and 196 mm/min; drill point angle 80°, 100° and 120° and external irrigation with water of 26°C. Results Combinations of drill speed and drill diameter with the use of external irrigation produced temperatures far below critical. Without external irrigation, temperature values for the same combination of parameters ranged 31.4–55.5°C. Temperatures above critical were recorded using 4.5 mm drill with higher drill speeds (1,140 and 1,820 rpm). There was no statistical significance of different drill point angles on the increase or decrease of bone temperature. The higher the feed-rate the lower the increase of bone temperature. Conclusions The external irrigation is the most important cooling factor. With all combinations of parameters used, external irrigation maintained the bone temperature below 47°C. The increase in drill diameter and drill speed caused increase in bone temperature. The changes in drill point angle did not show significant influence in the increase of the bone temperature. With the increase in feed-rate, increase in bone temperature is lower.

Informative title: Thermal Osteonecrosis and Bone Drilling Parameters Revisited Concise title: Thermal Osteonecrosis and Bone Drilling

2007

Introduction During the drilling of the bone, the temperature could increase above 47 o C and cause irreversible osteonecrosis. The result is weakened contact of implants with bone and possible loss of rigid fixation. The aim of this study was to find an optimal conditions where the increase in bone temperature during bone drilling process would be minimal. Materials and methods Influence of different drill parameters was evaluated on the increase of bone temperature. Drill diameters were 2.5, 3.2 and 4.5 mm; drill speed 188, 462, 1140 and 1820 rpm; feed-rate 24, 56, 84, 196 mm/min; drill point angle 80, 100 and 120 o and externall irrigation with water of 26 o C. Results Combinations of drill speed and drill diameter with the use of external irrigation produced temperatures far below critical. Without external irrigation, temperature values for the same combination of parameters ranged 31.4-55.5 o C. Temperatures above critical were recorded using 4.5 mm drill with higher drill speeds (1140 and 1820 rpm). There was no statistical significance of different drill point angles on the increase or decrease of bone temperature. The higher the feed-rate the lower the increase of bone temperature. Conclusions The external irrigation is the most important cooling factor. With all combinations of parameters used, external irrigation maintained the bone temperature below 47 o C. The increase in drill diameter and drill speed caused increase in bone temperature. The changes in drill point angle did not show significant influence in the increase of the bone temperature. With the increase in feed-rate, increase in bone temperature is lower.

Analysis of factors determining thermal changes at osteotomy site in dental implant placement - An in-vitro study

Journal of Clinical and Experimental Dentistry, 2021

Background Heat generation during osteotomy site preparation is a crucial factor that determines the success of dental implant placement. Among the factors that affect the heat generation, drilling speed, hand pressure and coolant temperature are independent variables. However, a relation between these three parameters and their optimal values required for the maximum outcome has not been studied so far. This study aims at finding out a relation between these factors in order to derive the optimum balance required, using an in vitro study. Material and Methods This in vitro experiment was performed on bovine femur. A total of 72 drillings were undertaken with the aid of a physiodispenser mounted on the test apparatus. Drill diameters of 2 mm and 2.8 mm, rotated at 1500, 2000 and 2500 rpm were included for the analysis. Hand pressures included for the comparison were 1.2 kgf and 2.4 kgf. Normal saline at room temperature, and that chilled to 00C were used for external irrigation. The...

Influence Of Implant Drills Wear On The Heat Generated During The Osteotomy.LiteratureReview.

IOSR Journals , 2019

Objective: Identify, if there is any evidence in literature of a detrimental increase in temperature when a deterioration and wear in implant drills occur. The Pubmed database was employed for this purpose.Results: Out of the 13 studies selected, all of them used an infrared camera as a temperature measurement method, since this is the most sensitive method defined. The highest temperature reported in the studies was 67.2ºC and the lowest was 24.1ºC. After 50 uses, a significant wear of the drill can be noticed. Even though this does not significantly affect the increase in temperature during drilling. This increment was more affected by factors such as: the diameter of the drill, the drilling sequence or irrigation.Conclusion: It seems to be that the wear of the drills does not significantly influence a temperature rise above 47ºC.

