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种植体钻头磨损、冲洗及钻头材料对截骨部位产热的影响。

Effects of implant drill wear, irrigation, and drill materials on heat generation in osteotomy sites.

作者信息

Koo Ki-Tae, Kim Min-Ho, Kim Hae-Young, Wikesjö Ulf M E, Yang Jae-Ho, Yeo In-Sung

机构信息

1  Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.

出版信息

J Oral Implantol. 2015 Apr;41(2):e19-23. doi: 10.1563/AAID-JOI-D-13-00151. Epub 2013 Dec 6.

Abstract

This study evaluated the effects of drill wear on bone temperature during osteotomy preparation with 3 types of drills and compared heat production between drills. The drills used in this study were titanium nitride-coated metal, tungsten carbide carbon-coated metal, and zirconia ceramic drills. An osteotomy 11 mm in depth was formed in bovine scapular bone following the manufacturer's recommended drill sequences. Drilling was performed without irrigation and repeated 20 times; temperature was measured every 5 times. Next, 200 rounds of drilling during irrigation were performed for each drill, with temperature change monitored until round 200. Analysis of variance statistics were used for analyses of the measured data. Drilling without irrigation showed significant thermal increase at all time points compared to drilling with irrigation (P < .001). No significant difference was found between drill materials. Under irrigation, the frequency of previous drilling had minimal effects on thermal change. The repeated-measures analysis of variance revealed major thermal change at the initial time point (P < .0001), and the multiple comparison tests revealed a significant difference in temperature between the initial drills that had been used 50 or fewer times and those that had been used more than 50 times, irrespective of the drill material. The results of this study indicate that the initial drill should be changed in osteotomy preparation with irrigation after they have been used 50 times. Irrigation may be a more critical factor for the control of temperature elevation than is the drill material.

摘要

本研究评估了3种类型的钻头在截骨术准备过程中钻头磨损对骨温度的影响,并比较了不同钻头之间的产热情况。本研究使用的钻头为氮化钛涂层金属钻头、碳化钨碳涂层金属钻头和氧化锆陶瓷钻头。按照制造商推荐的钻头顺序,在牛肩胛骨上形成深度为11毫米的截骨术。在不进行冲洗的情况下进行钻孔,并重复20次;每5次测量一次温度。接下来,对每种钻头在冲洗过程中进行200次钻孔,监测温度变化直至第200次。采用方差分析统计方法对测量数据进行分析。与冲洗钻孔相比,不冲洗钻孔在所有时间点均显示出显著的热增加(P <.001)。未发现钻头材料之间存在显著差异。在冲洗情况下,先前钻孔的次数对热变化影响极小。重复测量方差分析显示在初始时间点有主要的热变化(P <.0001),多重比较测试显示,无论钻头材料如何,最初使用次数在50次或更少的钻头与使用次数超过50次的钻头之间温度存在显著差异。本研究结果表明,在冲洗截骨术准备过程中,初始钻头使用50次后应更换。对于控制温度升高而言,冲洗可能比钻头材料是更关键的因素。

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