Investigation and prevention of intraosseous temperature rise in guided implant surgery: an ex-vivo study.

backgroundThis study evaluated temperature changes at implant preparation sites using a surgical guide, the effects of the cooling solution's temperature, and the impact of performing osteotomy at low speed without irrigation. The working hypothesis was that effective cooling with a low-temperature solution is essential to prevent excessive heat generation at the osteotomy site.

methodsA surgical guide was fabricated using stereolithographic technology. Temperature variations were recorded using a K-type thermocouple. On 40 sheep iliac bone specimens, four implant sites were prepared with a surgical guide as experimental groups: 2.9 mm × 8.5 mm and 2.9 mm × 13 mm representing narrow diameters, and 3.8 mm × 8.5 mm and 3.8 mm × 13 mm representing regular diameters. A 3.5 mm × 10 mm implant site prepared using the conventional method served as the control group.

resultsA statistically significant temperature increase was observed in all groups as the bur diameter increased. The temperature rise in implant sites prepared with surgical guides at high speed under irrigation was significantly higher than that observed with the conventional technique. Furthermore, the temperature elevation in the group irrigated with solution cooled to 10 °C was significantly lower than in the group irrigated with solution at 24 °C and the group subjected to low-speed drilling without irrigation.

conclusionsAppropriately applied external irrigation, tailored to patient-specific conditions, can maintain intraosseous temperatures within safe thresholds. Moreover, refraining from low-speed drilling without irrigation and employing low-temperature cooling solutions in guided surgical systems represent more reliable strategies for controlling thermal increases.