Oral Surgery Unit, Faculty of Medicine and Dentistry, Department of Stomatology, University of Valencia, Valencia, Spain.
University of Genova, Genoa, Italy.
Clin Implant Dent Relat Res. 2024 Aug;26(4):724-733. doi: 10.1111/cid.13346. Epub 2024 May 27.
To compare collected bone weight and the frequency of autologous bone harvesting from the flutes of surgical drills used for implant bed preparation using two different drilling techniques. A comparative evaluation of radiographic bone density and bone quality was also made.
A randomized clinical trial was made of 66 dental implants in patients with a single posterior edentulous site. The compared drilling techniques were high-speed drilling with irrigation (control group) and low-speed drilling without irrigation (test group). The bone collected in both groups was dried and weighed with a precise electronic balance. The frequency of harvesting was calculated. The median radiographic bone density of each implant site was measured using cone-beam computed tomography (CBCT) pixel values. Patient sex, age, implant position and dimensions, as well as the last drill diameter were analyzed as independent variables. The level of significance was 5%.
The harvesting of bone chips from drill flutes proved possible in 51.5% of the procedures in the control group and in 100% in the test group (p < 0.001). There were also statistically significant differences in bone weight between the control group (6.7 ± 10.6 mg) and the test group (41.9 ± 30.3 mg) (p < 0.001). The CBCT pixel values were directly correlated with the collected bone weight in both groups. The median radiographic bone density, arch and last drill diameter were significantly associated with harvesting bone frequency and collected bone weight (p < 0.05).
Our findings suggest that the frequency and weight of autologous bone harvested from drills are greater with low-speed drilling without irrigation than with high-speed drilling with irrigation. Radiographic bone density, arch and last drill diameter also significantly influenced the harvesting outcomes.
比较两种不同钻孔技术在准备种植床时从手术钻头的钻头中收集的骨量和自体骨采集的频率。还对影像学骨密度和骨质量进行了比较评估。
对 66 例单个后牙缺失患者的 66 个牙种植体进行了随机临床试验。比较的钻孔技术是带冲洗的高速钻孔（对照组）和不带冲洗的低速钻孔（试验组）。两组收集的骨均用精确的电子天平干燥称重。计算了采集的频率。使用锥形束计算机断层扫描（CBCT）像素值测量每个种植体部位的中位数影像学骨密度。分析了患者性别、年龄、种植体位置和尺寸以及最后钻头直径作为独立变量。显著性水平为 5%。
在对照组的 51.5%的手术中，从钻头钻头中采集骨屑是可行的，而在试验组中则为 100%（p<0.001）。对照组（6.7±10.6mg）和试验组（41.9±30.3mg）之间的骨重量也存在统计学差异（p<0.001）。两组的 CBCT 像素值与收集的骨量直接相关。影像学骨密度、牙槽弓和最后钻头直径与采集骨频率和收集骨量显著相关（p<0.05）。
我们的研究结果表明，与高速带冲洗钻孔相比，低速无冲洗钻孔从钻头中采集的自体骨的频率和重量更大。影像学骨密度、牙槽弓和最后钻头直径也显著影响采集结果。
