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Thermal evaluation of pilot- and partially guided implant surgery - an in vitro study using automated robotic
Dino Tur1, Zhiwei Tian2, Katharina Giannis3
1Clinical Division of Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
Background:
Since increased heat generation with guided implant surgery (GS) especially with pilot drills has been reported in the past, standardized investigation of pilot- and partially guided preparations was attempted.
Methods:
A total of 160 automated and reproducible surgical procedures with stainless steel pilot drills of 2.0 and 2.8 mm have been performed on bovine testing samples for investigating GS vs. conventional drilling (CD). Preparations were performed in 2 preparation depths (10 / 12 mm) by using 2 cooling modes (external / without cooling). Real-time temperature measurements were conducted in 2 distances to the osteotomy site (1 / 2 mm). Temperature increase between the surgical preparation techniques was compared by a linear mixed model including all experimentally controlled variables.
Results:
Comparison of pilot drills yielded significantly lower temperatures for GS in 2.0-mm diameter for preparation depths of 10 mm (p = 0.0107) and 12 mm (p = 0.0005) with external irrigation. 2.8-mm drills exerted higher temperatures during GS and external cooling, with significant outcome in 10-mm preparation depth (p = 0.0256).
Conclusions:
Significant differences in temperature generation were obtained between pilot drills of different diameters, indicating sufficient irrigation of larger drill diameters during GS to be essential, even in sequential drilling preparations. The reported results of this investigation may be considered clinically relevant with regard to an observed impairment of cooling efficacy in larger drills during guided surgical preparations.
