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Comparison of Maximum Heat Generation during Implant Site Preparation between Single and Gradual Drilling Protocols in Artificial D1 Bone Blocks: An In Vitro Study. Int J Dent 2022; 2022:9370395. [PMID: 35761968 PMCID: PMC9233590 DOI: 10.1155/2022/9370395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
Aim Two protocols for implant site preparation have been demonstrated in the literature: conventional gradual drilling and single drilling. Objectives The purpose of this study is to assess the maximum temperature changes reached during and after implant site preparation of 4.2 implant diameter using the gradual drilling protocol and single drilling protocol. Material and Methods. The artificial bone block samples (#1522-23; Sawbones, Malmö, Sweden) with the density of d1 were divided into two groups. Twelve implant site preparations were performed with the use of only one drill in group A, and the same number of preparations was performed using five gradual drills in group B. The drilling speed was set for each group at 1500 rpm with the use of external irrigation with a constant of 50 ml/min at room temperature (25 ± 1°C). The maximum temperature changes were measured using an infrared camera (Fluke Ti55, USA). The data were gathered and analyzed using Student's t-test for independent samples. Results With the 95% confidence intervals (CIs) for the means of ∆T between groups A and B, group B showed a statistically significant higher temperature change (∆T) than group A. Conclusions The current outcomes propose that the single drilling protocol, while preparing a bed for a 4.25 mm dental implant in d1 artificial bone blocks, generates less heat than the conventional gradual drilling protocol.
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Feher B, Frommlet F, Gruber R, Hirtler L, Ulm C, Kuchler U. Resonance frequency analysis of implants placed in condensed bone. Clin Oral Implants Res 2021; 32:1200-1208. [PMID: 34358360 PMCID: PMC9292279 DOI: 10.1111/clr.13817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/20/2021] [Accepted: 07/07/2021] [Indexed: 01/10/2023]
Abstract
Objectives Resonance frequency analysis (RFA) is used to monitor implant stability. Its output, the Implant Stability Quotient (ISQ), supposedly correlates with insertion torque, a common measurement of primary stability. However, the reliability of RFA in condensed bone remains unclear. Material and methods In this human cadaver study in edentulous jaws and fresh extraction sockets, implants were inserted using a split‐mouth approach into condensed or untreated bone. Mean ISQ, peak insertion torque, and pre‐ and postoperative bone volume fractions (BV/TV) were assessed. Results In edentulous jaws, insertion torque and ISQ correlated both in untreated (r = 0.63, p = 0.02) and in condensed (r = 0.82, p < 0.01) bone. In extraction sockets, insertion torque and ISQ only correlated in untreated (r = 0.78, p < 0.01), but not in condensed bone (r = 0.15, p = 0.58). In all edentulous jaws, preoperative BV/TV correlated with insertion torque (r = 0.90, p < 0.0001), ISQ (r = 0.64, p < 0.001), and changes in BV/TV (r = –0.71, p < 0.01). In all extraction sockets, preoperative BV/TV did not correlate with either insertion torque (r = 0.33, p = 0.15), ISQ (r = 0.38, p = 0.09), or changes in BV/TV (r = –0.41, p = 0.09). Joint analysis identified preoperative BV/TV as a predictor of postoperative BV/TV (p < 0.001), insertion torque (p < 0.001), and ISQ (p < 0.001). Conclusions RFA is feasible for monitoring stability after late implant placement into condensed bone, but not after immediate placement into condensed fresh extraction sites.
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Affiliation(s)
- Balazs Feher
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Florian Frommlet
- Institute of Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Lena Hirtler
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Christian Ulm
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Ulrike Kuchler
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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Influence of Drilling Technique on the Radiographic, Thermographic, and Geomorphometric Effects of Dental Implant Drills and Osteotomy Site Preparations. J Clin Med 2020; 9:jcm9113631. [PMID: 33187298 PMCID: PMC7697778 DOI: 10.3390/jcm9113631] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 01/28/2023] Open
Abstract
The aim of this comparative study is to analyze the influence of drilling technique on the radiographic, thermographic, and geomorphometric effects of dental implant drills and osteotomy site preparations. One hundred and twenty osteotomy site preparations were performed on sixty epoxy resin samples using three unused dental implant drill systems and four drilling techniques performed with a random distribution into the following study groups: Group A: drilling technique performed at 800 rpm with irrigation (n = 30); Group B: drilling technique performed at 45 rpm without irrigation (n = 30); Group C: drilling technique performed at 45 rpm with irrigation (n = 30); and Group D: drilling technique performed at 800 rpm without irrigation (n = 30). The osteotomy site preparation morphologies performed by the 4.1 mm diameter dental implant drills from each study group were analyzed and compared using a cone beam computed tomography (CBCT) scan. The termographic effects generated by the 4.1 mm diameter dental implant drills from each study group were registered using a termographic digital camera and the unused and 4.1 mm diameter dental implant drills that were used 30 times from each study group were exposed to a micro computed tomography (micro-CT) analysis to obtain a Standard Tessellation Language (STL) digital files that determined the wear comparison by geomorphometry. Statistically significant differences were observed between the thermographic and radiographic results of the study groups (p < 0.001). The effect of cooling significatively reduced the heat generation during osteotomy site preparation during high-speed drilling; furthermore, osteotomy site preparation was not affected by the wear of the dental implant drills after 30 uses, regardless of the drilling technique.
