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钻头磨损对牙种植体截骨术准备过程中切削效率和产热的影响:一项关于钻头耐用性的研究

The influence of drill wear on cutting efficiency and heat production during osteotomy preparation for dental implants: a study of drill durability.

作者信息

Ercoli Carlo, Funkenbusch Paul D, Lee Han-Joo, Moss Mark E, Graser Gerald N

机构信息

Division of Prosthodontics, Eastman Dental Center, University of Rochester, 625 Elmwood Avenue, Rochester, NY 14620, USA.

出版信息

Int J Oral Maxillofac Implants. 2004 May-Jun;19(3):335-49.

Abstract

PURPOSE

The authors evaluated, under conditions simulating implant placement, the cutting efficiency, durability, heat production, and wear of implant drills.

MATERIALS AND METHODS

Osteotomies were performed on bovine ribs using a surgical unit mounted in a testing apparatus. A software program controlled the apparatus and recorded temperatures, depths, and drilling times. Seven brands of drills were tested (Nobel Biocare, 3i/Implant Innovations, Steri-Oss, Paragon, Implamed, Lifecore, and ITI). Spade, twist, tri-flute, and TiN-coated drill designs were evaluated and compared during 100 successive osteotomies. Scanning electron microscopic and energy-dispersive x-ray spectroscopic examinations were performed, and hardness was measured.

RESULTS

Two 2-mm drills (Nobel Biocare and 3i/Implant Innovations) had mean removal rates significantly greater than the others (P < .05). The 2-mm twist drill design with a low hardness (Implamed) exhibited plastic deformation at the cutting edge, loss of cutting efficiency, and drill fracture. The TiN-coated drills (Steri-Oss and Paragon) showed greater wear and significantly lower removal rates (P < .05) than noncoated drills. Temperature increases with different drills were not significantly different at depths of 5 or 15 mm or between 2-mm or 3-mm drills. With 1 exception (the 2.3-mm Paragon drill at a depth of 15 mm), the temperatures generated by the different types of drills were not significantly different. Clinically harmful temperatures were detected only at a depth of 15 mm during 5 osteotomies and coincided with a marked decrease in the rate of drill advancement with a resulting continuous drilling action.

DISCUSSION

Temperatures generated at depths of 5 and 15 mm by the different drill types and diameters were not significantly different and, with only 5 exceptions, were clinically safe. Several differences between brands were noted in regard to cutting efficiency and durability, underscoring the importance of material selection and quality on drill performance.

CONCLUSIONS

Drill design, material, and mechanical properties significantly affect cutting efficiency and durability. Coolant availability and temperature were the predominant factors in determining bone temperatures. Implant drills can be used several times without resulting in bone temperatures that are potentially harmful. Continuous drilling in deep osteotomies can produce local temperatures that might be harmful to the bone.

摘要

目的

作者在模拟种植体植入的条件下,评估了种植体钻的切割效率、耐用性、产热和磨损情况。

材料与方法

使用安装在测试设备中的手术单元对牛肋骨进行截骨术。一个软件程序控制该设备并记录温度、深度和钻孔时间。测试了七个品牌的钻头(诺贝尔生物科技、3i/种植体创新、思乐奥、帕拉贡、Implamed、Lifecore和ITI)。在连续100次截骨术中对铲形、麻花形、三槽形和氮化钛涂层钻头设计进行了评估和比较。进行了扫描电子显微镜和能量色散X射线光谱检查,并测量了硬度。

结果

两款2毫米的钻头(诺贝尔生物科技和3i/种植体创新)的平均去除率显著高于其他钻头(P < 0.05)。硬度较低的2毫米麻花形钻头设计(Implamed)在切削刃处出现塑性变形,切割效率降低,钻头断裂。氮化钛涂层钻头(思乐奥和帕拉贡)比未涂层钻头表现出更大的磨损,去除率显著更低(P < 0.05)。在5毫米或15毫米深度处,不同钻头的温度升高没有显著差异,2毫米或3毫米钻头之间也没有显著差异。除了一个例外(15毫米深度处的2.3毫米帕拉贡钻头),不同类型钻头产生的温度没有显著差异。仅在5次截骨术中的15毫米深度处检测到临床有害温度,并且与钻头推进速度的显著下降同时出现,导致持续钻孔动作。

讨论

不同类型和直径的钻头在5毫米和15毫米深度处产生的温度没有显著差异,并且除了5个例外,在临床上是安全的。在切割效率和耐用性方面,各品牌之间存在一些差异,突出了材料选择和质量对钻头性能的重要性。

结论

钻头设计、材料和机械性能显著影响切割效率和耐用性。冷却液供应和温度是决定骨温的主要因素。种植体钻可以使用多次而不会产生可能有害的骨温。在深截骨术中持续钻孔会产生可能对骨有害的局部温度。

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