Intraosseous generation of heat during guided surgical drilling: an ex vivo study of the effect of the temperature of the irrigating fluid

Boa, Kristóf; Barrak, Ibrahim Ádám; Barootchi, Shayan; Joób-Fancsaly, Árpád; Piffkò, József

doi:10.1016/j.bjoms.2016.06.004

Cited by 27 publications

(33 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study showed that lowering the temperature of the cooling solution reduces the amount of heat generated during drilling in bone tissue. Other authors also came to such conclusions in their research [4,17]. In addition, internal cooling systems through increased irrigation of the drill lead to greater bone loss from the surface of the drill and, as shown by studies of other authors, are not more effective than external cooling systems [18].…”

Section: Discussionmentioning

confidence: 94%

“…Bone preparation time is another important parameter when preparing the implant bed. As indicated by the research of Boa et al [4], shortening of the bone preparation time has a significant impact on reducing the temperature changes in bone tissue. An important factor limiting temperature changes during preparation is also the use of irrigation with a coolant.…”

Section: Introductionmentioning

confidence: 99%

“…For this purpose, physiological saline is used as an inert solution at room temperature or below. According to some researchers, lowering the temperature of the cooling solution helps to reduce bleeding during surgery and further reduce tissue temperature [4]. The use of all the abovementioned drilling parameters is important for reducing heat emission to bone tissue, because its overheating above 47°C for over 1 minute may be critical and lead to necrosis [5,6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparative Analysis of Bone Tissue Temperature during Implant Preparation with Variable Drilling Parameters: In Vitro Study

Kosior

Pelc

Mikulewicz

2020

BioMed Research International

View full text Add to dashboard Cite

Purpose. The aim of this work was to compare the temperature fluctuations that occur during the development of the implant bed using three different implant systems and the impact on their value of cooling method and rotational speed of drill. Material and Methods. As a model of the human jaw due to the analogy of bone structure and hardness, pig ribs were used. Drills from three different implant systems were used in the study: Straumann® (Straumann GmbH, Basel, Switzerland), AnyRidge® (Megagen Implant Co., Ltd., Daegu, South Korea), and Osstem (OSSTEM IMPLANT CO., LTD., Seoul, South Korea). The sequence of three successive drills was given—from pilot drill to final drill. For each system, a group with two water cooling methods, without cooling, and three different speed ranges, 800, 1200, and 1500 rpm, and their effect on temperature fluctuations was evaluated. The temperature was measured by thermography. Results. The highest temperature increases were noted during preparation with pilot drills. The maximum temperature (50.8°C) was noted for the AnyRidge pilot drill at 1500 rpm without cooling. When cooling with physiological saline, none of the applied drills exceeded 28°C. Significant differences between lack of cooling and cooling with saline at 20°C and 3°C have been demonstrated. During preparation with cooling, the difference between the times of the maximum temperature achievement was observed between AnyRidge® and Osstem (2.6 vs. 1.6 s, p=0.004). Conclusion. The experiment showed that the drills of the tested implant systems differed in the amount of heat generated during operation. The temperature of the cooling solution and the rotational speed applied have an influence on its amount.

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparative Analysis of Bone Tissue Temperature during Implant Preparation with Variable Drilling Parameters: In Vitro Study

Kosior

Pelc

Mikulewicz

2020

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…In the present study, genetic algorithm-based optimization methodology has been implemented owing to its ability to find fit solutions as per defined heuristic in less time. Different input parameters have been investigated by the past researchers [10][11][12] for bone drilling such as rotational speed, feed rate, amplitude, depth of cut, drill diameter, contact angle, and input power. However, no study is available for ultrasonic-assisted bone grinding.…”

Section: Introductionmentioning

confidence: 99%

Thermogenesis mitigation using ultrasonic actuation during bone grinding: a hybrid approach using CEM43°C and Arrhenius model

Babbar

Jain

Gupta

2019

J Braz. Soc. Mech. Sci. Eng.