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de Carvalho Silva Leocádio A, Silva Júnior M, José Pimentel Lopes de Oliveira G, da Col Santos Pinto G, Silveira Faeda R, Marques Padovan LE, Marcantonio Júnior É. Evaluation of Implants with Different Macrostructures in Type I Bone-Pre-Clinical Study in Rabbits. MATERIALS 2020; 13:ma13071521. [PMID: 32224982 PMCID: PMC7178163 DOI: 10.3390/ma13071521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/13/2020] [Accepted: 03/22/2020] [Indexed: 12/13/2022]
Abstract
The objective of this study was to assess the primary stability and the osseointegration process in implants with different macrostructures (Cylindrical vs. Hybrid Conical) in rabbit tibiae. Twenty-four (24) rabbits were used, divided into 3 experimental periods (2, 4 and 8 weeks) with 8 animals each. Each animal bilaterally received 2 implants from each group in the tibial metaphysis: Cylindrical Implant (CI) and Hybrid Conical Implant (HCI). All implants were assessed for insertion torque. After the experimental periods, one of the implants in each group was submitted to the removal counter-torque test and descriptive histological analysis while the other implant was used for microtomographic and histometric analysis (%Bone-Implant Contact). HCI implants showed higher insertion torque (32.93 ± 10.61 Ncm vs. 27.99 ± 7.80 Ncm) and higher % of bone-implant contact in the 8-week period (79.08 ± 11.31% vs. 59.72 ± 11.29%) than CI implants. However, CI implants showed higher values of removal counter-torque than HCI implants in the 8-week period (91.05 ± 9.32 Ncm vs. 68.62 ± 13.70 Ncm). There were no differences between groups regarding microtomographic data. It can be concluded that HCI implants showed greater insertion torque and bone-implant contact in relation to CI implants in the period of 8 weeks when installed in cortical bone of rabbits.
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Affiliation(s)
- Amanda de Carvalho Silva Leocádio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University (UNESP), Araraquara 14801-385, Brazil;
- Correspondence: (A.d.C.S.L.); (É.M.J.); Tel.: +55-(35)-99138-5571 (A.d.C.S.L.); +55-(16)-33016378 (É.M.J.)
| | - Matusalém Silva Júnior
- Post Graduation Course in Implantology, Latin American Institute of Dental Research (ILAPEO), Curitiba 80710-150, Brazil; (M.S.J.); (L.E.M.P.)
| | | | - Gustavo da Col Santos Pinto
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University (UNESP), Araraquara 14801-385, Brazil;
| | - Rafael Silveira Faeda
- Post Graduation Course in Odontology, University of Araraquara/UNIARA, Araraquara 14801-320, Brazil;
| | - Luis Eduardo Marques Padovan
- Post Graduation Course in Implantology, Latin American Institute of Dental Research (ILAPEO), Curitiba 80710-150, Brazil; (M.S.J.); (L.E.M.P.)
| | - Élcio Marcantonio Júnior
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University (UNESP), Araraquara 14801-385, Brazil;
- Correspondence: (A.d.C.S.L.); (É.M.J.); Tel.: +55-(35)-99138-5571 (A.d.C.S.L.); +55-(16)-33016378 (É.M.J.)
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Jamil M, Rafique S, Khan AM, Hegab H, Mia M, Gupta MK, Song Q. Comprehensive analysis on orthopedic drilling: A state-of-the-art review. Proc Inst Mech Eng H 2020; 234:537-561. [DOI: 10.1177/0954411920911283] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bone drilling is a well-known internal fixation procedure to drill a hole, fixing the bone fragments to reduce the susceptibility of permanent paralysis. The success of bone drilling is evaluated based on the extent of osteonecrosis in terms of heat generation, tissue damage, quality of hole, and drilling forces. The appropriate control of cutting conditions, drill geometric parameters, and bone-specific parameters offer bone drilling a viable solution through conventional and non-conventional drilling techniques. The majority of the published research work considers only limited parameters and tries to optimize the drilling parameters and performance measures. However, bone drilling involves numerous conventional and non-conventional drilling parameters and technologies. In order to develop a better understanding of all the studied parameters and performance measures, there is a dire need to develop a framework. The key objective of this review study is to establish a hierarchy of the framework by collecting almost all the parameters studied until now and addressed the relationship between parameters and performance measures to diminish the controversies in the published literature. Therefore, this framework is novel in nature, organizing all the parameters, performance measures, logical comparisons, and limitations of studies. This holistic review can help medical surgeons and design engineers to understand the complicated relationship among parameters and performance measures associated with this state-of-art technologies. Also, modeling, simulations, and optimization techniques are included to explore the application of such techniques in recent advancements in orthopedic drilling.
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Affiliation(s)
- Muhammad Jamil
- Department of Mechanical Manufacture and Automation, College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Department of Industrial Engineering, University of Engineering and Technology Taxila, Taxila, Pakistan
| | - Saima Rafique
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
| | - Aqib Mashood Khan
- Department of Mechanical Manufacture and Automation, College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- Department of Industrial Engineering, University of Engineering and Technology Taxila, Taxila, Pakistan
| | - Hussien Hegab
- Department of Mechanical Design and Production Engineering, Cairo University, Giza, Egypt
| | - Mozammel Mia
- Department of Mechanical Engineering, Imperial College London, London, UK
| | - Munish Kumar Gupta
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture, Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan, China
| | - Qinghua Song
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture, Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan, China
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Scarano A, Lorusso F, Noumbissi S. Infrared Thermographic Evaluation of Temperature Modifications Induced during Implant Site Preparation with Steel vs. Zirconia Implant Drill. J Clin Med 2020; 9:jcm9010148. [PMID: 31948130 PMCID: PMC7019482 DOI: 10.3390/jcm9010148] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 12/21/2019] [Accepted: 12/31/2019] [Indexed: 12/12/2022] Open
Abstract
Background: The heat produced during implant site osteotomy can potentially interfere with and influence the osseointegration process of a dental implant. The objective of this in vitro investigation was to measure the temperature changes during simulated osteotomies in bovine rib bone. The measurements were made at the apical area of the osteotomies with steel implant drills compared to zirconia implant drills. Methods: Steel cylindrical drills (2 mm) and zirconia cylindrical drills (2 mm) were evaluated in vitro using bovine rib bone for a total of five groups based on the number of osteotomies performed with each drill: 10, 20, 40, 90, or 120 osteotomies. Bone and apical drill temperatures were measured by means of infrared thermography. The drilling time for each osteotomy was measured for each preparation. Results: Statistically significant differences were found in the temperature measurements in the bone and apical portion of the drills between the study groups (p < 0.05). A statistically significant difference was observed for drilling time preparation between steel cylindrical drill (2 mm) and zirconia cylindrical drills (2 mm) (p < 0.01). Conclusions: The drill material has an impact on the temperature changes that occur at its apical portion during bone preparation for implant placement.
