Heat generated during preparation of titanium implants of the ITI® Dental Implant System: an in vitro study

Abstract

The aim of the present study was to assess in vitro the heat generated within the implant body when preparing titanium implants of the ITI Dental Implant System to estimate the potential risk of tissue damage of individual abutment preparation. The speed and the pressure were applied according to routine clinical procedures used in the patient's mouth. Much attention was paid to ensure optimal cooling at the point where the implant and secondary part were being cut. For each of 3 preparations the change from the original temperature was measured over a period of 40 s. Each type of preparation was repeated on 5 implants fitted with temperature probes. Three different preparatory procedures performed with rotating diamond burs and stainless steel finishing burs under cooling with spray from the dental unit may result in a maximal increase in temperature of 10 degrees, 7 degrees and 3 degrees measured coronally, both at the implant shoulder and at the coronal extent of the plasma-sprayed surface after 10 s. The use of additional spray and pressured air significantly reduced this maximal increase to 5 degrees C, 5 degrees C and 4 degrees C, respectively at 10 s. At the 30-s and 40-s time points, all the measured temperatures were significantly lower. Preparation of implants or abutments does not lead to detrimental effects on peri-implant tissues provided that adequate cooling with spray is used. However, without cooling, extreme overheating could be provoked, reaching the critical temperature that would lead to irreversible bone damage within only a few seconds.

Thermal changes observed at implant sites during internal and external irrigation

“…Temperature increases have previously been measured by a variety of methods for both the implant structures (Bragger et al. 1995) and within the bone substrate itself (Matthews & Hirsch 1972).…”

“…Temperature increases have previously been measured by a variety of methods for both the implant structures (Bragger et al 1995) and within the bone substrate itself (Matthews & Hirsch 1972). Studies have also been performed, where animal cortical bone has been drilled for different implant systems in vitro (Jo et al 1993;Benington et al 1996).…”

Implant Survival after Preparation of the Implant Site Using a Single Bur: A Case Series

“…Excessive heating of the surgical site during drilling has been advocated to be detrimental for tissue healing, causing excessive bone loss. [1][2][3][4][5] The temperature increase is also related to bone density that is to the hardness of the bone tissue and its resistance to drilling. The latter depends on the local bone composition, namely the ratio between cortical and cancellous bone.…”

“…Hence implant site preparation becomes critical for achieving a predictable osseointegration and for obtaining a pleasing natural implant restoration. Among the factors correlated to implant site preparation, the rising of the temperature during drilling has long been identified as critical to preservation of the surrounding tissue . A temperature of 47°C for 1 minute in fact has been reported to cause bone necrosis at the drilling site .…”

“…Among the factors correlated to implant site preparation, the rising of the temperature during drilling has long been identified as critical to preservation of the surrounding tissue. [1][2][3][4] A temperature of 47°C for 1 minute in fact has been reported to cause bone necrosis at the drilling site. 3 The latter may hinder osseointegration process and is one of the most credited reasons for excessive early periimplant bone loss, which may compromise implant stability as well as facilitate bacterial infiltration and peri-implantitis.…”