Greenstein Gary, Greenstein Ben, Desai Rishin Niranjan
Dr. Gary Greenstein is a clinical professor, Department of Periodontology, College of Dental Medicine, Columbia University, New York City, and is in private practice, Surgical Implantology and Periodontics, 900 W. Main St., Freehold, N.J. 07727,
J Am Dent Assoc. 2014 Apr;145(4):371-5. doi: 10.14219/jada.2014.10.
A growing number of dental implants are being placed each year in the United States. This upward trend is associated with an increased incidence of comorbidities. In this regard, use of a drill stop has the potential to decrease unintended consequences of overdrilling the depth of an osteotomy.
The authors did not find any studies in the dental literature in which researchers assessed the safety and effectiveness of using drill stops on twist drills. Nevertheless, the advantages of utilizing drill stops and the undesired results due to excessive drilling can be reasonably deduced.
The authors describe the following clinically relevant issues pertaining to overdrilling of osteotomies for dental implants: the anatomical effect of excessive drilling in different sections of the oral cavity, reasons for excessive drilling, methods to avoid overlengthening of implant sites and benefits of using drill stops on twist drills.
Use of drill stops enhances safety, accuracy and efficiency when creating an osteotomy. Drill stops also reduce the clinicians and patients stress during operative procedures.
Drills stops can be beneficial when utilized in situations in which there is reduced visibility, making it difficult to read the lines on a twist drill. They also are helpful when there is a dearth of bone over the mandibular or mental nerves, and precisely lengthened osteotomies are needed to avoid nerve injuries.
在美国,每年植入的牙种植体数量不断增加。这种上升趋势与合并症发病率的增加有关。在这方面,使用钻孔限位器有可能减少因过度钻磨牙槽骨深度而产生的意外后果。
作者在牙科文献中未找到任何研究,其中研究人员评估了在麻花钻上使用钻孔限位器的安全性和有效性。然而,利用钻孔限位器的优点以及过度钻孔导致的不良结果可以合理推断。
作者描述了以下与牙种植体牙槽骨过度钻孔相关的临床问题:口腔不同部位过度钻孔的解剖学影响、过度钻孔的原因、避免种植体部位过长的方法以及在麻花钻上使用钻孔限位器的益处。
在制备牙槽骨时,使用钻孔限位器可提高安全性、准确性和效率。钻孔限位器还可减轻手术过程中临床医生和患者的压力。
当视野受限难以看清麻花钻上的刻度线时,使用钻孔限位器可能会有帮助。当在下颌神经或颏神经上方骨量不足且需要精确延长牙槽骨以避免神经损伤时,它也很有用。