Dental implant
Effect of Surgical Drill Guide on Heat Generated From Implant Drilling

https://doi.org/10.1016/j.joms.2009.07.056Get rights and content

Purpose

The purpose of this study was to evaluate the heat generated in bone by 2 implant drill systems in vitro with and without using surgical drill guides.

Materials and Methods

Temperature was measured with K type thermocouple in vitro using the bovine femoral cortical bone model. A constant drill load of 2.0 kg was applied throughout the drilling procedures via a drilling rig at a speed of 1,500 rpm. Two different implant drill systems—System A (with external irrigation) and System B (with both external and internal irrigation)—were evaluated. The samples were divided into 4 groups. System A test group 1 (TG1) included the following: 20 samples for drilling with surgical drill guides; control group 1 (CG1): 20 samples for classical implant site preparation. System B test group 2 (TG2) included the following: 20 samples for drilling with surgical drill guides; control group 2 (CG2): 20 samples for classical implant site preparation. Heat was measured at the final drill in the drilling sequence (4.2 and 4.4 mm). Thermocouples were placed at a 1-mm distance from the osteotomy area at depths of 3, 6, and 9 mm. Heat measurements were recorded out to 50 uses by a software program. Data were subjected to the Mann-Whitney U and Kruskal-Wallis tests. The α level was set a priori at 0.05.

Results

The mean maximum temperatures at the depths of 3, 6, and 9 mm using surgical drill guides were 34.2°, 39.7°, and 39.8°C, respectively, although without using surgical drill guides the values were 28.8°, 30.7°, and 31.1°C. A statistically significant difference was found at the depths of 3, 6, and 9 mm between using surgical drill guides and classical drilling procedure.

Conclusions

From a heat generation standpoint, we conclude that preparing an implant site with using surgical drill guides generates heat more than classical implant site preparation regardless of the irrigation type.

Section snippets

Materials and Methods

A total of 80 uniform fresh bovine femoral cortical bone samples were used in the present study. The rationale for choosing bovine cortical bones was that both human and bovine cortical bones are thermally isotropic.13 The specimens were kept frozen until used. Two different implant drill systems—System A (ITI Straumann, Basel, Switzerland) and System B (Zimmer Dental, Carlsbad, CA)—were evaluated using surgical drill guides versus classical implant site preparation. The metal sleeves

Results

The mean temperature in the water bath was 30.1°C. The mean maximum temperature with external irrigation (System A) was 31.9°C, whereas the temperature with both external and internal irrigation (System B) was 36.1°C. The mean maximum temperatures with and without surgical guides were 37.9° and 30.2°C, respectively. The mean maximum temperatures at the depths of 3, 6, and 9 mm were 31.5°, 35.2°, and 35.4°C, respectively. The mean drilling time was 18.1 s.

Thermal rise was significantly lower at

Discussion

For atraumatic surgical preparation, avoidance of excess heat generation during implant drilling is essential.4 Several factors, including drill speed, drill morphology, and sharpness of the drills has been reported to influence temperature rise during drilling procedures. Hobkirk and Rusiniak14 reported that spear point and twist drills required lower operating pressures and shorter operating times than round and fissure burs that were associated with lower thermal trauma to the bone. Cordioli

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