Heat Generated by Dental Implant Drills During Osteotomy—A Review

AbstractStatement of problem: Osseointegration is the more stable situation and results in a high success rate of dental implants. Heat generation during rotary cutting is one of the important factors influencing the development of osseointegration. Purpose: To assess the various factors related to implant drills responsible for heat generation during osteotomy. Materials and Methods: To identify suitable literature, an electronic search was performed using Medline and Pubmed database. Articles published in between 1960 to February 2013 were searched. The search is focused on heat generated by dental implant drills during osteotomy. Various factors related to implant drill such effect of number of blades; drill design, drill fatigue, drill speed and force applied during osteotomies which were responsible for heat generation were reviewed. Titles and abstracts were screened, and literature that fulfilled the inclusion criteria was selected for a full-text reading. Results: The initial literature search resulted in 299 articles out of which only 70 articles fulfils the inclusion criteria and were included in this systematic review. Many factors related to implant drill responsible for heat generation were found. Successful preparation of an implant cavity with minimal damage to the surrounding bone depends on the avoidance of excessive temperature generation during surgical drilling. Conclusion: The relationship between heat generated and implant drilling osteotomy is multifactorial in nature and its complexity has not been fully studied. Lack of scientific knowledge regarding this issue still exists. Further studies should be conducted to determine the various factors which generate less heat while osteotomy such as ideal ratio of force and speed in vivo, exact time to replace a drill, ideal drill design, irrigation system, drill-bone contact area.

[1]  P Tetsch,et al.  Development of raised temperature after osteotomies. , 1974, Journal of maxillofacial surgery.

[2]  David B. Jones,et al.  The influence of mechanical stimulation on osteocyte apoptosis and bone viability in human trabecular bone. , 2006, Journal of musculoskeletal & neuronal interactions.

[3]  F. W. Rhinelander The normal circulation of bone and its response to surgical intervention. , 1974, Journal of biomedical materials research.

[4]  I. Garcia,et al.  Evaluation of bone heating, immediate bone cell viability, and wear of high-resistance drills after the creation of implant osteotomies in rabbit tibias. , 2011, The International journal of oral & maxillofacial implants.

[5]  S. Khosla,et al.  Minireview: the OPG/RANKL/RANK system. , 2001, Endocrinology.

[6]  K. Schlegel,et al.  Expression of bone matrix proteins during de novo bone formation using a bovine collagen and platelet-rich plasma (prp)--an immunohistochemical analysis. , 2005, Biomaterials.

[7]  Tomas Albrektsson,et al.  Measurements of shaft speed while drilling through bone , 1995 .

[8]  H. Zwipp,et al.  Osteocalcin enhances bone remodeling around hydroxyapatite/collagen composites. , 2005, Journal of biomedical materials research. Part A.

[9]  Abouzgia Mb,et al.  Temperature rise during drilling through bone. , 1997 .

[10]  R. Eastell,et al.  Circulating osteoprotegerin and receptor activator for nuclear factor kappaB ligand: clinical utility in metabolic bone disease assessment. , 2005, The Journal of clinical endocrinology and metabolism.

[11]  G Watzek,et al.  Effects of drill cooling and bone structure on IMZ implant fixation. , 1993, The International journal of oral & maxillofacial implants.

[12]  Arthur T. Johnson Biological process engineering : an analogical approach to fluid flow, heat transfer, and mass transfer applied to biological systems , 1998 .

[13]  Z Majzoub,et al.  Heat generation during implant site preparation: an in vitro study. , 1997, The International journal of oral & maxillofacial implants.

[14]  P. Lamey,et al.  Thermal changes observed at implant sites during internal and external irrigation. , 2002, Clinical oral implants research.

[15]  S. Ahmed,et al.  Biology and clinical applications , 2004 .

[16]  J Lundskog,et al.  Heat and bone tissue. An experimental investigation of the thermal properties of bone and threshold levels for thermal injury. , 1972, Scandinavian journal of plastic and reconstructive surgery.

[17]  S. Morony,et al.  osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification. , 1998, Genes & development.

[18]  Franchi Marco,et al.  Peri-implant osteogenesis in health and osteoporosis. , 2005, Micron.

[19]  R. Vanderby,et al.  Ultrasonic wave velocity measurement in small polymeric and cortical bone specimens. , 1997, Journal of biomechanical engineering.