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Affiliation(s)
- Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences and CeSI-Met, University of Chieti-Pescara, Via Dei Vestini, 31, 66100 Chieti, Italy
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA;
- Department of Oral Implantology, Dental Research Division, College Ingà, UNINGÁ, Cachoeiro de Itapemirim 29312, Brazil
- Correspondence: ; Tel.: +39-08713664099
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy;
| | - Sammy Noumbissi
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA;
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy;
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Zipprich H, Weigl P, König E, Toderas A, Balaban Ü, Ratka C. Heat Generation at the Implant-Bone Interface by Insertion of Ceramic and Titanium Implants. J Clin Med 2019; 8:jcm8101541. [PMID: 31557930 PMCID: PMC6832646 DOI: 10.3390/jcm8101541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The aim of this study is to record material- and surface-dependent heat dissipation during the process of inserting implants into native animal bone. MATERIALS AND METHODS Implants made of titanium and zirconium that were identical in macrodesign were inserted under controlled conditions into a bovine rib tempered to 37 °C. The resulting surface temperature was measured on two bone windows by an infrared camera. The results of the six experimental groups, ceramic machined (1), sandblasted (2), and sandblasted and acid-etched surfaces (3) versus titanium implants with the corresponding surfaces (4, 5, and 6) were statistically tested. RESULTS The average temperature increase, 3 mm subcrestally at ceramic implants, differed with high statistical significance (p = 7.163 × 10-9, resulting from group-adjusted linear mixed-effects model) from titanium. The surface texture of ceramic implants shows a statistical difference between group 3 (15.44 ± 3.63 °C) and group 1 (19.94 ± 3.28 °C) or group 2 (19.39 ± 5.73 °C) surfaces. Within the titanium implants, the temperature changes were similar for all surfaces. CONCLUSION Within the limits of an in vitro study, the high temperature rises at ceramic versus titanium implants should be limited by a very slow insertion velocity.
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Affiliation(s)
- Holger Zipprich
- Department of Prosthodontics, Faculty of Oral and Dental Medicine at Goethe University, 60590 Frankfurt am Main, Germany.
| | - Paul Weigl
- Department of Prosthodontics, Faculty of Oral and Dental Medicine at Goethe University, 60590 Frankfurt am Main, Germany.
| | - Eugenie König
- Private practice, 60385 Frankfurt am Main, Germany. koenig-@hotmail.de
| | | | - Ümniye Balaban
- Institute of Biostatistics and Mathematical Modelling at Goethe University, 60590 Frankfurt am Main, Germany.
| | - Christoph Ratka
- Department of Prosthodontics, Faculty of Oral and Dental Medicine at Goethe University, 60590 Frankfurt am Main, Germany.
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Stocchero M, Jinno Y, Toia M, Ahmad M, Papia E, Yamaguchi S, Becktor JP. Intraosseous Temperature Change during Installation of Dental Implants with Two Different Surfaces and Different Drilling Protocols: An In Vivo Study in Sheep. J Clin Med 2019; 8:jcm8081198. [PMID: 31405207 PMCID: PMC6723378 DOI: 10.3390/jcm8081198] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/03/2019] [Accepted: 08/06/2019] [Indexed: 12/30/2022] Open
Abstract
Background: The intraosseous temperature during implant installation has never been evaluated in an in vivo controlled setup. The aims were to investigate the influence of a drilling protocol and implant surface on the intraosseous temperature during implant installation, to evaluate the influence of temperature increase on osseointegration and to calculate the heat distribution in cortical bone. Methods: Forty Brånemark implants were installed into the metatarsal bone of Finnish Dorset crossbred sheep according to two different drilling protocols (undersized/non-undersized) and two surfaces (moderately rough/turned). The intraosseous temperature was recorded, and Finite Element Model (FEM) was generated to understand the thermal behavior. Non-decalcified histology was carried out after five weeks of healing. The following osseointegration parameters were calculated: Bone-to-implant contact (BIC), Bone Area Fraction Occupancy (BAFO), and Bone Area Fraction Occupancy up to 1.5 mm (BA1.5). A multiple regression model was used to identify the influencing variables on the histomorphometric parameters. Results: The temperature was affected by the drilling protocol, while no influence was demonstrated by the implant surface. BIC was positively influenced by the undersized drilling protocol and rough surface, BAFO was negatively influenced by the temperature rise, and BA1.5 was negatively influenced by the undersized drilling protocol. FEM showed that the temperature at the implant interface might exceed the limit for bone necrosis. Conclusion: The intraosseous temperature is greatly increased by an undersized drilling protocol but not from the implant surface. The temperature increase negatively affects the bone healing in the proximity of the implant. The undersized drilling protocol for Brånemark implant systems increases the amount of bone at the interface, but it negatively impacts the bone far from the implant.
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Affiliation(s)
- Michele Stocchero
- Department of Oral & Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 20506 Malmö, Sweden
| | - Yohei Jinno
- Department of Oral & Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 20506 Malmö, Sweden.
| | - Marco Toia
- Department of Oral & Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 20506 Malmö, Sweden
| | - Marianne Ahmad
- Department of Oral & Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 20506 Malmö, Sweden
| | - Evaggelia Papia
- Department of Materials Science and Technology, Faculty of Odontology, Malmö University, 20506 Malmö, Sweden
| | - Satoshi Yamaguchi
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan
| | - Jonas P Becktor
- Department of Oral & Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 20506 Malmö, Sweden
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Salles MB, Allegrini S, Yoshimoto M, Pérez-Díaz L, Calvo-Guirado JL, Gehrke SA. Analysis of Trauma Intensity during Surgical Bone Procedures Using NF-κB Expression Levels as a Stress Sensor: An Experimental Study in a Wistar Rat Model. MATERIALS 2018; 11:ma11122532. [PMID: 30545159 PMCID: PMC6316927 DOI: 10.3390/ma11122532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/29/2018] [Accepted: 12/03/2018] [Indexed: 01/19/2023]
Abstract
Aim and objectives: It is well known that the transcription factor NF-κB regulates multiple aspects of innate and adaptive immune functions and functions as a pivotal mediator of inflammatory responses. In the present study, we evaluated the trauma generated (inflammatory reaction) after osteotomy bone surgical procedures and placement of implants in the femoral cortical bone of Wistar rats. Surgical stress was evaluated measuring the release and activation of the NF-κB factor. Materials and Methods: Rats were divided into four groups (n = 10) and submitted to different surgical treatments: Control Group (G1 group), only bone perforation was performed without irrigation; Implant Group (G2 group), a titanium implant was inserted after bone perforation without irrigation; Irrigated Group (G3 group) perforations were performed with intense irrigation; and Vitaminic Compound Group (G4 group) surgical perforation was performed without irrigation and a vitaminic compound containing the principal ions present in the natural bone structure was used to fill the bone defect. All animals were euthanized six hours after the surgical procedure and NF-κB levels were determined through immunohistochemical stain followed by direct counting of labeled and unlabeled osteocytes. Results: Among different treated groups, the overall mean of the NF-κB positive cell count in all positions were higher for G1 group (33.4 ± 2.45 cells). NF-κB values were lower in the G2 group (28.9 ± 2.70 cells), whereas in the G3 group (24.3 ± 2.72 cells) as well as in G4 group still lesser NF-κB positive cells were counted (26.5 ± 2.60 cells). Conclusions: The results here presented suggest that maneuvers performed during osteotomy procedures can significantly affect inflammation levels. The NF-κB activation during the surgical procedures can be minimized and/or controlled thought the adequate irrigation or application of adequate substances.
