In Vitro Study on Bone Heating during Drilling of the Implant Site: Material, Design and Wear of the Surgical Drill.

Abstract

Objective: 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. Material and methods: 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). Results: 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. Conclusions: 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.