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Clin Oral Implants Res. 2014 Jun;25(6):665-74. doi: 10.1111/clr.12032. Epub 2012 Sep 26.

Thermal effects of a combined irrigation method during implant site drilling. A standardized in vitro study using a bovine rib model.

Author information

1
Department of Oral Surgery, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.

Abstract

OBJECTIVES:

The purpose of this study was to evaluate the temperature changes during implant osteotomies with a combined irrigation system as compared to the commonly used external and internal irrigation under standardized conditions.

MATERIAL AND METHODS:

Drilling procedures were performed on VII bovine ribs using a computer-aided surgical system that ensured automated intermittent drilling cycles to simulate clinical conditions. A total of 320 drilling osteotomies were performed with twist (2 mm) and conical implant drills (3.5/4.3/5 mm) at various drilling depths (10/16 mm) and with different saline irrigation (50 ml/min) methods (without/external/internal/combined). Temperature changes were recorded in real time by two custom-built thermoprobes with 14 temperature sensors (7 sensors/thermoprobe) at defined measuring depths.

RESULTS:

The highest temperature increase during osteotomies was observed without any coolant irrigation (median, 8.01°C), followed by commonly used external saline irrigation (median, 2.60°C), combined irrigation (median, 1.51°C) and ultimately with internal saline irrigation (median, 1.48°C). Temperature increase with different drill diameters showed significant differences (P < 0.05) regarding drill depth, confirming drill depth and time of drilling as influencing factors of heat generation. Internal saline irrigation showed a significantly smaller temperature increase (P < 0.05) compared with combined and external irrigation. A combined irrigation procedure appears to be preferable (P < 0.05) to an external irrigation method primarily with higher osteotomy depths.

CONCLUSIONS:

Combined irrigation provides sufficient reduction in temperature changes during drilling, and it may be more beneficial in deeper site osteotomies. Further studies to optimize the effects of a combined irrigation are needed.

KEYWORDS:

bone drilling; combined irrigation; dental implants; heat generation; implant drills; implant preparation; multiple temperature sensors; thermal osteonecrosis

PMID:
23009204
DOI:
10.1111/clr.12032
[Indexed for MEDLINE]

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