Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland.
Clin Oral Implants Res. 2021 Jun;32(6):672-683. doi: 10.1111/clr.13729. Epub 2021 Mar 21.
Thermal and mechanical stresses during osteotomy preparation can impair implant osseointegration. This study investigated implant osseointegration following the measurement of temperature exposure during osteotomy drilling, varying drill design, sequence, and drill wear.
36 tapered implants were placed in a mandibular minipig model after guided drilling of implant osteotomies using 4 different groups: (1) control drills with a conservative, sequential drilling sequence, (2) control drills using a shortened drill sequence (PF), (3) novel test drill displaying an optimized drill design and surface treatment, PF, and (4) aged test drill, PF. Intraosseous temperatures during drilling were measured using a temperature probe. BIC, fBIC, and tissue reactions were histomorphometrically derived after 2 and 8 weeks of healing.
Compared to control drills (1) or (2), test drills (3) resulted in significantly lower maximum temperatures ((35.4 (CI 30.2-40.5)°C vs. (46.5 (CI 41.0-52.0)°C, p = .0021)) and shorter drill times ((4.5 (CI 1.6-7.3)sec vs. 10.3 (7.3-13.4)sec). Lower osteotomy temperature values and shorter drill times corroborated with significantly higher BIC after 2 and 8 weeks healing for the test (3) compared to control groups (2) (2 weeks: (44.9 (CI 34.1-55. 7)% vs. (31.3 (CI 20.5-42.2)%, p = <.0001 and 8 weeks: (73.7 ( CI 64.2-83.2)% vs. (66.2 (CI 57.0-75.4)%, p = <.0455).
The improved osseointegration of implants placed after osteotomy preparation with novel test drills using a shortened drill sequence compared to standard drills and conventional drill protocols might be attributed to more favorable thermal profiles and less mechanical stress exerted on the bone surrounding the implant osteotomy.
在截骨准备过程中产生的热和机械应力会损害种植体的骨整合。本研究通过测量截骨钻过程中的温度暴露情况，研究了不同钻头设计、顺序和钻头磨损对种植体骨整合的影响。
在使用 4 种不同组别的引导钻引导下颌骨迷你猪模型中的种植体截骨后，共放置了 36 个锥形种植体：（1）使用保守的顺序钻孔顺序的对照钻头，（2）使用缩短的钻孔顺序（PF）的对照钻头，（3）显示优化的钻头设计和表面处理的新型测试钻头，PF，和（4）老化的测试钻头，PF。使用温度探头测量钻孔过程中的骨内温度。在 2 和 8 周愈合后，通过组织形态计量学获得 BIC、fBIC 和组织反应。
与对照钻头（1）或（2）相比，测试钻头（3）导致的最大温度显著降低（（35.4（CI 30.2-40.5）°C 与（46.5（CI 41.0-52.0）°C，p=0.0021）和较短的钻孔时间（（4.5（CI 1.6-7.3）sec 与 10.3（7.3-13.4）sec）。较低的截骨温度值和较短的钻孔时间，证实了在 2 和 8 周愈合后，测试组（3）的 BIC 明显高于对照组（2）（2 周：（44.9（CI 34.1-55.7）% 与（31.3（CI 20.5-42.2）%，p<.0001；8 周：（73.7（CI 64.2-83.2）% 与（66.2（CI 57.0-75.4）%，p<.0455）。
与标准钻头和传统钻头方案相比，新型测试钻头使用缩短的钻头序列进行截骨准备后植入的种植体的骨整合得到了改善，这可能归因于更有利的热分布和对种植体周围骨施加的机械应力更小。
