Abstract
The aim of this comparative study is to analyze the influence of drilling technique on the radiographic, thermographic, and geomorphometric effects of dental implant drills and osteotomy site preparations. One hundred and twenty osteotomy site preparations were performed on sixty epoxy resin samples using three unused dental implant drill systems and four drilling techniques performed with a random distribution into the following study groups: Group A: drilling technique performed at 800 rpm with irrigation (n = 30); Group B: drilling technique performed at 45 rpm without irrigation (n = 30); Group C: drilling technique performed at 45 rpm with irrigation (n = 30); and Group D: drilling technique performed at 800 rpm without irrigation (n = 30). The osteotomy site preparation morphologies performed by the 4.1 mm diameter dental implant drills from each study group were analyzed and compared using a cone beam computed tomography (CBCT) scan. The termographic effects generated by the 4.1 mm diameter dental implant drills from each study group were registered using a termographic digital camera and the unused and 4.1 mm diameter dental implant drills that were used 30 times from each study group were exposed to a micro computed tomography (micro-CT) analysis to obtain a Standard Tessellation Language (STL) digital files that determined the wear comparison by geomorphometry. Statistically significant differences were observed between the thermographic and radiographic results of the study groups (p < 0.001). The effect of cooling significatively reduced the heat generation during osteotomy site preparation during high-speed drilling; furthermore, osteotomy site preparation was not affected by the wear of the dental implant drills after 30 uses, regardless of the drilling technique.
Highlights
Osseointegration is a direct connection between living bone and an endosseous implant at a microscopic level [1]
The aim of this work was to analyze and compare the influence of the osteotomy technique on the radiographic, thermographic, and geomorphometric effects, with a null hypothesis (H0) stating that there will be no difference between the radiographic, thermographic, and geomorphometric results of drilling performed at 800 revolutions per minute with irrigation, drilling performed at 45 rpm without irrigation, drilling performed at 45 rpm with irrigation, and the drilling technique performed at 800 rpm without irrigation
The ANOVA revealed statistically significant differences between the radiographic results of the volume of osteotomy site preparations performed at 800 rpm with irrigation and the volume of osteotomy site preparations performed at 45 rpm without irrigation (p < 0.001), the volume of osteotomy site preparations performed at 800 rpm with irrigation, the volume of osteotomy site preparations performed at 800 rpm without irrigation (p < 0.001), the volume of osteotomy site preparations performed at 45 rpm without irrigation, and the volume of osteotomy site preparations performed at 800 rpm without irrigation (p < 0.001)
Summary
Osseointegration is a direct connection between living bone and an endosseous implant at a microscopic level [1]. Heat produced by the drilling process during osteotomy site preparation might influence the development of osseointegration as bone tissues are very sensitive to thermal injury [10]. Möhlhenrich et al reported that the sharpness of the dental implant drill is directly related to the number of times it is used, the pressure applied, sterilization technique, bone density, construction material, and surface treatment [12], and the waste of the dental implant drills could reduce their cutting capability and increase drilling time and seems to correlate with the increase in temperature [17]. Geomorphometric technique allows an accurate measurement of both surface and volumetric changes between the non-use and continued use dental implant drill. Fons-Badal et al used the geomorphometric technique to measure the volume gain after soft tissue graft surgery [21] and Zubizarreta-Macho et al used it to quantify accurately the area and volume of cement remaining and enamel removed after fixed multibracket appliance therapy debonding [22]
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