View full text Add to dashboard Cite

Bone grinding has cemented its applications in the various sorts of the neurosurgeries. Generally, a rotating burr is used to remove a part of the bone to expose the tumors present underneath the bone. The abrasion caused by the grinding wheel causes a rise in temperature owing to the generation of the heat during grinding and would have severe consequences with the initiation of thermogenesis. To bridge this gap, an in-house experimental setup was developed to perform multi-pass rotary ultrasonic neurosurgical bone grinding. Three functional characteristics, namely rotational speed, feed rate, and amplitude, have been investigated using Taguchi L18 orthogonal array design. The regression equations have been obtained and validated with confirmation experiments using a random set of machining parameters. Further, machining parameters are optimized using genetic algorithm and confirmatory trials are performed using optimized conditions. The results of statistical analysis (ANOVA) revealed that the feed rate is the most significant parameter influencing the change in temperature during osteotomy. Nevertheless, the standard deviation was most affected by rotational speed. Furthermore, a comparative analysis has been carried out for conventional and rotary ultrasonic neurosurgical grinding. A hybrid approach using cumulative equivalent minutes (CEM43°C) and Arrhenius model has been used to predict the thermal damage caused to the human body's tissues during bone grinding. The results obtained have been experimentally validated, and outcomes revealed that ultrasonically actuated grinding burr may prevent osteonecrosis and neural damage duly supported with infrared thermograms and graphical plots. Keywords Bone grinding • Ultrasonic • Genetic algorithm • Infrared thermography • CEM43°C • Arrhenius equations List of symbols Ω Tissue damage function A Pre-exponential factor (s −1) E a Arrhenius activation energy (J/mol) τ Time (s) R Universal gas constant (J/mol k) K Rate constant T Actual exposure temperature (°C) T break Breaking point temperature CEM43°C Cumulative number of equivalent minutes at 43 °C F Feed rate (mm/min) A Amplitude (µm) D Depth of cut (mm) ∆T Change in temperature (°C) σ Standard deviation CG Conventional grinding RUNG Rotary ultrasonic neurosurgical grinding

show abstract

“…There is no standard model for the observations into the preparation of implant sites. A variety of different osseous models have been used based on bone blocks from pig rib (22), pig mandible and maxilla (27), sheep tibia (28), bovine cortical/medullary bone (29)(30)(31)(32)(33)(34)(35)(36)(37), rabbit tibia (38) and rabbit mandible (39,40). There were studies which used synthetic blocks or resin models (41)(42)(43)(44).…”

Section: I31 Study Modelsmentioning

confidence: 99%

Intraosseous heat generation during guided osteotomy for dental implantological purposes

