Bernabeu-Mira Juan Carlos, Pellicer-Chover Hilario, Peñarrocha-Diago Miguel, Peñarrocha-Oltra David
Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Oliag Gascó 1, 46010 Valencia, Spain.
Materials (Basel). 2020 Apr 19;13(8):1921. doi: 10.3390/ma13081921.
An in vitro study was made to compare mean thermal variation according to the material, design and wear of the surgical drills used during dental implant site preparation.
Three study groups (stainless steel drills with straight blades; diamond-like carbon-coated drills with straight blades; and diamond-like carbon-coated drills with twisted blades) were tested to compare material, design and wear of the surgical drill in terms of overall mean values (complete sequence of drills) and specific mean values (each drill separately). The groups comprised four drills: initial, pilot, progressive and final drill. Implant site configuration was performed through an intermittent and gradual drilling technique without irrigation at 800 rpm in standardized synthetic blocks. Maximum axial loading of two kilograms was controlled by an automatic press. Each surgical drill was submitted to 50 drillings and was sterilized every five uses. A thermographic camera analyzed the mean thermal changes. The software-controlled automatic press kept systematic drilling, axial loading and operational speed constant without any human intervention. Student's t-test, ANOVA and multiple linear regression models were performed. The level of significance was 5% (p = 0.05).
The overall mean comparison between the stainless steel and diamond-like carbon-coated materials showed no statistically significant differences (p > 0.05), though specific mean comparison showed statistically significant differences between the drills of the different groups (p < 0.05). The twisted blades exhibited less overall and specific mean thermal variation than straight blades for the progressive and final drills (p < 0.01). In addition, the initial and pilot drills showed a greater mean thermal change than the progressive and final drills. The mean thermal variation was seen to increase during the 50 drillings.
Within the limitations of this study, it can be concluded that the drill material did not significantly influence the overall mean thermal variation except for the pilot drill. The drill design affected overall and specific mean thermal variation since the twisted blades heated less than the straight blades. The initial and pilot drills increased the specific mean thermal variation with respect to the progressive and final drills. In addition, all drills in each group produced a gradual increase in mean temperature during the 50 drillings.
进行一项体外研究，以比较在牙种植体植入部位制备过程中使用的手术钻根据材料、设计和磨损情况的平均热变化。
测试了三个研究组（直刃不锈钢钻；直刃类金刚石碳涂层钻；螺旋刃类金刚石碳涂层钻），以比较手术钻在总体平均值（完整的钻序列）和特定平均值（每个钻单独）方面的材料、设计和磨损情况。这些组包括四个钻：初始钻、导向钻、进阶钻和终末钻。在标准化合成块中以800转/分钟的转速通过间歇性渐进钻孔技术进行种植体植入部位的制备，不进行冲洗。由自动压力机控制两千克的最大轴向负荷。每个手术钻进行50次钻孔，每使用五次进行一次消毒。用热成像相机分析平均热变化。软件控制的自动压力机在无任何人工干预的情况下使系统钻孔、轴向负荷和操作速度保持恒定。进行了学生t检验、方差分析和多元线性回归模型。显著性水平为5%（p = 0.05）。
不锈钢和类金刚石碳涂层材料之间的总体平均值比较未显示出统计学上的显著差异（p > 0.05），尽管特定平均值比较显示不同组的钻之间存在统计学上的显著差异（p < 0.05）。对于进阶钻和终末钻，螺旋刃的总体和特定平均热变化比直刃小（p < 0.01）。此外，初始钻和导向钻的平均热变化比进阶钻和终末钻大。在50次钻孔过程中，平均热变化被观察到有所增加。
在本研究的局限性内，可以得出结论，除导向钻外，钻材料对总体平均热变化没有显著影响。钻的设计影响总体和特定平均热变化，因为螺旋刃比直刃升温少。相对于进阶钻和终末钻，初始钻和导向钻增加了特定平均热变化。此外，每组中的所有钻在50次钻孔过程中平均温度都逐渐升高。
