In Vitro Study on Bone Heating during Drilling of the Implant Site: Material, Design and Wear of the Surgical Drill

Abstract

Objective: An in vitro study was made to compare mean thermal variation according to the material, design and wear of the surgical drills used during dental implant site preparation. Material and methods: Three study groups (stainless steel drills with straight blades; diamond-like carbon-coated drills with straight blades; and diamond-like carbon-coated drills with twisted blades) were tested to compare material, design and wear of the surgical drill in terms of overall mean values (complete sequence of drills) and specific mean values (each drill separately). The groups comprised four drills: initial, pilot, progressive and final drill. Implant site configuration was performed through an intermittent and gradual drilling technique without irrigation at 800 rpm in standardized synthetic blocks. Maximum axial loading of two kilograms was controlled by an automatic press. Each surgical drill was submitted to 50 drillings and was sterilized every five uses. A thermographic camera analyzed the mean thermal changes. The software-controlled automatic press kept systematic drilling, axial loading and operational speed constant without any human intervention. Student’s t-test, ANOVA and multiple linear regression models were performed. The level of significance was 5% (p = 0.05). Results: The overall mean comparison between the stainless steel and diamond-like carbon-coated materials showed no statistically significant differences (p > 0.05), though specific mean comparison showed statistically significant differences between the drills of the different groups (p < 0.05). The twisted blades exhibited less overall and specific mean thermal variation than straight blades for the progressive and final drills (p < 0.01). In addition, the initial and pilot drills showed a greater mean thermal change than the progressive and final drills. The mean thermal variation was seen to increase during the 50 drillings. Conclusions: Within the limitations of this study, it can be concluded that the drill material did not significantly influence the overall mean thermal variation except for the pilot drill. The drill design affected overall and specific mean thermal variation since the twisted blades heated less than the straight blades. The initial and pilot drills increased the specific mean thermal variation with respect to the progressive and final drills. In addition, all drills in each group produced a gradual increase in mean temperature during the 50 drillings.

Evaluation of Change in Radiographic Fractal Dimension around Dental Implants Placed with Low-Speed Drilling and Standard Drilling Protocols

“…On the other hand, various authors focus on the techniques used for implant placement, highlighting that they condition the results obtained when evaluating the success rate and the osseointegration processes [ 25 , 26 , 27 ]. Different factors can influence: Temperature during drilling.…”

Peri-Implant Bone Damage Procured by Piezoelectric and Conventional Implant Site Preparation: An In Vitro Comparison

“…In recent decades, many authors have sought to identify factors that minimize damage during implant site preparation [1][2][3][4][5][6][7][8][9][10]. An appropriate procedure should procure a thin layer of necrotic bone subsequently replaced by vital bone tissue [25][26][27][28].…”

“…All of the surgical factors that increase the thickness of the bone necrotic layer can negatively compromise implant osseointegration. Extension of the necrotic zone around the preparation site is considered proportional to the amount of heat generated during osteotomy, which can be related to different factors: (i) the operator (pressure, status, movement, speed, and duration of drilling); (ii) the manufacturer (design and sharpness of the drill and the irrigation system); (iii) the implant site (cortical thickness, bone density, and depth drilled); (iv) the patient's age; (v) the surgical method (drilling, ultrasonic, and condensation [1][2][3][7][8][9]). The bone damage is related to the magnitude of the temperature elevation and the time the tissue is subjected to a damaging temperature, identified as 47 • C for 1 min [15][16][17][18][19][20][21][22].…”

“…Research has improved many aspects of dental implant therapy: surgical planning, implant placement, fixture surface and macro-morphology, and prosthetic rehabilitation [1][2][3][4][5][6][7]. The surgical drill technique is the most common implant site preparation method.…”

Development of a New Drill Design to Improve the Temperature Control during the Osteotomy for Dental Implants: A Comparative In Vitro Analysis

“…The osteotomy protocols, regardless of the system used, determine that it should be performed with a low-temperature variation, never exceeding 47 °C, as it could denature bone tissue proteins and generate necrosis in that area [ 1 ]. Several studies have been developed with different irrigation systems and with different drill designs to improve and decrease trauma during the osteotomy procedure for installing implants and, consequently, reducing inflammatory reactions [ 2 , 3 , 4 ].…”