背景:过度手术创伤被认为是早期植入物丢失的最重要原因之一。由于对骨骼的热损伤不仅取决于产生的热量,还取决于组织暴露时间,并且在退出期内发现了最大的温度升高,整个截骨手术的参数对热损伤有特别的临床意义.这项研究的目的是研究金属基和陶瓷种植体钻头在整个截骨过程中的温度暴露时间的热性能。
方法:本次调查共包括240个单独的制剂,包括两个不同的钻孔深度(10和16毫米),两种灌溉方法(外部和不灌溉),两种种植体钻孔材料(不锈钢和氧化锆),和每种材料的三个连续的钻头直径(2.0/2.2,2.8和3.5mm),重复10次。在标准化牛骨标本的自动钻孔过程中进行实时多通道温度测量。
结果:最大温度变化与被动取钻的时间段高度相关(p≤0.05),不考虑钻孔材料,钻孔深度,或钻头直径。在两个钻孔深度较小的钻孔直径(2.0/2.2和2.8mm,p≤0.05)。
结论:这项体外研究的结果可以证明,在两种研究的钻孔材料中,最高温度升高与被动抽出时间之间存在很强的关联。考虑到这些发现以及整个外科手术导致的热骨损伤,高的整体温度与延长的热暴露时间相结合可能会影响未来的骨整合过程。
BACKGROUND: Excessive surgical trauma is believed to be among the most important causes for early implant losses. As thermal injury to the bone is not only dependent on the amount of generated heat but also on the tissue exposure time, and the greatest temperature increase was found within the withdrawing period, the entire osteotomy procedure with the parameters contributing to thermal damage is of particular clinical relevance. The aim of this study was to investigate the thermal performance of metal-based and ceramic implant drills regarding the temperature exposure time during the whole osteotomy process.
METHODS: This investigation consisted of 240 individual preparations in total, comprising two different drilling depths (10 and 16 mm), two irrigation methods (external and without irrigation), two implant drill materials (stainless steel and zirconia), and three consecutive drill diameters per material (2.0/2.2, 2.8, and 3.5 mm) with 10 identical repetitions. Real-time multichannel temperature measurement was conducted during automated drilling procedures in standardized bovine bone specimens.
RESULTS: The maximum temperature changes were highly associated with the time period of passive drill withdrawing (p ≤ 0.05), irrespective of drill material, drilling depth, or drill diameter. Statistically significant differences in temperature generation between stainless steel and ceramic drills were observed in irrigated testing sites at both drilling depths with smaller drill diameters (2.0/2.2 and 2.8 mm, p ≤ 0.05).
CONCLUSIONS: Results of this in vitro study could demonstrate a strong association between the highest temperature increase and the passive withdrawing time period in both investigated drill materials. Considering these findings and the resulting thermal bone damage due to the whole surgical procedure, high overall temperatures in combination with a prolonged heat exposure time may impact the future osseointegration process.