Rashad Ashkan, Sadr-Eshkevari Pooyan, Heiland Max, Smeets Ralf, Hanken Henning, Gröbe Alexander, Assaf Alexandre T, Köhnke Robert H, Mehryar Pouyan, Riecke Björn, Wikner Johannes
Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Max Heiland; MD, DMD, PhD), University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Department of Neuroanatomy and Molecular Brain Research, Ruhr-University Bochum, Germany.
J Craniomaxillofac Surg. 2015 Sep;43(7):1072-7. doi: 10.1016/j.jcms.2015.05.018. Epub 2015 Jun 4.
To assess heat generation in osteotomies during application of sonic and ultrasonic saws compared to conventional bur.
Two glass-fiber isolated nickel-chromium thermocouples, connected to a recording device, were inserted into fresh bovine rib bone blocks and kept in 20 ± 0.5 °C water at determined depths of 1.5 mm (cortical layer) and 7 mm (cancellous layer) and 1.0 mm away from the planned osteotomy site. Handpieces, angulated 24-32°, were mounted in a vertical drill stand, and standardized weights were attached to their tops to exert loads of 5, 8, 15 and 20 N. Irrigation volumes of 20, 50 and 80 ml/min were used for each load. Ten repetitions were conducted using new tips each time for each test condition. The Mann-Whitney-U test was used for statistical analysis (p < 0.05).
Both ultrasonic and sonic osteotomies were associated with significantly lower heat generation than conventional osteotomy (p < 0.01). Sonic osteotomy showed non-significantly lower heat generation than ultrasonic osteotomy. Generated heat never exceeded the critical limit of 47 °C in any system. Variation of load had no effect on heat generation in both bone layers for all tested systems. An increased irrigation volume resulted in lower temperatures in both cortical and cancellous bone layers during all tested osteotomies.
Although none of the systems under the conditions of the present study resulted in critical heat generation, the application of ultrasonic and sonic osteotomy systems was associated with lower heat generation compared to the conventional saw osteotomy. Copious irrigation seems to play a critical role in preventing heat generation in the osteotomy site.
评估与传统牙钻相比,使用声波锯和超声锯进行截骨术时的产热情况。
将两根连接到记录装置的玻璃纤维绝缘镍铬热电偶插入新鲜牛肋骨块中,并保持在20±0.5°C的水中,深度分别为1.5毫米(皮质层)和7毫米(松质层),且距离计划截骨部位1.0毫米。将成角24 - 32°的机头安装在垂直钻台上,并在其顶部附加标准重量以施加5、8、15和20牛的负荷。每种负荷使用20、50和80毫升/分钟的冲洗量。每次测试条件下每次都使用新的锯片进行十次重复操作。采用曼-惠特尼-U检验进行统计分析(p < 0.05)。
与传统截骨术相比,超声截骨术和声波截骨术的产热均显著更低(p < 0.01)。声波截骨术的产热比超声截骨术略低,但无显著差异。在任何系统中,产生的热量均未超过47°C的临界限度。对于所有测试系统,负荷变化对两层骨中的产热均无影响。在所有测试的截骨术中,冲洗量增加均导致皮质骨层和松质骨层的温度降低。
尽管在本研究条件下,没有一个系统产生临界热量,但与传统锯截骨术相比,超声和声波截骨术系统的产热更低。大量冲洗似乎在防止截骨部位产热方面起着关键作用。