Search

Background/Aim. During drilling implant sites, mechanical energy is converted into thermal one resulting in transient rise in temperature of surrounding bone. The temperature of 47°C exeeding one minute impairs osseointegration, compromises mechanical properties of the local bone and could cause early implant failure. This in vitro study aimed to assess the effect of surgical drill guide and temperature of irrigans on thermal changes of the local bone during drilling implant sites, and to test the influence of irrigans temperature on the temperature of surgical drill guide. Methods. A total of 48 specimens obtained from bovine ribs were randomly allocated to four experimental conditions according to the 2 x 2 factorial design: drill guide (with or without) and saline (at 25°C or 5°C). Real-time infrared thermography was used as a method for temperature measurement. The primary outcome was bone temperature change during drilling implant sites measured at 3 osteotomy depths, whereas the second one was change in the temperature of the drill guide. Data were analyzed by Brunner and Langer nonparametric analysis and Wilcoxon test. Results. The effect of drill guide on the changes of bone temperature was significant at the entrance of osteotomy, whereas the effect of saline temperature was significant at all osteotomy levels (p lt 0.001). No significant interaction was found (p > 0.05). Guided surgery and irrigation with saline at 25°C were associated with the highest bone temperature increase. Increase in drill guide temperature was significantly higher when saline at 25°C was used (p lt 0.001). Conclusion. Guided implant site preparation generates higher temperature of the local bone than conventional drilling, not exceeding the threshold for thermal bone necrosis. Although saline at room temperature provides sufficient heat control during drilling, cooled saline is more effective regardless the use of surgical drill guide., 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 x 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 promenutemperature kosti bio je značajan na ulazu u ležište za implantat, dok je uticaj temperature irigansa bio značajan na svim dubinama ležišta (p lt 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 lt 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.