The effect of guided flapless implant procedure on heat generation from implant drilling

Je-Hyeon Yoo; Seung-Mi Jeong; Byung-Ho Choi; Sang-Don Joo

doi:10.4047/jkap.2013.51.1.11

Journal List > J Korean Acad Prosthodont > v.51(1) > 1034737

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Yoo, Jeong, Choi, and Joo: The effect of guided flapless implant procedure on heat generation from implant drilling

ORIGINAL ARTICLE

J Korean Acad Prosthodont 2013;51(1):11-19.

Published online: 18 December 2013

DOI: https://doi.org/10.4047/jkap.2013.51.1.11

The effect of guided flapless implant procedure on heat generation from implant drilling

Je-Hyeon Yoo, DDS, MSD¹, Seung-Mi Jeong, DDS, PhD^2,^∗, Byung-Ho Choi, DDS, PhD², Sang-Don Joo, DDS, PhD³

^¹Department of Medicine, Graduate School of Yonsei University, Seoul, South Korea

^²Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea

^³Ye Dental Clinic, Daegu, South Korea

∗Corresponding Author: Seung-Mi Jeong Department of Dentistry, Yonsei University Wonju Medical School, 162 Ilsan-dong, Wonju, Gangwondo, 220-701, South Korea +82 33 741 1435: e-mail, smj3@yonsei.ac.kr

Received 4 October 201213 November 2012 Accepted 29 November 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to evaluate the heat generation in bone in vitro during the guided flapless drilling procedure and the effect of drilling methods on the heat generation.

Materials and methods

A model that has missing the first and second mandibular molars bilaterally was used. In group A, classical flap implant surgery was performed. In group B, flapless implant surgery using surgical guide was performed. In group C, flapless implant surgery using surgical guide without up-and-down pumping motion was performed. Temperature was measured with k-type thermocouple and a real-time digital thermometer. The thermocouples were placed at 0.5 mm away from the osteotomy area at the depths of 3 mm and 6 mm. The measured values were evaluated with independent t-test.

Results

The mean temperature generated was 27.2℃ (SD ± 2.1℃) and 27.5℃ (SD ± 2.3℃) for groups A and B, respectively. These differences were not statistically significant. In group C, the mean temperature was 37.0℃ (SD ± 3.4℃). There were statistically significant differences between groups B and C with respect to the mean temperature.

Conclusion

These findings suggest that guided flapless drilling with up-and-down pumping motion may not significantly increase the bone temperature. (J Korean Acad Prosthodont 2013;51:11-9)

Keywords: Dental implant, Flapless implant surgery, Up-and-down pumping motion, Drilling, Thermocouple, Surgical guide

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Fig. 1.

Experimental Model.

Fig. 2.

Exposure of synthetic bone on the experimental model after removing synthetic gingiva.

Fig. 3.

Radiographic stent.

Fig. 4.

Radiographic image of Cone Beam Computer Tomography with radiographic stent.

Fig. 5.

Diagnostic images of implant location using Simplant^°.

Fig. 6.

Surgical guide.

Fig. 7.

Real-time digital thermometer (Yokogawa, Tokyo, Japan).

Fig. 8.

Diagram showing the relationship between the location of thermocouples and implant drilling site. Thermocouples were located 0.5 mm away from the boundary of final implant drill (diameter 3.8 mm) and 3 mm lingual and 6 mm buccal, in depth.

Fig. 9.

Implant drilling for group A. For flap elevated group (A), implant drilling was done by opening the buccal side of the surgical guide in order for irrigation from the handpiece as well as additional extrenal (syringe) irrigation to reach the drilling site effectively.

Fig. 10.

Implant drilling for group B and C. For flapless implant groups (B and C) after the surgical guide was placed, implant drilling was carried out only using irrigation from the handpiece with and without up-and-down pumping motion, respectively.

Fig. 11.

Real-time temperature graph for group A and B.

Fig. 12.

Real-time temperature graph for group C.

Table 1.

Statistical results for group A and B

	n	Mean	Standard deviation	95% CI		P-value
	n	Mean	Standard deviation	Lower	Upper	P-value
Flap (A)	48	27.2	2.1	-0.6	1.2	.506
Flapless (B)	48	27.5	2.4	-0.6	1.2	.506

Table 2.

Statistical results for group B and C

	n	Mean	Standard deviation	95% CI		P-valu
	n	Mean	Standard deviation	Lower	Upper	P-valu
Flapless with Pumping (B)	48	27.5	2.4	-10.7	-8.3	<.001
Flapless without Pumping (C)	48	37.0	3.5	-10.7	-8.3	<.001

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