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Affiliation(s)
- Marcos Barbosa Salles
- Department of Anatomy, Universidade de São Paulo, Cidade Universitária, São Paulo, SP 05508-900, Brazil.
| | - Sergio Allegrini
- Department of Anatomy, Universidade de São Paulo, Cidade Universitária, São Paulo, SP 05508-900, Brazil.
| | - Marcelo Yoshimoto
- Department of Anatomy, Universidade de São Paulo, Cidade Universitária, São Paulo, SP 05508-900, Brazil.
| | - Leticia Pérez-Díaz
- Laboratorio de Interacciones Moleculares, Facultad de Ciencias, Universidad de la Republica, Iguá 4225, Montevideo, Canelones 11400, Uruguay.
| | - José Luis Calvo-Guirado
- Department of Research in Oral Implantology, Universidad Católica San Antonio (UCAM), 30107 Murcia, Spain.
| | - Sergio Alexandre Gehrke
- Department of Biotechnology, Biotecnos-Technology and Science, Cuareim 1483, Montevideo, Canelones 11100, Uruguay.
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Effects of Osteotomy Lengths on the Temperature Rise of the Crestal Bone During Implant Site Preparation. IMPLANT DENT 2018; 27:213-220. [PMID: 29443816 DOI: 10.1097/id.0000000000000732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To compare temperatures of the crestal bone during implant site preparation for different osteotomy lengths and implant systems. METHODS Bovine ribs were used to simulate the cortical bone of the human mandible. Three different implant systems were tested: Astra Tech, Ankylos, and XiVE. Six drills per system were performed, meaning each drilling set was used for 2 drills per 3 osteotomy lengths (8, 12, and 16 mm). Drilling force, drilling speed, drilling length, and temperature were recorded. RESULTS Differences in the maximum temperature of the crestal bone during the first drilling for various osteotomy lengths (P = 0.021) and all implant systems (P = 0.013) were observed. A similar result was showed during the second drilling; osteotomy lengths (P = 0.014) and drilling systems (P = 0.003). Second drillings showed lower temperatures of the crestal bone with statistical differences on all measurements (P < 0.001). Astra Tech and Ankylos implant systems showed similar performance; XiVE had lower temperature and higher temperature differences between osteotomy lengths. CONCLUSIONS Different drilling lengths contributed to the variation in temperature regardless of the implant system. Longer drills and osteotomies induced higher temperatures on the crestal bone. The maximum temperature difference between the shortest and the longest osteotomy was under 1°C. Temperature above 47°C that could cause bone necrosis was not recorded at any time. The XiVE system showed the best performance.
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Pellicer-Chover H, Peñarrocha-Oltra D, Aloy-Prosper A, Sanchis-Gonzalez JC, Peñarrocha-Diago MA, Peñarrocha-Diago M. Comparison of peri-implant bone loss between conventional drilling with irrigation versus low-speed drilling without irrigation. Med Oral Patol Oral Cir Bucal 2017; 22:e730-e736. [PMID: 29053645 PMCID: PMC5813992 DOI: 10.4317/medoral.21694] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 05/25/2017] [Indexed: 11/22/2022] Open
Abstract
Background To compare the technique of high speed drilling with irrigation and low speed drilling without irrigation in order to evaluate the success rate and peri-implant bone loss at 12 months of follow-up. Material and Methods A randomized, controlled, parallel-group clinical trial was carried out in patients requiring dental implants to rehabilitate their unitary edentulism. Patients were recruited from the Oral Surgery Unit of the University of Valencia (Spain) between September 2014 and August 2015. Patients who met the inclusion criteria were randomized to two groups: group A (high-speed drilling with irrigation) and group B (low-speed drilling without irrigation). The success rate and peri-implant bone loss were recorded at 12 months of follow-up. Results Twenty-five patients (9 men and 16 women) with 30 implants were enrolled in the study: 15 implants in group A and 15 implants in group B. The mean bone loss of the implants in group A and group B was 0.83 ± 0.73 mm and 0.62 ± 0.70 mm, respectively (p > 0.05). In the maxilla, the bone loss was 1.04 ± 0.63 mm in group A and 0.71 ± 0.36 mm in group B (p > 0.05), while bone loss in the mandible was 0.59 ± 0.80 mm in group A and 0.69 ± 0.77 mm in group B (p > 0.05). The implant success rate at 12 months was 93.3% in group A and 100% in group B. Conclusions Within the limitations of the study, the low-speed drilling technique presented peri-implant bone loss outcomes similar to those of the conventional drilling technique at 12 months of follow-up. Key words:Low-speed without irrigation, drilling technique.