Barrak¹

View full text Add to dashboard Cite

Prosthodontically driven implant surgery has been subject of interest to dental professionals for the past decade. The correct positioning of implants has a number of obvious advantages, such as favourable functional and aesthetic outcomes, better occlusion and less chance of implant overload, to mention just a few. A well-positioned implant can also make it easier for the patient to maintain good oral hygiene, once the superstructure has been inserted. Thermal osteonecrosis, thermal damage As the application of metal implants has become routine in musculoskeletal trauma surgery, orthopaedic surgery, spine surgery, cranio-maxillofacial surgery, dentistry and oral implantology, drilling of bone has also become one of the most common basic surgical steps. As for the healing of the osseous structure, this can be influenced by several factors including implant design, chemical composition, the material and shape of the implant, the physiological characteristics of the host bone bed, loading conditions, the topography of the implant surface, the healing potential of the host bone, the use of adjuvant treatments, pharmacological agents and also heat generation during osteotomy. The bone tissue is very vulnerable to thermal injury, and the temperature threshold for tissue survival during osteotomy is 47˚C when drilling is maintained for more than 1 minute. Therefore, it is critical for successful osseointegration to keep heat generation under control during osteotomy. Excess heating above this limit can lead to the primary failure to of osseointegration. In the last few years a rapid development could be observed in the field of computer-assisted implant placement. Increased beneficial use of computers was made possible through the recent advances in computer technology, which allowed the planning and the execution of various steps involved in dental reconstructions during the placement of dental implants. The above mentioned novel possibilities include computer assistance for the planning of surgical interventions, for the implementation of the surgical steps, for capturing intraoral situation and also for designing temporary and final prosthetic solutions or even for the manufacturing of prosthetic components. Combining the cone-beam computed tomography (CBCT) images with an implant planning software has made it possible to virtually plan the optimal implant positions, in regard of the future prosthetic needs and the vital anatomical structures. This information can be used to fabricate a drill guide, which ultimately results in the transfer of the planned implant position from the computer to the patient, with the guide directing both the osteotomy and the insertion of the implant. The present thesis sought to find answers to the following questions: 1. How does the effect of the combination of low-speed drilling and cooled irrigation fluid influence intraosseous temperature elevation during guided and freehand implant surgery? Our hypothesis was that with the combination of low-speed and cooled irrigation fluid we can control the temperature increment in such a way that with any of the drilling procedures it will be avoidable to do thermal damage to the bony structure. 2. How does drill wear and consequent intraosseous temperature elevation during freehand and guided bone drilling change, with special attention to the effect of metal-on metal contact during guided drilling? We hypothesized that the metal-on-metal contact would damage the surface of the drilling bits, and therefore it would be associated with significantly higher temperatures during the drilling procedures. In the present thesis, we sought, first of all, to examine the effect of several factors that we believed would significantly contribute to heat generation during osteotomy: the presence of the metal sleeve in the surgical template and the combination of different drilling speed with different temperature irrigation fluids. The effect of metal to metal contact was compared with freehand osteotomy, and 3 further factors, sterilization, drilling speed, and drill wear, were also considered. To summarize the findings, at 800rpm, the intraosseous temperature never reached the necrotic threshold in any of the examined conditions during the total of 210 osteotomies. At higher drilling speeds, 90 osteotomies could be safely (i.e., without approaching 47°C) performed regardless of the applied sterilization protocol and whether the drilling was performed freehand or through a metal guide. The results also show that whether guide use led to a near-necrotic temperature increment depended largely on the applied sterilization protocol. In general, our hypothesis regarding the significant and cumulative effect of each studied factor during the experiments regarding the drill wear has been confirmed. It has been proven that the metal guide sleeve contributes significantly to heat generation during osteotomy, but this does not mean a safety risk if a soft sterilization protocol is used. As for temperature elevations in guided osteotomy our results suggest that the use of a low drilling speed of 800 rpm combined with the external irrigation fluid being cooled to 10°C can result in a mean cortical intraosseous temperature change being below 1.0°C, regardless of drill diameter or drilling method (freehand surgery or guided surgery). All in all, the literature almost unequivocally suggests that guided osteotomy (with a metal sleeve) does not pose an extra safety risk in terms of temperature elevation, which is in agreement with our results. Based on the results of the investigations that provide the basis of the present work, a low drilling speed with cooled irrigation are recommended when performing osteotomy through a surgical guide. 800 rpm and 10°C proved to be optimal in our experiments. Furthermore, drills that are used for guided osteotomy should be taken care of with extra precaution regarding the cleaning and the sterilization protocols and their use (the drill bits) should be maximized at a level of 90 osteotomies.

show abstract

Intraosseous generation of heat during guided surgical drilling: an ex vivo study of the effect of the temperature of the irrigating fluid

Cited by 27 publications

References 18 publications

Comparative Analysis of Bone Tissue Temperature during Implant Preparation with Variable Drilling Parameters: In Vitro Study

Comparative Analysis of Bone Tissue Temperature during Implant Preparation with Variable Drilling Parameters: In Vitro Study

Thermogenesis mitigation using ultrasonic actuation during bone grinding: a hybrid approach using CEM43°C and Arrhenius model

Intraosseous heat generation during guided osteotomy for dental implantological purposes

Contact Info

Product

Resources

About