Introduction: Guided implant surgery is becoming more prevalent among clinicians and is crucial for cases in which there are concerns about the proximity of the implant to vital anatomical structures, esthetic concerns, and the amount/quality of bone available. Surgical guides help with the angulation and positioning of the implant through the use of a CBCT scan and digital intraoral impression. However, there are some drawbacks with guided surgery. Heat that is generated during the osteotomy is one of the issues that has been of concern. The guide acts as a shield against the water irrigation from reaching the osteotomy site where the water acts as a cooling agent. The concern is that the guide will not allow proper water to flow and that the extra heat that is generated will have a deleterious effect on the bone.

Purpose: This study was conducted to evaluate and compare the heat generated during the initial pilot drilling for surgical guides versus free-hand implant surgery.

Materials and Methods: Blocks of approximately 35 x 18 mm bovine rib bone were used to replicate the human mandible. Alginate impressions were taken of the bone samples in order to get stone models of the bone. Then a light-cured resin material was used in order to fabricate the surgical guide. The surgical guides were planned to have initial, pilot guide holes for the implant drills. There were two groups that were tested with either a surgical guide or with a freehand surgical method. Real time temperature measurements were recorded directly before and after the drilling by a second operator. The depth of the drilling was done to approximately 8-10 mm from the base of the surgical guides. 50 temperature readings were recorded for both groups by a second operator.

Results: The results showed a mean temperature change of -1.27 ± (0.75) for the guided group and 1.37 ± (0.85) for the non-guided group. An independent t-test showed no significant difference with p=0.55 (Table 1). A one-way analysis of variance analysis (ANOVA) was done to test the mean temperature change between bone blocks used. No significant difference existed with a p=0.86 (Table 3, Figure 4).

Conclusion: There was not a statistically significant temperature change when comparing the guided and non-guided groups. It can be concluded from this study that with proper irrigation, there is not a significant temperature change when comparing using a guide and not using a guide for the initial pilot drill.

LLU Discipline





School of Dentistry

First Advisor

Erik Sahl

Second Advisor

Yoon Jeong Kim

Third Advisor

Mario Flores

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Osteotomy -- methods; Dental implants



Page Count

ix, 16 p.

Digital Format


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.


Loma Linda University Electronic Theses and Dissertations

Collection Website



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