Abstract

Purpose: This study was conducted to evaluate heat generated during the implantoplasty procedure by comparing the heat generated using either a carbide or diamond round bur. Materials and Methods: Bovine ribs were selected as the osseous model for this study. Changes in temperature were measured using a digital thermometer (Extech SDL200 four channel thermometer, Extech instruments, Melrose MA). Ther k-thermocouples were positioned within the implant screw access, apex of the implant, and crestal bone adjacent to the implant and ambient air. 5 bovine rib bone blocks were prepared by place 5 cylindrical titanium grade 5 alloy large grit sand blasted acid etch (SLA) non-self tapping implants (Sydent Astral 4.2x10mm) into the prepared osteotomies with an insertion torque of 30Ncm. Implants were placed in a final position of 6mm depth leaving 4mm of surface treated implant threads exposed above the crest of bone. A total of 25 implants were placed in 5 bone models. Implantoplasty was performed using an electric high-speed rotary handpiece (Bien Air, 200,000rpm) with a carbide and diamond round bur (Brassler 8 FG surg carbide and Brassler FG surg course diamond). Each implant was divided in half along its long axis. On one half of the implant, group 1, the implantoplasty was performed with a new carbide round bur using constant irrigation of 23°C. In group 2, implantoplasty was performed on the remaining half of the implant using a new course grit diamond bur. Implantoplasty was considered complete once all the exposed implant threads and SLA treated surface was removed. Using IBM SPS 26 (Armonk, New York, United states), descriptive statistics including mean and standard deviation were calculated. A paired t-test and one-way ANOVA test was used evaluate results. Results: In group 1, a mean change of temperature inside the screw access of ix 2.06°C with a standard deviation (SD) of ± 8.71°C, crestal bone adjacent to the implant had a mean change of -6.10 ± 3.19°C SD, and the apex of the implant had a mean change of -0.67 ± 0.34°C. For group 2, implantoplasty resulted in a mean change in temperature inside the screw access of 19.06 ± 11.38°C, crestal bone adjacent to the implant had a mean change of -3.56 ± 2.61°C, and the apex of the implant had a mean change of -0.55 ± 0.66°C. Mean difference between group 1 and group 2 of 16.99 ± 14.09°C inside the screw access, a mean difference 2.53 ± 4.25°C in the crestal bone adjacent to the implant, and a mean difference of 0.12 ± 0.68°C SD at the apex of the implant. A statistically significant increase in temperature was observed in the crestal bone adjacent to the implant and within the screw implant when implantoplasty was performed using a diamond round bur at a p-value < 0.01. No statistically significant difference was found at the apex of the implant in either carbide or diamond group with p-value = 0.38. Temperature was highest within the implant during implantoplasty. The peak temperature within the implant of both groups are illustrated in figure 3. In the carbide group, the mean peak temperature difference -3.04 ± 5.74°C while in the diamond group the mean was 4.91 ± 10.02°C (table 2). The temperature increase within the implant was statistically significantly greater in the diamond group with a mean of 8.32 ± 11.91°C at p-value <0.0. The time to reach peak temperature was measured within the implant screw access. The mean time to peak temperature was 20.48± 8.36 seconds for the diamond group and 19.96± 5.25 seconds for the carbide group. There was no statistical significant difference between groups for time to peak temperature within the implant screw access. Conclusion: A statistical significant increase in temperature was observed within the implant screw access and crestal bone adjacent to the implant when implantoplasty was performed with a diamond bur. No significant change in temperature was observed at the apex of the implant in either the carbide or diamond group. From this study, it was concluded that implantoplasty is performed using constant irrigation results in minimal increase in bone temperature. The cooling effect of constant irrigation is adequate to prevent the transfer of heat into the bone that could raise bone temperature to a critical level resulting in bone necrosis. When diamond burs were used to perform implantoplasty there was significantly more heat produced than carbide burs but neither resulted in a critical increase in bone temperature. It is concluded that when implantoplasty is best performed using constant irrigation and a carbide round bur to minimize heat production and reduce risk to the adjacent peri-implant bone.

LLU Discipline

Periodontics

Department

Periodontics

School

School of Dentistry

First Advisor

Erik Sahl

Second Advisor

Yoon Jeong Kim

Third Advisor

Mario Flores

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

2020

Date (Title Page)

5-2020

Language

English

Library of Congress/MESH Subject Headings

PERI-implantitis; Dental implants; Diamond; Materials Testing

Type

Thesis

Page Count

21 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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