Uticaj hirurškog stenta i temperature irigansa na termičke promene u kosti tokom preparacije ležišta implantata – termografska analiza na goveđim rebrima

  • Aleksa Marković Univerzitet u Beogradu, Stomatološki fakultet, Klinika za oralnu hirurgiju
  • Zoran Lazić Clinic of Dentistry, Military Medical Academy, Belgrade, Serbia, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Tijana Mišić Clinic of Oral Surgery, University of Belgrade, Belgrade, Serbia
  • Miodrag Šćepanović Clinic of Oral Surgery, Faculty of Dentistry, University of Priština/Kosovska Mitrovica, Kosovska Mitrovica, Serbia
  • Aleksandar Todorović Clinic of Oral Surgery, Faculty of Dentistry, University of Priština/Kosovska Mitrovica, Kosovska Mitrovica, Serbia
  • Kaustubh Thakare Clinic of Oral Surgery, University of Belgrade, Belgrade, Serbia
  • Bojan Janjić Clinic of Oral Surgery, University of Belgrade, Belgrade, Serbia
  • Zoran Vlahovic Clinic of Oral Surgery, Faculty of Dentistry Pristina , Kosovska Mitrovic, Serbia
  • Mirko Glišić Clinic of Oral Surgery, Faculty of Dentistry Pristina , Kosovska Mitrovic, Serbia
DOI: https://doi.org/10.2298/VSP141208041M
Ključne reči: dental implants||, ||implanti, stomatološki, irrigation||, ||lavaža, temperature||, ||temperatura, bone and bones||, ||kost, stents||, ||stentovi,

Sažetak


Uvod/Cilj. Tokom preparacije ležišta za implantat mehanička energija pretvara se u toplotnu, što dovodi do prolaznog povišenja temperature okolne kosti. Temperatura od 47°C tokom više od jednog minuta narušava oseointegraciju, mehaničke osobine lokalne kosti i može dovesti do ranog neuspeha implantata. Cilj ove in vitro studije bio je da se ispita uticaj hirurškog stenta i temperature irigansa na termičke promene u kosti tokom preparacije ležišta za implantat, kao i uticaj temperature irigansa na temperaturu hirurškog stenta. Metode. Ukupno 48 uzoraka dobijenih od goveđih rebara bilo je podeljeno metodom slučajnog izbora u četiri grupe prema 2 ´ 2 faktorskom dizajnu: prisustvo hirurškog stenta (da/ne) i temperatura fiziološkog rastvora (25°C/5°C). Temperatura je merena infracrvenom termografijom u realnom vremenu. Primarni ishod bio je promena temperature kosti tokom preparacije ležišta implantata merena na tri dubine ležišta, a sekundarni ishod promena temperature hirurškog stenta. Podaci su analizirani Bruner-Langer neparametrijskom analizom i Vilkoksonovim testom. Rezultati. Uticaj hirurškog stenta na promenu temperature kosti bio je značajan na ulazu u ležište za implantat, dok je uticaj temperature irigansa bio značajan na svim dubinama ležišta (p < 0,001). Međusobni uticaj ispitivanih faktora nije bio značajan (p > 0,05). Upotreba hirurškog stenta i ispiranje fiziološkim rastvorom temperature 25°C bili su praćeni najvišim porastom temperature kosti. Porast temperature hirurškog stenta bio je značajno viši kada je korišćeno ispiranje na temperaturi od 25°C (p < 0,001). Zaključak. Tokom kontrolisane preparacije ležišta za implantat došlo je do većeg zagrevanja kosti u poređenju sa standardnom preparacijom, ne premašujući temperaturu kritičnu za termičku nekrozu kosti. Iako ispiranje na sobnoj temperaturi obezbeđuje dovoljno hlađenja kosti tokom preparacije ležišta za implantat, ohlađeni rastvor za ispiranje je efikasniji bez obzira na primenu hirurškog stenta.

Reference

Ercoli C, Funkenbusch PD, Lee H, Moss ME, Graser GN. The in-fluence of drill wear on cutting efficiency and heat production during osteotomy preparation for dental implants: a study of drill durability. Int J Oral Maxillofac Implants 2004; 19(3): 335−49.

Abouzgia MB, James DF. Temperature rise during drilling through bone. Int J Oral Maxillofac Implants 1997; 12(3): 342−53.

Eriksson AR, Albrektsson T. Temperature threshold levels for heat-induced bone tissue injury: a vital-microscopic study in the rabbit. J Prosthet Dent 1983; 50(1): 101−7.