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Affiliation(s)
- H Pellicer-Chover
- Clínica Odontológica, Unidad de Cirugía Bucal, Gascó Oliag 1, 46021 - Valencia, Spain,
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12
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Wang L, Wu Y, Perez KC, Hyman S, Brunski JB, Tulu U, Bao C, Salmon B, Helms JA. Effects of Condensation on Peri-implant Bone Density and Remodeling. J Dent Res 2017; 96:413-420. [PMID: 28048963 DOI: 10.1177/0022034516683932] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Bone condensation is thought to densify interfacial bone and thus improve implant primary stability, but scant data substantiate either claim. We developed a murine oral implant model to test these hypotheses. Osteotomies were created in healed maxillary extraction sites 1) by drilling or 2) by drilling followed by stepwise condensation with tapered osteotomes. Condensation increased interfacial bone density, as measured by a significant change in bone volume/total volume and trabecular spacing, but it simultaneously damaged the bone. On postimplant day 1, the condensed bone interface exhibited microfractures and osteoclast activity. Finite element modeling, mechanical testing, and immunohistochemical analyses at multiple time points throughout the osseointegration period demonstrated that condensation caused very high interfacial strains, marginal bone resorption, and no improvement in implant stability. Collectively, these multiscale analyses demonstrate that condensation does not positively contribute to implant stability.
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Affiliation(s)
- L Wang
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Y Wu
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.,3 Orthodontic Department, Stomatology Hospital of Chongqing Medical University; Chongqing Key Laboratory of Oral Disease and Biomedical Sciences; Chongqing Municipal Key Laboratory, Chongqing, China
| | - K C Perez
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - S Hyman
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - J B Brunski
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - U Tulu
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - C Bao
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - B Salmon
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.,4 EA 2496, Orofacial Pathologies, Imaging and Biotherapies Laboratory, Paris Descartes University-Sorbonne Paris Cité, Montrouge, France; and AP-HP Odontology Department Bretonneau, Hopitaux Universitaires Paris Nord Val de Seine, Paris, France
| | - J A Helms
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Effect of temperature on the dental implant osseointegration development in low-density bone: an in vivo histological evaluation. IMPLANT DENT 2016; 24:96-100. [PMID: 25621555 DOI: 10.1097/id.0000000000000204] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To make an in vivo evaluation of the effects of 2 different bone temperatures, on the development of implant osseointegration, in low-density bone. MATERIALS AND METHODS Fifteen implant osteotomic sites were prepared in the iliac crests of sheep. Before the implant insertion, 5 sites were heated to 50°C for 1 minute, 5 sites to 60°C for 1 minute, and 5 sites were not overheated. Fifteen titanium dental implants (Cortex, Israel) were inserted. After a healing period of 2 months, the histomorphometric parameters calculated for each implant were the Bone-Implant Contact percentage (%BIC) and the infrabony pocket depth. Unpaired t test was applied to find statistical differences between groups. RESULTS No implants failed. Statistical significant differences in %BIC and periimplant bone loss were found between the 60°C group and control group. No significant differences were found between the 50°C group and control group, although bone suffering signs were present. CONCLUSION An osteotomic site overheating up to 60°C for 1 minute in low-density bone, before implant insertion, did not lead to implant failure, but it induced significant crestal bone loss during healing and lower %BIC.
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Thermal evaluation by infrared measurement of implant site preparation between single and gradual drilling in artificial bone blocks of different densities. Int J Oral Maxillofac Surg 2016; 45:1478-1484. [DOI: 10.1016/j.ijom.2016.05.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 05/07/2016] [Accepted: 05/26/2016] [Indexed: 11/21/2022]
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Abstract
PURPOSE The aim of this study was to understand whether the pitch relationship between micro and macro thread designs with a parametrical relationship in a dual-thread mini-implant can improve primary stability. MATERIALS AND METHODS Three types of mini-implants consisting of single-thread (ST) (0.75 mm pitch in whole length), dual-thread A (DTA) with double-start 0.375 mm pitch, and dual-thread B (DTB) with single-start 0.2 mm pitch in upper 2-mm micro thread region for performing insertion and pull-out testing. Histomorphometric analysis was performed in these specimens in evaluating peri-implant bone defects using a non-contact vision measuring system. RESULTS The maximum inserted torque (Tmax) in type DTA was found to be the smallest significantly, but corresponding values found no significant difference between ST and DTB. The largest pull-out strength (Fmax) in the DTA mini-implant was found significantly greater than that for the ST mini-implant regardless of implant insertion orientation. Mini-implant engaged the cortical bone well as observed in ST and DTA types. CONCLUSION Dual-thread mini-implant with correct micro thread pitch (parametrical relationship with macro thread pitch) in the cortical bone region can improve primary stability and enhanced mechanical retention.
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Dal Molin Molinari AR, Thomé CA, Moura LM, Kim SH. Thermal change in a resin block during motorized and manual implant placement. J Prosthet Dent 2016; 116:885-889. [PMID: 27422233 DOI: 10.1016/j.prosdent.2016.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM Several studies have demonstrated the harmful role of heat generation during implant site drilling in subsequent bone healing. However, heat generation during implant placement should also be carefully considered. PURPOSE The purpose of this in vitro study was to evaluate thermal change in a resin block during motorized and manual implant placement with and without saline irrigation. MATERIAL AND METHODS Thermocouple probes were placed in resin blocks to measure the thermal change during forty 3.75x15-mm self-tapping cylindrical screw implant placements as follows: MtI group, 10 motorized implant placements with external saline irrigation; MtNI group, 10 motorized implant placements without irrigation; MI group, 10 manual implant placements with external saline irrigation; MNI group, 10 manual implant placements without irrigation. The temperature values were recorded with a data acquisition system with a 20-channel multiplexer module connected to a personal computer. The normality of data distribution was assessed with the Shapiro-Wilk test and the homogeneity of variances with the Levene test. The mean temperatures of the groups was assessed with the 3-way ANOVA test followed by the Tukey HSD test for normal distribution and the Games-Howell test for non-normal distribution (α=.05). RESULTS The rate of temperature rise in the resin blocks was 1.1°C to 7.3°C. The highest mean temperature was present in the group for manual implant placement without irrigation (26.2 ±1.1°C), and the lowest thermal change was in the motorized implant placement group with external saline irrigation (23.6 ±1.0°C). CONCLUSIONS The thermal change in resin blocks during motorized implant placement was lower than manual implant placement, especially with external saline irrigation.