[20]  M. Yenísey,et al.  Effect of surgical drill guide on heat generated from implant drilling. , 2009, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[21]  H. C. Thompson,et al.  Effect of drilling into bone. , 1958, Journal of oral surgery.

[22]  P. Fielder,et al.  Implants: Bone physiology and metabolism. , 1987, CDA journal.

[23]  Tomas Albrektsson,et al.  Thermal injury to bone , 1982 .

[24]  Edwin A McGlumphy,et al.  Heat production by 3 implant drill systems after repeated drilling and sterilization. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[25]  C. Lavelle,et al.  Effect of internal irrigation on frictional heat generated from bone drilling. , 1980, Journal of oral surgery.

[26]  Jay R Lieberman,et al.  The role of growth factors in the repair of bone. Biology and clinical applications. , 2002, The Journal of bone and joint surgery. American volume.

[27]  H. H. Ryffel Machinery's Handbook , 1984 .

[28]  T Albrektsson,et al.  Assessment of bone viability after heat trauma. A histological, histochemical and vital microscopic study in the rabbit. , 1984, Scandinavian journal of plastic and reconstructive surgery.

[29]  U. Lekholm Clinical procedures for treatment with osseointegrated dental implants. , 1983, The Journal of prosthetic dentistry.

[30]  S. Iyer,et al.  Effects of drill speed on heat production and the rate and quality of bone formation in dental implant osteotomies. Part I: Relationship between drill speed and heat production. , 1997, The International journal of prosthodontics.

[31]  S. Iyer,et al.  Effects of drill speed on heat production and the rate and quality of bone formation in dental implant osteotomies. Part II: Relationship between drill speed and healing. , 1997, The International journal of prosthodontics.

[32]  M. Yenísey,et al.  Comparison of heat generation during implant drilling using stainless steel and ceramic drills. , 2011, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[33]  F G PALLAN,et al.  Histological changes in bone after insertdon of skeletal fixation pins. , 1960, Journal of oral surgery, anesthesia, and hospital dental service.

[34]  M. Klein,et al.  The effect of irrigation on osteotomy depth and bur diameter. , 1996, The International journal of oral & maxillofacial implants.

[35]  A Scarano,et al.  Effects of Bur Wear during Implant Site Preparation: An in Vitro Study , 2007, International journal of immunopathology and pharmacology.

[36]  Reid Js,et al.  Thermally induced bone necrosis in rabbits. Relation to implant failure in humans. , 1984 .

[37]  Hyun Jun Oh,et al.  Effect of implant drill characteristics on heat generation in osteotomy sites: a pilot study. , 2011, Clinical oral implants research.

[38]  T Albrektsson,et al.  Thermal injury to bone. A vital-microscopic description of heat effects. , 1982, International journal of oral surgery.

[39]  R. Jinnah,et al.  The biology of bone grafting. , 1991, Orthopedics.

[40]  J. Ko,et al.  Osteoprotegerin is present on the membrane of osteoclasts isolated from mouse long bones , 2002, Experimental & Molecular Medicine.

[41]  George A. Zarb,et al.  Introduction to osseointegration in clinical dentistry , 1983 .

[42]  H. Zwipp,et al.  Coating of titanium implants with type‐I collagen , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[43]  Rafel Ss Temperature changes during high-speed drilling on bone. , 1962 .

[44]  S. Szmukler‐Moncler,et al.  Influence of different parameters on bone heating and drilling time in implantology. , 1997, Clinical oral implants research.

[45]  F. Bauss,et al.  The bisphosphonate ibandronate accelerates osseointegration of hydroxyapatite-coated cementless implants in an animal model , 2007, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[46]  H. F. Morris,et al.  SECOND‐STAGE FAILURES RELATED TO BONE QUALITY IN PATIENTS RECEIVING ENDOSSEOUS DENTAL IMPLANTS: DICRG INTERIM REPORT No. 7 , 1994, Implant dentistry.

[47]  K. Søballe,et al.  Hydroxyapatite ceramic coating for bone implant fixation. Mechanical and histological studies in dogs. , 1993, Acta orthopaedica Scandinavica. Supplementum.

[48]  L. Bonewald,et al.  Osteocytes: a proposed multifunctional bone cell. , 2002, Journal of musculoskeletal & neuronal interactions.

[49]  Jan Lundskog,et al.  Oxygen consumption by granulation tissue in bipedicle tube flaps. , 1975 .

