Numerical and Experimental Analyses on the Temperature Distribution in the Dental Implant Preparation Area when Using a Surgical Guide

Abstract

Based on theoretical analysis, experimentation, and FEM simulation, the temperature distribution of the drilling area in the placement of dental implants under surgical guide was determined. For clinical operation, improved cooling methods, such as using a drill with an internal cooling channel, should be used, and the drill should be regularly withdrawn during drilling.

Comparison of heat generation between guided and conventional implant surgery for single and sequential drilling protocols—An in vitro study

“…During guided sequential drilling with a 4.2 mm final drill, the time over critical temperature (time with a temperature increase over 15°C for a 25°C polyurethane foam block) was more than 1 min and exceeded the threshold for causing morphological bone damage (Eriksson & Albrektsson, ). Our results do not correspond to the findings of other in vitro studies which documented that heat generation with GOP did not reach temperature levels critical to bone (Dos Santos et al, ; Liu et al, ; Markovic et al, ; Migliorati et al, ; Misir et al, ).…”

“…This is in line with several other studies that suggest the greater heat generation with guided procedures is caused by the surgical guide impairing the irrigation fluid from entering the drilling site (Dos Santos et al, ; Markovic et al, ; Migliorati et al, ; Misir et al, ). Drilling with a cooling channel in the guide has been shown to reduce the temperature increase by 1.9‐fold (Liu et al, ). Increased heat development can also result from friction between the drill and the guiding handle.…”

“…Most experimental studies investigating temperature development have used thermocouples (Bulloch et al, 2012;Migliorati et al, 2013;Misir et al, 2009), which allow temperature measurements only at single points and provide limited data about the temperature distribution in the entire surgical field (Liu et al, 2016). Real-time infrared thermography was used in the present study to generate an overall thermal profile, as previously described (Markovic et al, 2016).…”

“…Furthermore, the friction between the drill and the cylinder of the drill handle might also contribute to temperature increases (Markovic et al, 2016). In a review of the current literature, most studies that investigated the heat generation during GOP measured the temperature development at single depths by the use of thermocouples (Bulloch, Olsen, & Bulloch, 2012;Liu, Wu, Zhang, Peng, & Liao, 2016;Migliorati et al, 2013;Misir, Sumer, Yenisey, & Ergioglu, 2009). As far as we are aware, the present study is the first to evaluate heat generation in artificial bone samples during guided surgery by means of an infrared camera.…”

Guided implant surgery risks and their prevention

“…Guided implant surgery typically requires use of longer drills, compared with conventional implant surgery, because of the required guiding tubes and the distance between guide and bone. The increased drill length, the possible friction between drill and guiding tube, and the physical barriers represented by the guiding tube and the guide can all contribute to significantly decreased irrigation efficiency, thus preventing adequate drill cooling; this will result in overheating of the bone, which could lead to thermal osteonecrosis (Figure ). Improved cooling procedures, such as frequent withdrawal and reinsertion of the drill during osteotomy preparation, use of drills with internal cooling, and copious and continuous irrigation with cold saline solution, should be employed during guided implant surgery.…”