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Affiliation(s)
- Alexandre Ricardo Dal Molin Molinari
- Graduate student, Graduate Program in Periodontics, Pontifical Catholic University of Parana, School of Health and Biosciences, Curitiba, Brazil
| | - Cesar Augusto Thomé
- Graduate student, Graduate Program in Periodontics, Pontifical Catholic University of Parana, School of Health and Biosciences, Curitiba, Brazil
| | - Luis Mauro Moura
- Professor, Graduate Program in Mechanical Engineering, Pontifical Catholic University of Parana, Polytechnic School, Curitiba, Brazil
| | - Sung Hyun Kim
- Professor, Graduate Program in Periodontics, Pontifical Catholic University of Parana, School of Health and Biosciences, Curitiba, Brazil.
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Tsolaki IN, Tonsekar PP, Najafi B, Drew HJ, Sullivan AJ, Petrov SD. Comparison of Osteotome and Conventional Drilling Techniques for Primary Implant Stability: An In Vitro Study. J ORAL IMPLANTOL 2016; 42:321-5. [PMID: 26938712 DOI: 10.1563/aaid-joi-d-15-00176] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It may be difficult to achieve primary stability in the posterior maxilla because of poor quality and quantity of bone. Studies have shown that the osteotome technique immediately increases bone density thereby increasing primary stability. An in vitro study was conducted to compare the stability achieved by the osteotome and conventional drilling techniques in low density bone. Forty endosseous implant fixtures (n = 40) were inserted in a solid rigid polyurethane block simulating low density (D3) bone. The implants were divided into 4 groups to test 2 variables: (1) implant length (10 mm or 13 mm) and (2) preparation of osteotomy (conventional drilling or osteotome technique). Insertion torque (IT) and resonance frequency analysis (RFA) were measured for each implant. Statistical analysis using one-way ANOVA and Tukey post hoc test was done to study IT and RFA data of the 4 groups. Pearson Correlation test was used to determine the correlation between IT and RFA values of the implants. The IT and RFA values were statistically significant higher using the osteotome technique as compared to conventional drilling (P < 0.0001). Statistically significant higher values were also found for IT and RFA of 13 mm implants as compared to 10 mm implants. A significant correlation was found between insertion torque and RFA values in all 4 groups (r = 0.86, P < 0.0001). The conclusion was that the osteotome technique significantly increased primary stability.
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Affiliation(s)
- Ioanna N Tsolaki
- 1 Periodontics Department at Rutgers School of Dental Medicine, Newark, New Jersey
| | - Pallavi P Tonsekar
- 1 Periodontics Department at Rutgers School of Dental Medicine, Newark, New Jersey
| | - Babak Najafi
- 1 Periodontics Department at Rutgers School of Dental Medicine, Newark, New Jersey
| | - Howard J Drew
- 1 Periodontics Department at Rutgers School of Dental Medicine, Newark, New Jersey
| | - Andrew J Sullivan
- 1 Periodontics Department at Rutgers School of Dental Medicine, Newark, New Jersey
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A Revolving Temporary Anchorage Cap Connecting to an Orthodontic Miniscrew Using In Vitro Experimental Testing: Safety and Biomechanical Evaluations. IMPLANT DENT 2015. [PMID: 26204168 DOI: 10.1097/id.0000000000000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study is to develop a plastic revolving (translation and rotation) temporary anchorage cap (TAC) as the orthodontic anchor and evaluate its biomechanical safety and clinical used feasibility. MATERIALS AND METHODS The TAC was designed to connect onto a mini-implant head with 45-degree switching unit and extended arm for tying an orthodontic elastic chain/coil spring. The removal force between the TAC and mini-implant head and torque resistance on the mini-implant/bone interface were performed to evaluate the biomechanical safety. Clinical molar uprighting and mesial drive application were performed to reveal the TAC feasibility/capacity. RESULTS The removal force was 43.95 N (>>finger-pulling force 9.3 N) to prevent the TAC from detaching, and the torque resistance was 159.25 N·mm to maintain micromotion smaller than 30.4 μm between the screw and bone. The strain value in using TAC treatment was found to be about 2 times that of traditional tracing (without using TAC) in molar uprighting/mesial drive application. CONCLUSIONS The plastic revolving TAC can provide optional use with translation/rotation features to change the angles and directions in orthodontic tractions and increase treatment efficiency under biomechanical safety considerations.
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Möhlhenrich SC, Modabber A, Steiner T, Mitchell DA, Hölzle F. Heat generation and drill wear during dental implant site preparation: systematic review. Br J Oral Maxillofac Surg 2015; 53:679-89. [PMID: 26051868 DOI: 10.1016/j.bjoms.2015.05.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
To identify factors that minimise damage during the drilling of sites for dental implants, we reviewed published papers on the amount of heat that is generated. We systematically searched English language studies published between January 2000 and February 2014 on MEDLINE/PubMed and found 41 articles, of which 27 related to an increase in temperature during preparation of the site. We found only basic research with a low level of evidence. Most of the studies were in vitro, and osteotomies were usually made in non-vital bone from cows or pigs. To measure heat in real time, thermocouples were used in 18 studies and infrared thermographs in 7. Three studies reported the use of immunohistochemical analysis to investigate immediate viability of cells. The highest temperature measured was 64.4°C and the lowest 28.4°C. Drill wear was reported after preparation of 50 sites, and there was a significant increase in temperature and a small change in the physiological balance of the proteins in the bone cells. Differences in the study designs meant that meta-analysis was not appropriate. For future work, we recommend the use of standard variables: an axial load of 2kg, drilling speed of 1500rpm, irrigation, standard artificial bone blocks, and the use of infrared thermography.
