Optimizing Osseodensification Drilling for Dental Implant Placement: An In Vitro Study

IF 2.2 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Xingru Tao, Jie Yang, Tai Ma, Ming Chen, Qinglong An, Dedong Yu
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Abstract

Objectives

This study aims to optimize the parameters of osseodensification drilling (OD) to improve the primary stability of dental implants in low-density bone.

Material and Methods

Polyurethane foam blocks (PFB) of 0.160 g/cm3 were used to simulate low-density bone (Type IV bone). Two drills, i.e., bone level tapered drills and Densah drills, were used in conventional drilling (CD) and OD, respectively. Drilling was performed on a DMU machine, varying spin speed, feed per tooth, and irrigation with or without 4°C saline. Thrust force, temperature, and entrance characteristics of implant sites in CD and OD were compared. The primary stability of implants was assessed via insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ).

Results

OD demonstrated higher thrust force than CD with maximum values at 300 rpm (2.99 ± 0.22 N vs. 2.77 ± 0.17 N, p < 0.01). Temperature elevation was lower in OD than that in CD under irrigation (3.35°C vs. 4.67°C). Despite comparable ISQ values (CD: 46.71 ± 8.56 vs OD: 47.08 ± 5.95, p = 0.86), OD achieved higher IT (11.73 ± 0.45 N·m vs. 7.77 ± 0.21 N·m, p < 0.001) and higher RT (9.28 ± 0.45 N·m vs. 6.65 ± 0.19 N·m, p < 0.001). Morphological analysis revealed fewer defects (tears/potholes) in OD than CD.

Conclusions

OD drills may avoid iatrogenic damage of the morphology of implant sites and enhance primary stability in Type IV bone at 1500 rpm and 0.04 mm/z with irrigation to prevent thermal damage. OD also outweights CD in increased bone density, thrust force, and torque.

Clinical Implications

For Type IV alveolar bone, OD at 1500 rpm and 0.04 mm/z is recommended for improving he primary stability of dental implants. Sufficient irrigation is crucial in both CD and OD for circumventing the thermal damage to bone.

Abstract Image

优化牙种植体骨密度钻孔:一项体外研究
目的优化骨密度钻孔工艺参数,提高低密度骨种植体的初代稳定性。材料与方法采用0.160 g/cm3的聚氨酯泡沫块(PFB)模拟低密度骨(IV型骨)。常规钻孔(CD)和OD分别使用两种钻头,即骨水平锥度钻头和Densah钻头。在DMU机器上进行钻孔,改变旋转速度,每牙进给量,用或不用4°C盐水冲洗。比较CD组和OD组种植体的推力、温度和入口特性。通过插入扭矩(IT)、移除扭矩(RT)和种植体稳定商(ISQ)评估种植体的初级稳定性。结果外径推力大于内径推力,在300 rpm时最大(2.99±0.22 N vs. 2.77±0.17 N, p < 0.01)。灌溉条件下OD的温度升高比CD低(3.35°C比4.67°C)。尽管可比ISQ值(CD: 46.71±8.56 vs OD: 47.08±5.95,p = 0.86), OD达到更高的(11.73±0.45 N·m和7.77±0.21 N·m p & lt; 0.001)和更高的RT(9.28±0.45 N·m和6.65±0.19 N·m p & lt; 0.001)。形态学分析显示,与CD相比,OD钻孔可以避免医源性种植体部位形态学损伤,并增强IV型骨在1500 rpm和0.04 mm/z速度下的初级稳定性,以防止热损伤。外径在增加骨密度、推力和扭矩方面也优于内径。对于IV型牙槽骨,推荐使用1500 rpm和0.04 mm/z的OD来改善种植牙的初级稳定性。充分的灌洗对CD和OD都是至关重要的,以避免骨热损伤。
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来源期刊
Clinical and Experimental Dental Research
Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.30
自引率
5.60%
发文量
165
审稿时长
26 weeks
期刊介绍: Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.
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