[50]  S H Tehemar,et al.  Factors affecting heat generation during implant site preparation: a review of biologic observations and future considerations. , 1999, The International journal of oral & maxillofacial implants.

[51]  Brisman Dl,et al.  The effect of speed, pressure, and time on bone temperature during the drilling of implant sites. , 1996 .

[52]  J A Hobkirk,et al.  Investigation of variable factors in drilling bone. , 1977, Journal of oral surgery.

[53]  T Albrektsson,et al.  Temperature threshold levels for heat-induced bone tissue injury: a vital-microscopic study in the rabbit. , 1983, The Journal of prosthetic dentistry.

[54]  Han-Joo Lee,et al.  The influence of drill wear on cutting efficiency and heat production during osteotomy preparation for dental implants: a study of drill durability. , 2004, The International journal of oral & maxillofacial implants.

[55]  X. Guo,et al.  Osteocyte Viability and Regulation of Osteoblast Function in a 3D Trabecular Bone Explant Under Dynamic Hydrostatic Pressure , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[56]  Carl E Misch,et al.  Heat generation during implant drilling: the significance of motor speed. , 2002, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[57]  P. Branemark Osseointegration and its experimental background. , 1983, The Journal of prosthetic dentistry.

[58]  P. Branemark,et al.  Introduction to osseointegration , 1985 .

[59]  L. S. Matthews,et al.  Temperatures measured in human cortical bone when drilling. , 1972, The Journal of bone and joint surgery. American volume.

[60]  G. Krekeler,et al.  Atraumatic surgical technique and implant bed preparation. , 1992, Quintessence international.

[61]  R M Jochum,et al.  Influence of multiple use of Timedur-titanium cannon drills: thermal response and scanning electron microscopic findings. , 2000, Clinical oral implants research.

[62]  F Watanabe,et al.  Heat distribution in bone during preparation of implant sites: heat analysis by real-time thermography. , 1992, The International journal of oral & maxillofacial implants.

[63]  D. F. James,et al.  Temperature rise during drilling through bone. , 1997, The International journal of oral & maxillofacial implants.

[64]  R Huiskes,et al.  Some fundamental aspects of human joint replacement. Analyses of stresses and heat conduction in bone-prosthesis structures. , 1980, Acta orthopaedica Scandinavica. Supplementum.

[65]  M. B. Abouzgia,et al.  Effect of drill speed on bone temperature. , 1996, International journal of oral and maxillofacial surgery.

[66]  Pallan Fg,et al.  Histological changes in bone after insertdon of skeletal fixation pins. , 1960 .

[67]  M. Swain,et al.  Descriptive study of the longevity of dental implant surgery drills. , 2011, Clinical implant dentistry and related research.

[68]  T. Takano-Yamamoto,et al.  Molecular events caused by mechanical stress in bone. , 2000, Matrix biology : journal of the International Society for Matrix Biology.

[69]  H. Zreiqat,et al.  Factors regulating osteoclast formation in human tissues adjacent to peri-implant bone loss: expression of receptor activator NFkappaB, RANK ligand and osteoprotegerin. , 2004, Biomaterials.

[70]  S. Kohles,et al.  Effects of mechanical and thermal fatigue on dental drill performance. , 2001, The International journal of oral & maxillofacial implants.

[71]  R. Adell,et al.  Temperatures during drilling for the placement of implants using the osseointegration technique. , 1986, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[72]  R. Serakides,et al.  Técnica histoquímica aplicada ao tecido ósseo desmineralizado e parafinado para o estudo do osteócito e suas conexões , 2006 .

[73]  Mustafa B. Abouzgia,et al.  Measurements of shaft speed while drilling through bone , 1995 .

[74]  T Albrektsson,et al.  The effect of heat on bone regeneration: an experimental study in the rabbit using the bone growth chamber. , 1984, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[75]  M. Yoshinari,et al.  In vitro study of collagen coating of titanium implants for initial cell attachment. , 2002, Dental materials journal.

[76]  P I Brånemark,et al.  A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. , 1981, International journal of oral surgery.

[77]  G Boivin,et al.  Osseointegration of metallic implants. II. Transmission electron microscopy in the rabbit. , 1989, Acta orthopaedica Scandinavica.

[78]  E. Keleşoğlu,et al.  Effects of irrigation temperature on heat control in vitro at different drilling depths. , 2009, Clinical oral implants research.