Heat generation during implant placement in low-density bone: effect of surgical technique, insertion torque and implant macro design

Clin Oral Implants Res. 2013 Jul;24(7):798-805. doi: 10.1111/j.1600-0501.2012.02460.x. Epub 2012 Apr 2.

Abstract

Objectives: The study aimed to investigate the effect of surgical technique, implant macrodesign and insertion torque on bone temperature changes during implant placement.

Material and methods: In the in vitro study, 144 self-tapping (blueSKY(®) 4 × 10 mm; Bredent) and 144 non-self-tapping (Standard implant(®) 4.1 × 10 mm; Straumann) were placed in osteotomies prepared in pig ribs by lateral bone condensing or bone drilling techniques. The maximum insertion torque values of 30, 35 and 40 Ncm were used. Real-time bone temperature measurement during implant placement was performed by three thermocouples positioned vertically, in tripod configuration around every osteotomy, at a distance of 5 mm from it and at depths of 1, 5 and 10 mm. Data were analysed using Kruskal-Wallis, Mann-Whitney U-tests and Regression analysis.

Results: Significant predictor of bone temperature at the osteotomy depth of 1 mm was insertion torque (P = 0.003) and at the depth of 10-mm implant macrodesign (P = 0.029), while no significant predictor at depth of 5 mm was identified (P > 0.05). Higher insertion torque values as well as non-self-tapping implant macrodesign were related to higher temperatures. Implant placement in sites prepared by bone drilling induced significantly higher temperature increase (P = 0.021) compared with bone condensing sites at the depth of 5 mm, while no significant difference was recorded at other depths. Compared with 30 Ncm, insertion torque values of 35 and 40 Ncm produced significantly higher temperature increase (P = 0.005; P = 0.003, respectively) at the depth of 1 mm. There was no significant difference in temperature change induced by 35 and 40 Ncm, neither by implant macrodesign at all investigated depths (P > 0.05).

Conclusions: Placement of self-tapping implants with low insertion torque into sites prepared by lateral bone condensing technique might be advantageous in terms of thermal effect on bone.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Body Temperature / physiology*
  • Bone Density / physiology*
  • Dental Implantation, Endosseous / instrumentation
  • Dental Implantation, Endosseous / methods*
  • Dental Implants*
  • Dental Prosthesis Design*
  • Hot Temperature
  • Male
  • Models, Animal
  • Osteotomy / instrumentation
  • Osteotomy / methods
  • Random Allocation
  • Ribs / surgery
  • Swine
  • Thermometers
  • Torque

Substances

  • Dental Implants