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Affiliation(s)
- S C Möhlhenrich
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - A Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - T Steiner
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - D A Mitchell
- Department of Oral and Maxillofacial Surgery, Oral and Facial Specialties Mid-Yorkshire Hospitals, Pinderfields Hospital, Aberford Road, Wakefield, West Yorks WF1 4DG, England, UK
| | - F Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
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Bullon B, Bueno EF, Herrero M, Fernandez-Palacin A, Rios JV, Bullon P, Gil FJ. Effect of irrigation and stainless steel drills on dental implant bed heat generation. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:75. [PMID: 25631272 DOI: 10.1007/s10856-015-5412-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 11/01/2014] [Indexed: 06/04/2023]
Abstract
The objective of this study is assessing the influence of the use of different drill types and external irrigation on heat generation in the bone. In-vitro study to compare two different sequences for implant-bed preparation by means of two stainless steels: precipitation-hardening stainless steel (AISI 420B) (K drills), and martensitic stainless steel (AISI 440) (S drills). Besides, the drilled sequences were realized without irrigation, and with external irrigation by means of normal saline solution at room temperature. The study was realized on bovine ribs using: K without irrigation (KSI) and with irrigation (KCI) and S without irrigation (SSI) and with irrigation (SCI) with five drills for each system. Each drill was used 100 times. Bone temperature was measured with a thermocouple immediately after drilled. Average bone temperature with irrigation was for K drills 17.58±3.32 °C and for S drills 16.66±1.30 °C. Average bone temperature without irrigation was for K drills 23.58±2.94 °C and for S drills 19.41±2.27 °C. Statistically significant differences were found between K without irrigation versus S with irrigation and K with irrigation (p<0.05, Bonferroni correction). Lower temperature variation coefficient throughout the 50 measurements was observed in irrigated groups (K=5.6%, S=5.1% vs. without irrigation groups K=9.4%, S=9.3%). The first K drill generated more heat than the remaining drills. No significant differences were detected among temperature values in any of the analyzed drill groups. Unlike irrigation, drill use and type were observed to have no significant impact on heat generation. The stainless steel AISI 420B presents better mechanical properties and corrosion resistance than AISI440.
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Affiliation(s)
- B Bullon
- Master de Implantología, Facultad de Odontología de Sevilla, Seville, Spain
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Youk SY, Lee JH, Park JM, Heo SJ, Roh HK, Park EJ, Shin IH. A survey of the satisfaction of patients who have undergone implant surgery with and without employing a computer-guided implant surgical template. J Adv Prosthodont 2014; 6:395-405. [PMID: 25352962 PMCID: PMC4211056 DOI: 10.4047/jap.2014.6.5.395] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 07/21/2014] [Accepted: 07/28/2014] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aims to investigate the degree of subjective pain and the satisfaction of patients who have undergone an implant treatment using a computer-guided template. MATERIALS AND METHODS A survey was conducted for 135 patients who have undergone implant surgery with and without the use of the computer-guided template during the period of 2012 and 2013 in university hospitals, dental hospitals and dental clinics that practiced implant surgery using the computer-guided template. Likert scale and VAS score were used in the survey questions, and the independent t-test and One-Way ANOVA were performed (α=.05). RESULTS The route that the subjects were introduced to the computer-guided implant surgery using a surgical template was mostly advices by dentists, and the most common reason for which they chose to undergo such surgery was that it was accurate and safe. Most of them gave an answer that they were willing to recommend it to others. The patients who have undergone the computer-guided implant surgery felt less pain during the operation and showed higher satisfaction than those who have undergone conventional implant surgery. Among the patients who have undergone computer-guided implant surgery, those who also had prior experience of surgery without a computer-guided template expressed higher satisfaction with the former (P<.05). CONCLUSION In this study, it could be seen that the patients who have undergone computer-guided implant surgery employing a surgical template felt less pain and had higher satisfaction than those with the conventional one, and the dentist's description could provide the confidence about the safety of surgery.
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Affiliation(s)
- Shin-Young Youk
- Department of Prosthodontics, Ewha Womans University, Seoul, Republic of Korea
| | - Jee-Ho Lee
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Ji-Man Park
- Department of Prosthodontics, Ewha Womans University, Seoul, Republic of Korea
| | - Seong-Joo Heo
- Department of Prosthodontics & Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyun-Ki Roh
- Department of Prosthodontics, S-PLANT Dental Hospital, Seoul, Republic of Korea
| | - Eun-Jin Park
- Department of Prosthodontics, Ewha Womans University, Seoul, Republic of Korea
| | - Im Hee Shin
- Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
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Abboud M, Delgado-Ruiz RA, Kucine A, Rugova S, Balanta J, Calvo-Guirado JL. Multistepped Drill Design for Single-Stage Implant Site Preparation: Experimental Study in Type 2 Bone. Clin Implant Dent Relat Res 2014; 17 Suppl 2:e472-85. [PMID: 25263993 DOI: 10.1111/cid.12273] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate an experimental multistepped drill for single-stage implant site preparation by means of real-time analysis of thermal variations during and postdrilling, and by implant stability evaluation. MATERIALS AND METHODS Temperature and time were recorded in real time by paired microprobe thermocouples during simulated osteotomy in type 2 bone similes at the cortical and cancellous zones. Three different drilling groups with a new multistepped drill design were compared: Control (2-mm diameter pilot drill + 3.3-mm three-stepped drill + 4.1-mm three-stepped drill); Test A (3.3-mm three-stepped drill); and Test B (4.1-mm three-stepped drill). Implants were inserted, and implant stability was evaluated with the Perio Test Value (PTV). Two-way anova was used to test the independent effects of osteotomy and implant diameter on temperature and stability. RESULTS All the drills induced thermal changes without significant differences between groups (p > .05). Drilling in cortical bone produced significant increase of the temperatures in a range of 1.8 ± 0.9°C compared with drilling in cancellous bone (p < .05). ΔT temperatures were significantly higher for test groups in cortical and cancellous bone (p < .05); ΔT10 for all groups showed a reduction of the temperature in a range of 1.7 ± 0.3°C without significant differences between groups (p > .05); the mean time to accomplish drilling was significantly longer in the control group (p < .05); test groups took 10 ± 0.3 seconds less to reach the required drilling depth. PTV values were higher in test groups compared with controls (p < .05). CONCLUSIONS The multistepped drills used for single-stage implant site preparation Increase temperature as in comparison with a conventional incremental protocol; Induce the temperature increment in cortical bone compared with the cancellous bone; Reduce drilling time when a multistepped drill is used alone; and Increase implant stability twofold compared with a conventional incremental protocol.
