Journal of Oral Implantology April 2014 - (Page 174)

RESEARCH Heat Generated During Seating of Dental Implant Fixtures Dennis Flanagan, DDS* Frictional heat can be generated during seating of dental implants into a drill-prepared osteotomy. This in vitro study tested the heat generated by implant seating in dense bovine mandible ramus. A thermocouple was placed approximately 0.5 mm from the rim of the osteotomy during seating of each dental implant. Four diameters of implants were tested. The average temperature increases were 0.0758C for the 5.7-mm-diameter implant, 0.978C for the 4.7-mm-diameter implant, 1.48C for the 3.7-mm-diameter implant, and 8.68C for the 2.5mm-diameter implant. The results showed that heat was indeed generated and a small temperature rise occurred, apparently by the friction of the implant surface against the fresh-cut bone surface. Bone is a poor thermal conductor. The titanium of the implant and the steel of the handpiece are much better heat conductors. Titanium may be 70 times more heat conductive than bone. The larger diameter and displacement implant may act as a heat sink to draw away any heat produced from the friction of seating the implant at the bone-implant interface. The peak temperature duration was momentary, and not measured, but this was approximately less than 1 second. Except for the 2.5-mm-diameter implants, the temperature rises and durations were found to be below those previously deemed to be detrimental, so no clinically significant osseous damage would be expected during dental implant fixture seating of standard and large-diameter-sized implants. A 2.5-mm implant may generate detrimental heat during seating in nonvital bone, but this may be clinically insignificant in vital bone. The surface area and thermal conductivity are important factors in removing generated heat transfer at the bone-implant interface. The F value as determined by analysis of variance was 69.22, and the P value was less than .0001, demonstrating significant differences between the groups considered as a whole. Key Words: dental implant, friction, compression, bone, heat, thermal, screw rotation, osteotomy, temperature INTRODUCTION I rrigation to address heat generated by the dental implant osteotomy drill is a highly controversial topic. Many clinicians do not use sterile water or saline irrigation to cool the implant drill with no detrimental outcomes.1 However, there may be another source of heat generation that may have been overlooked by clinicians, that is, frictional heat generated during implant fixture seating into the osteotomy. The implant osteotomy is generally 0.5 mm smaller in diameter than the definitive implant that is placed in the osteotomy. This undersizing is done to ensure that the implant is mechanically secure in the bone to prevent any micro movement that may Private practice, Willimantic, Conn * Corresponding author, e-mail: dffdds@comcast.net DOI: 10.1563/AAID-JOI-D-13-00261 174 Vol. XL /No. Two /2014 disturb or prevent osseointegration during healing.2 During placement of the implant fixture, there may be heat generated due to the friction of the implant fixture against the fresh-cut bone. The magnitude and time duration for causation of any detrimental osteotomy heat are uncertain. Most heat-generation studies on this were done on osteotomies and in vitro or on lower animals in nondental implant circumstances.3 Bone has a thermal conductivity between lowconducting subcutaneous fat and high-conducting muscle.4 This relatively low-to-moderate thermal conductivity property may cause the bone to retain generated heat and induce osseous necrosis.4 This also causes bone to not readily absorb heat. The purpose of this study was to determine what heat magnitude may be generated during dental implant fixture seating into the osteotomy. The null hypothesis was that there is no heat

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2014

Consolidated Standards of Reporting Trials (CONSORT): Answering the Call for JOI’s Endorsement
Photoelastic Analysis of Stress Distribution With Different Implant Systems
Influence of Abutment Screw Design and Surface Coating on the Bending Flexural Strength of the Implant Set
Comparison of Implant-Abutment Interface Misfits After Casting and Soldering Procedures
Evaluation of Accuracy of Casts of Multiple Internal Connection Implant Prosthesis Obtained From Different Impression Materials and Techniques: An In Vitro Study
The Effect of Different Implant-Abutment Connections on Screw Joint Stability
Effects of pH and Elevated Glucose Levels on the Electrochemical Behavior of Dental Implants
Finite Element Analysis of Provisional Structures of Implant-Supported Complete Prostheses
Saliva Versus Peri-implant Inflammation: Quantification of IL-1b in Partially and Totally Edentulous Patients
Heat Generated During Seating of Dental Implant Fixtures
An Alternative Approach for Augmenting the Anterior Maxilla Using Autogenous Free Gingival Bone Graft for Implant Retained Prosthesis
Nasopalatine Duct Cyst, a Delayed Complication to Successful Dental Implant Placement: Diagnosis and Surgical Management
The Custom Endosteal Implant: Histology and Case Report of a Retrieved Maxillary Custom Osseous-Integrated Implant Nine Years in Service
Occlusal Concepts Application in Resolving Implant Prosthetic Failure: Case Report
Three-Year Follow-Up of a Single Immediate Implant Placed in an Infected Area: A New Approach for Harvesting Autogenous Symphysis Graft
Use of Stress Analysis Methods to Evaluate the Biomechanics of Oral Rehabilitation With Implants

Journal of Oral Implantology April 2014