Heat generation during implant drilling: The significance of motor speed

Journal of Oral and Maxillofacial Surgery, 2002

Purpose: The purpose of this study was to measure the heat generated from 3 drilling speeds (1,225, 1,667, and 2,500 rpm) using the armamentarium of 4 implant systems. Materials and Methods: The mean rise in temperature, the time of drilling, and the time needed for pig jaw bone to return to the baseline temperature were monitored using 4 thermocouple technology. Results: The mean rise in temperature, the time of drilling, and the time needed for the specimens to return to the baseline temperature were lower at 2,500 rpm than at 1,667 or 1,225 rpm (P Յ .05), regardless of the system used. The rpm also directly correlated to the amount of time the bone remained at an elevated temperature. Conclusion: From a heat generation standpoint, we conclude that preparing an implant site at 2500 rpm could decrease the risk of osseous damage, which may affect the initial healing of dental implants. This may decrease the devital zone adjacent to an implant after surgery and be most advantageous in immediate load application to dental implants.

Experimental Analysis of Temperature Differences During Implant Site Preparation: Continuous Drilling Technique Versus Intermittent Drilling Technique

The Journal of oral implantology, 2018

Implant site preparation through drilling procedures may cause bone thermonecrosis. The aim of this in vitro study was to evaluate, using a thermal probe, overheating at implant sites during osteotomies through 2 different drilling methods (continuous drilling technique versus intermittent drilling technique) using irrigation at different temperatures. Five implant sites 13 mm in length were performed on 16 blocks (fresh bovine ribs), for a total of 80 implant sites. The PT-100 thermal probe was positioned 5 mm from each site. Two physiological refrigerant solutions were used: one at 23.7°C and one at 6.0°C. Four experimental groups were considered: group A (continuous drilling with physiological solution at 23.7°C), group B (intermittent drilling with physiological solution at 23.7°C), group C (continuous drilling with physiological solution at 6.0°C), and group D (intermittent drilling with physiological solution at 6.0°C). The Wilcoxon rank-sum test (2-tailed) was used to compare...

Heat Generation During Initial Osteotomy for Implant Site Preparation: An In Vitro Measurement Study

Journal of Maxillofacial and Oral Surgery

Introduction Controlling temperature generation during implant site preparation is important to prevent implant early failure. Aim The present in vitro study aimed at measuring temperature variation generated during the initial osteotomy using both rotatory and piezo-surgical inserts. Methods Nine groups were defined according to drill and insert type, cooling volume (mL/min) and cooling temperature. A total of 315 implant site preparations were performed in an artificial bone sample and the temperature was measured using an infrared camera. Drills’ wear was assessed using scanning electron microscopy at baseline and after 10 and 35 utilizations. Results Piezo-surgical insert groups determined a temperature increase that was significantly higher than the one generated by rotatory drills groups (p < 0.001). When considering rotatory drills groups a temperature ≥ 40 °C was never recorded. Conclusion Lower saline temperature implied a significant temperature decrease (p < 0.001),...

Heat Generation During Implant Placement in High-Density Bone: Effect of Different Drilling Techniques

Alexandria Dental Journal, 2021

Introduction: A precise drilling-sequence-protocol is essential for long-term dental implant success in high bone density (mandibular cortical bone of D1-quality). Cone beam computed tomography (CBCT) radiographic imaging and CBCT-based construction of surgical guides have been substantial for diagnosis and treatment planning. Objectives: The study aimed to measure the effect of different guided drilling techniques on the amount of heat generated during implant placement in high density. Materials and Methods: Twenty-four osteotomies for implant placement, divided equally into three groups, to test the effect of the three drilling techniques " Undersized Drilling (UD), Undersized Drilling + Ridge Spreader size 4 (UD+RS4) and Undersized Drilling + counter sink size 4 (UD+CS4) techniques". Heat generation was assessed using K-type thermocouple. Drilling and thermocouple canals were guided by the surgical template. Bone assessment, virtual planning of the implants and surgica...

Thermographic analysis of burs and bone heating developed during osteotomy for dental implant placement: an in vitro study

2018

Inappropriate alveolar bone drilling during the osteotomy procedure can develop a risky local overheating. This in vitro study was conceived to investigating the simultaneous thermal changes of burs and bone tissue caused by mechanical friction while preparing the new alveolus for dental implant placement. There were drilled without cooling in bovine femoral bone a total of 30 osteotomy sites with MIS System burs at 2000 rpm, as follows: group 1 (10 osteotomies with the pilot bur of 2 mm diameter), group 2 (10 osteotomies with the bur of 2.8 mm diameter), and group 3 (10 osteotomies with the bur of 3.2 mm diameter). The thermal changes were recorded in real-time by digital infrared camera FLIR SC640 (Flir Systems). The thermographic analysis showed that the 2 mm diameter bur developed in bone a mean temperature of 46,5 ± 0,42, whereas the recorded bur temperature was of 64,2oC ± 2,58. The bur of 2.8 mm diameter produced in bone a mean temperature of 58,2oC ± 1,83 while the bur tempe...