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Affiliation(s)
- Marcus Abboud
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Allan Kucine
- Department of Oral Surgery, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Sihana Rugova
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Julian Balanta
- Department of Prosthodontics, Faculty of Dentistry, Universidad del Valle, Cali, Colombia
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Sumer M, Keskiner I, Mercan U, Misir F, Cankaya S. Assessment of heat generation during implant insertion. J Prosthet Dent 2014; 112:522-5. [DOI: 10.1016/j.prosdent.2013.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 11/26/2013] [Accepted: 12/10/2013] [Indexed: 10/25/2022]
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Katić V, Kamenar E, Blažević D, Spalj S. Geometrical design characteristics of orthodontic mini-implants predicting maximum insertion torque. Korean J Orthod 2014; 44:177-83. [PMID: 25133132 PMCID: PMC4130913 DOI: 10.4041/kjod.2014.44.4.177] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 10/14/2013] [Accepted: 11/15/2013] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To determine the unique contribution of geometrical design characteristics of orthodontic mini-implants on maximum insertion torque while controlling for the influence of cortical bone thickness. METHODS Total number of 100 cylindrical orthodontic mini-implants was used. Geometrical design characteristics of ten specimens of ten types of cylindrical self-drilling orthodontic mini-implants (Ortho Easy®, Aarhus, and Dual Top™) with diameters ranging from 1.4 to 2.0 mm and lengths of 6 and 8 mm were measured. Maximum insertion torque was recorded during manual insertion of mini-implants into bone samples. Cortical bone thickness was measured. Retrieved data were analyzed in a multiple regression model. RESULTS Significant predictors for higher maximum insertion torque included larger outer diameter of implant, higher lead angle of thread, and thicker cortical bone, and their unique contribution to maximum insertion torque was 12.3%, 10.7%, and 24.7%, respectively. CONCLUSIONS The maximum insertion torque values are best controlled by choosing an implant diameter and lead angle according to the assessed thickness of cortical bone.
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Affiliation(s)
- Višnja Katić
- Department of Pediatric Dentistry and Orthodontics, School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Ervin Kamenar
- Department of Mechanical Engineering Design, Faculty of Engineering, University of Rijeka, Rijeka, Croatia
| | - David Blažević
- Department of Mechanical Engineering Design, Faculty of Engineering, University of Rijeka, Rijeka, Croatia
| | - Stjepan Spalj
- Department of Pediatric Dentistry and Orthodontics, School of Medicine, University of Rijeka, Rijeka, Croatia
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Calvo-Guirado JL, Delgado-Peña J, Maté-Sánchez JE, Mareque Bueno J, Delgado-Ruiz RA, Romanos GE. Novel hybrid drilling protocol: evaluation for the implant healing--thermal changes, crestal bone loss, and bone-to-implant contact. Clin Oral Implants Res 2014; 26:753-60. [PMID: 24502654 DOI: 10.1111/clr.12341] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate a new hybrid drilling protocol, by the analysis of thermal changes in vitro, and their effects in the crestal bone loss and bone-to-implant contact in vivo. MATERIALS AND METHODS Temperature changes during simulated osteotomies with a hybrid drilling technique (biologic plus simplified) (test) versus an incremental drilling technique (control) were investigated. One hundred and twenty random osteotomies were performed (60 by group) in pig ribs up to 3.75-mm-diameter drill to a depth of 10 mm. Thermal changes and time were recorded by paired thermocouples. In a parallel experiment, bilateral mandibular premolars P2, P3, P4, and first molar M1 were extracted from six dogs. After 2-month healing, implant sites were randomly prepared using either of the drilling techniques. Forty eight implants of 3.75 mm diameter and 10 mm length were inserted. The dogs were euthanized at 30 and 90 days, and crestal bone loss (CBL) and bone-to-implant contact (BIC) were evaluated. RESULTS The control group showed maximum temperatures of 35.3 °C ± 1.8 °C, ΔT of 10.4 °C, and a mean time of 100 s/procedure; meanwhile, the test group showed maximum temperatures of 36.7 °C ± 1.2 °C, ΔT of 8.1 °C, and a mean time of 240 s/procedure. After 30 days, CBL values for both groups (test: 1.168 ± 0.194 mm; control: 1.181 ± 0.113 mm) and BIC values (test: 43 ± 2.8%; control: 45 ± 1.3%) were similar, without significant differences (P > 0.05). After 90 days, CBL (test: 1.173 ± 0.187 mm; control: 1.205 ± 0.122 mm) and BIC (test: 64 ± 3.3%; control: 64 ± 2.4%) values were similar, without significant differences (P > 0.05). The BIC values were increased at 90 days in both groups compared with the 30-day period (P < 0.05). CONCLUSIONS Within the limitations of this study, the new hybrid protocol for the preparation of the implant bed without irrigation, increase the temperature similarly to the incremental conventional protocol, and requires twice the time for the completion of the drilling procedure in vitro. Crestal bone loss and bone-to-implant contact in the hybrid drilling protocol are comparable with the conventional drilling protocol and do not affect the osseointegration process in vivo.
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Abstract
Frictional heat can be generated during seating of dental implants into a drill-prepared osteotomy. This in vitro study tested the heat generated by implant seating in dense bovine mandible ramus. A thermocouple was placed approximately 0.5 mm from the rim of the osteotomy during seating of each dental implant. Four diameters of implants were tested. The average temperature increases were 0.075°C for the 5.7-mm-diameter implant, 0.97°C for the 4.7-mm-diameter implant, 1.4°C for the 3.7-mm-diameter implant, and 8.6°C for the 2.5-mm-diameter implant. The results showed that heat was indeed generated and a small temperature rise occurred, apparently by the friction of the implant surface against the fresh-cut bone surface. Bone is a poor thermal conductor. The titanium of the implant and the steel of the handpiece are much better heat conductors. Titanium may be 70 times more heat conductive than bone. The larger diameter and displacement implant may act as a heat sink to draw away any heat produced from the friction of seating the implant at the bone-implant interface. The peak temperature duration was momentary, and not measured, but this was approximately less than 1 second. Except for the 2.5-mm-diameter implants, the temperature rises and durations were found to be below those previously deemed to be detrimental, so no clinically significant osseous damage would be expected during dental implant fixture seating of standard and large-diameter-sized implants. A 2.5-mm implant may generate detrimental heat during seating in nonvital bone, but this may be clinically insignificant in vital bone. The surface area and thermal conductivity are important factors in removing generated heat transfer at the bone-implant interface. The F value as determined by analysis of variance was 69.22, and the P value was less than .0001, demonstrating significant differences between the groups considered as a whole.
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