Strbac Georg D, Unger Ewald, Donner René, Bijak Manfred, Watzek Georg, Zechner Werner
Department of Oral Surgery, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
Clin Oral Implants Res. 2014 Jun;25(6):665-74. doi: 10.1111/clr.12032. Epub 2012 Sep 26.
The purpose of this study was to evaluate the temperature changes during implant osteotomies with a combined irrigation system as compared to the commonly used external and internal irrigation under standardized conditions.
Drilling procedures were performed on VII bovine ribs using a computer-aided surgical system that ensured automated intermittent drilling cycles to simulate clinical conditions. A total of 320 drilling osteotomies were performed with twist (2 mm) and conical implant drills (3.5/4.3/5 mm) at various drilling depths (10/16 mm) and with different saline irrigation (50 ml/min) methods (without/external/internal/combined). Temperature changes were recorded in real time by two custom-built thermoprobes with 14 temperature sensors (7 sensors/thermoprobe) at defined measuring depths.
The highest temperature increase during osteotomies was observed without any coolant irrigation (median, 8.01°C), followed by commonly used external saline irrigation (median, 2.60°C), combined irrigation (median, 1.51°C) and ultimately with internal saline irrigation (median, 1.48°C). Temperature increase with different drill diameters showed significant differences (P < 0.05) regarding drill depth, confirming drill depth and time of drilling as influencing factors of heat generation. Internal saline irrigation showed a significantly smaller temperature increase (P < 0.05) compared with combined and external irrigation. A combined irrigation procedure appears to be preferable (P < 0.05) to an external irrigation method primarily with higher osteotomy depths.
Combined irrigation provides sufficient reduction in temperature changes during drilling, and it may be more beneficial in deeper site osteotomies. Further studies to optimize the effects of a combined irrigation are needed.
本研究旨在评估在标准化条件下，与常用的外部和内部冲洗相比，联合冲洗系统在种植体截骨术中的温度变化。
使用计算机辅助手术系统在VII根牛肋骨上进行钻孔操作，该系统确保自动间歇性钻孔循环以模拟临床情况。使用麻花钻（2毫米）和锥形种植体钻（3.5/4.3/5毫米）在不同钻孔深度（10/16毫米）并采用不同的生理盐水冲洗方法（无/外部/内部/联合）共进行320次钻孔截骨术。通过两个定制的带有14个温度传感器（每个温度探头7个传感器）的温度探头在规定测量深度实时记录温度变化。
在没有任何冷却液冲洗的情况下截骨时观察到最高温度升高（中位数，8.01°C），其次是常用的外部生理盐水冲洗（中位数，2.60°C）、联合冲洗（中位数，1.51°C），最终是内部生理盐水冲洗（中位数，1.48°C）。不同钻头直径的温度升高在钻孔深度方面显示出显著差异（P < 0.05），证实钻孔深度和钻孔时间是发热的影响因素。与联合冲洗和外部冲洗相比，内部生理盐水冲洗显示出显著更小的温度升高（P < 0.05）。对于主要是较高截骨深度的情况，联合冲洗程序似乎比外部冲洗方法更可取（P < 0.05）。
联合冲洗在钻孔过程中能充分降低温度变化，并且在更深部位的截骨术中可能更有益。需要进一步研究以优化联合冲洗的效果。