Borchers RE, Gibson LJ, Burchardt H, Hayes WC. Effects of se-lected thermal variables on the mechanical properties of trabe-cular bone. Biomaterials 1995; 16(7): 545−51.

Jo K, Yoon K, Park K, Bae J, You K, Han J, Cheong J. Thermally induced bone necrosis during implant surgery: 3 case reports. J Korean Assoc Oral Maxillofac Surg 2011; 37(5): 406−14.

Piattelli A, Piattelli M, Mangano C, Scarano A. A histologic evalu-ation of eight cases of failed dental implants: is bone overheat-ing the most probable cause. Biomaterials 1998; 19(7−9): 683−90.

Ganz SD. Presurgical planning with CT-derived fabrication of surgical guides. J Oral Maxillofac Surg 2005; 63(9 Suppl 2): 59−71.

Misir A, Sumer M, Yenisey M, Ergioglu E. Effect of surgical drill guide on heat generated from implant drilling. J Oral Maxillo-fac Surg 2009; 67(12): 2663−8.

Migliorati M, Amorfini L, Signori A, Barberis F, Biavati AS, Benedi-centi S. Internal Bone Temperature Change During Guided Surgery Preparations for Dental Implants: An In Vitro Study. Int J Oral Maxillofac Implants 2013; 28(6): 1464−9.

dos Santos PL, Queiroz TP, Margonar R, de Souza CA, Betoni W, Rezende RR, et al. Evaluation of bone heating, drill deformation, and drill roughness after implant osteotomy: guided surgery and classic drilling procedure. Int J Oral Maxillofac Implants 2014; 29(1): 51−8.

Bulloch SE, Olsen RG, Bulloch B. Comparison of heat generation between internally guided (cannulated) single drill and tradi-tional sequential drilling with and without a drill guide for den-tal implants. Int J Oral Maxillofac Implants 2012; 27(6): 1456−60.

Mishra SK, Chowdhary R. Heat generated by dental implant drills during osteotomy-a review: heat generated by dental implant drills. J Indian Prosthodont Soc 2014; 14(2): 131−43.

Lundskog J. Heat and bone tissue. An experimental investiga-tion of the thermal properties of bone and threshold levels for thermal injury. Scand J Plast Reconstr Surg 1972; 9: 1−80.

Al-Dabag AN. Effect of Cooling an Irrigation Solution During Preparation of Implant Site on Heat Generation Using Elite System for implant. (Experimental Study). Al-Rafidain Dent J 2010; 10(2): 260−4.

Sener BC, Dergin G, Gursoy B, Kelesoglu E, Slih I. Effects of irriga-tion temperature on heat control in vitro at different drilling depths. Clin Oral Implants Res 2009; 20(3): 294−8.

Marković A, Mišić T, Miličić B, Calvo-Guirado JL, Aleksić Z, Ðinić A. Heat generation during implant placement in low-density bone: effect of surgical technique, insertion torque and implant macro design. Clin Oral Implants Res 2013; 24(7): 798−805.

Sedlin ED, Hirsch C. Factors affecting the determination of the physical properties of femoral cortical bone. Acta Orthop Scand 1966; 37(1): 29−48.

Marković A, Mišić T, Mančić D, Jovanović I, Šćepanović M, Jezdić Z. Real-time thermographic analysis of low-density bone during implant placement: a randomized parallel-group clinical study comparing lateral condensation with bone drilling surgical technique. Clin Oral Implants Res 2014; 25(8): 910−8.

Matthews LS, Hirsch C. Temperatures measured in human cor-tical bone when drilling. J Bone Joint Surg Am 1972; 54(2): 297−308.

Kondo S, Okada Y, Iseki H, Hori T, Takakura K, Kobayashi A, et al. Thermological study of drilling bone tissue with a high-speed drill. Neurosurgery 2000; 46(5): 1162−8.

Isler SC, Cansiz E, Tanyel C, Soluk M, Selvi F, Cebi Z. The effect of irrigation temperature on bone healing. Int J Med Sci 2011; 8(8): 704−8.

Tehemar SH. Factors affecting heat generation during implant site preparation: a review of biologic observations and future considerations. Int J Oral Maxillofac Implants 1999; 14(1): 127−36.

Objavljeno
2017/03/03
Broj časopisa
Vol. 73 Br. 8 (2016)
Rubrika
Originalni članak