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Thermal exposure of implant osteotomies and its impact on osseointegration—A preclinical in vivo study

Heuzeroth, Raphael ; Pippenger, Benjamin E. ; Sandgren, Rebecca LU ; Bellón, Benjamin and Kühl, Sebastian (2021) In Clinical Oral Implants Research 32(6). p.672-683
Abstract

Objectives: Thermal and mechanical stresses during osteotomy preparation can impair implant osseointegration. This study investigated implant osseointegration following the measurement of temperature exposure during osteotomy drilling, varying drill design, sequence, and drill wear. Materials and methods: 36 tapered implants were placed in a mandibular minipig model after guided drilling of implant osteotomies using 4 different groups: (1) control drills with a conservative, sequential drilling sequence, (2) control drills using a shortened drill sequence (PF), (3) novel test drill displaying an optimized drill design and surface treatment, PF, and (4) aged test drill, PF. Intraosseous temperatures during drilling were measured using a... (More)

Objectives: Thermal and mechanical stresses during osteotomy preparation can impair implant osseointegration. This study investigated implant osseointegration following the measurement of temperature exposure during osteotomy drilling, varying drill design, sequence, and drill wear. Materials and methods: 36 tapered implants were placed in a mandibular minipig model after guided drilling of implant osteotomies using 4 different groups: (1) control drills with a conservative, sequential drilling sequence, (2) control drills using a shortened drill sequence (PF), (3) novel test drill displaying an optimized drill design and surface treatment, PF, and (4) aged test drill, PF. Intraosseous temperatures during drilling were measured using a temperature probe. BIC, fBIC, and tissue reactions were histomorphometrically derived after 2 and 8 weeks of healing. Results: Compared to control drills (1) or (2), test drills (3) resulted in significantly lower maximum temperatures ((35.4 (CI 30.2–40.5)°C vs. (46.5 (CI 41.0–52.0)°C, p =.0021)) and shorter drill times ((4.5 (CI 1.6–7.3)sec vs. 10.3 (7.3–13.4)sec). Lower osteotomy temperature values and shorter drill times corroborated with significantly higher BIC after 2 and 8 weeks healing for the test (3) compared to control groups (2) (2 weeks: (44.9 (CI 34.1–55. 7)% vs. (31.3 (CI 20.5–42.2)%, p = <.0001 and 8 weeks: (73.7 (CI 64.2–83.2)% vs. (66.2 (CI 57.0–75.4)%, p = <.0455). Conclusion: The improved osseointegration of implants placed after osteotomy preparation with novel test drills using a shortened drill sequence compared to standard drills and conventional drill protocols might be attributed to more favorable thermal profiles and less mechanical stress exerted on the bone surrounding the implant osteotomy.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
drilling, implant, osteotomy, temperature, thermal exposure
in
Clinical Oral Implants Research
volume
32
issue
6
pages
11 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85102743219
  • pmid:33629437
ISSN
0905-7161
DOI
10.1111/clr.13729
language
English
LU publication?
yes
id
b9a77f6c-e7d8-4911-825d-30872abbc5d0
date added to LUP
2021-04-06 09:35:27
date last changed
2023-02-02 01:22:53
@article{b9a77f6c-e7d8-4911-825d-30872abbc5d0,
  abstract     = {{<p>Objectives: Thermal and mechanical stresses during osteotomy preparation can impair implant osseointegration. This study investigated implant osseointegration following the measurement of temperature exposure during osteotomy drilling, varying drill design, sequence, and drill wear. Materials and methods: 36 tapered implants were placed in a mandibular minipig model after guided drilling of implant osteotomies using 4 different groups: (1) control drills with a conservative, sequential drilling sequence, (2) control drills using a shortened drill sequence (PF), (3) novel test drill displaying an optimized drill design and surface treatment, PF, and (4) aged test drill, PF. Intraosseous temperatures during drilling were measured using a temperature probe. BIC, fBIC, and tissue reactions were histomorphometrically derived after 2 and 8 weeks of healing. Results: Compared to control drills (1) or (2), test drills (3) resulted in significantly lower maximum temperatures ((35.4 (CI 30.2–40.5)°C vs. (46.5 (CI 41.0–52.0)°C, p =.0021)) and shorter drill times ((4.5 (CI 1.6–7.3)sec vs. 10.3 (7.3–13.4)sec). Lower osteotomy temperature values and shorter drill times corroborated with significantly higher BIC after 2 and 8 weeks healing for the test (3) compared to control groups (2) (2 weeks: (44.9 (CI 34.1–55. 7)% vs. (31.3 (CI 20.5–42.2)%, p = &lt;.0001 and 8 weeks: (73.7 (CI 64.2–83.2)% vs. (66.2 (CI 57.0–75.4)%, p = &lt;.0455). Conclusion: The improved osseointegration of implants placed after osteotomy preparation with novel test drills using a shortened drill sequence compared to standard drills and conventional drill protocols might be attributed to more favorable thermal profiles and less mechanical stress exerted on the bone surrounding the implant osteotomy.</p>}},
  author       = {{Heuzeroth, Raphael and Pippenger, Benjamin E. and Sandgren, Rebecca and Bellón, Benjamin and Kühl, Sebastian}},
  issn         = {{0905-7161}},
  keywords     = {{drilling; implant; osteotomy; temperature; thermal exposure}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  pages        = {{672--683}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Clinical Oral Implants Research}},
  title        = {{Thermal exposure of implant osteotomies and its impact on osseointegration—A preclinical in vivo study}},
  url          = {{http://dx.doi.org/10.1111/clr.13729}},
  doi          = {{10.1111/clr.13729}},
  volume       = {{32}},
  year         = {{2021}},
}