• Title/Summary/Keyword: Implant drilling

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Comparison of implant stability measurements between a resonance frequency analysis device and a modified damping capacity analysis device: an in vitro study

  • Lee, Jungwon;Pyo, Se-Wook;Cho, Hyun-Jae;An, Jung-Sub;Lee, Jae-Hyun;Koo, Ki-Tae;Lee, Yong-Moo
    • Journal of Periodontal and Implant Science
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    • v.50 no.1
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    • pp.56-66
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    • 2020
  • Purpose: A stability-measuring device that utilizes damping capacity analysis (DCA) has recently been introduced in the field of dental implantology. This study aimed to evaluate the sensitivity and reliability of this device by measuring the implant stability of ex vivo samples in comparison with a resonance frequency analysis (RFA) device. Methods: Six implant beds were prepared in porcine ribs using 3 different drilling protocols to simulate various implant stability conditions. Thirty-six pork ribs and 216 bone-level implants measuring 10 mm in height were used. The implant beds were prepared using 1 of the following 3 drilling protocols: 10-mm drilling depth with a 3.5-mm-diameter twist drill, 5-mm drilling depth with a 4.0-mm-diameter twist drill, and 10-mm drilling depth with a 4.0-mm-diameter twist drill. The first 108 implants were external-connection implants 4.0 mm in diameter, while the other 108 implants were internal-connection implants 4.3 mm in diameter. The peak insertion torque (PIT) during implant placement, the stability values obtained with DCA and RFA devices after implant placement, and the peak removal torque (PRT) during implant removal were measured. Results: The intraclass correlation coefficients (ICCs) of the implant stability quotient (ISQ) results obtained using the RFA device at the medial, distal, ventral, and dorsal points were 0.997, 0.994, 0.994, and 0.998, respectively. The ICCs of the implant stability test (IST) results obtained using the DCA device at the corresponding locations were 0.972, 0.975, 0.974, and 0.976, respectively. Logarithmic relationships between PIT and IST, PIT and ISQ, PRT and IST, and PRT and ISQ were observed. The mean absolute difference between the ISQ and IST values on a Bland-Altman plot was -6.76 (-25.05 to 11.53, P<0.05). Conclusions: Within the limits of ex vivo studies, measurements made using the RFA and DCA devices were found to be correlated under a variety of stability conditions.

The effect of implant drilling speed on the composition of particle collected during site preparation

  • Jeong, Chang-Hee;Kim, Do-Young;Shin, Seung-Yun;Hong, Jong-Rak;Kye, Seung-Beom;Yang, Seung-Min
    • Journal of Periodontal and Implant Science
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    • v.39 no.sup2
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    • pp.253-259
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    • 2009
  • Purpose: This study was aimed to evaluate the effect of implant drilling speed on the composition of particle size of collected bone debris. Methods: $Br{\aa}nemark$ $System^{(R)}$ drills were used to collect bone debris from 10 drilling holes (1 unit) at 1,500 rpm (Group A) and 800 rpm (Group B) in bovine mandible. After separating particles by size into > 500 ${\mu}m$, between 250 ${\mu}m$ and 500 ${\mu}m$, and < 250 ${\mu}m$ fractions, particle wet volume, dry volume, and weight were measured and the proportion of 3 fractions of bone debris to total wet volume, dry volume and weight was calculated as wet volume % , dry volume % and weight %. Results: No significant differences were found between Group A and B in wet volume, dry volume, and weight. However, of >500 ${\mu}m$ fractions, Group B had significantly higher wet volume %(P = 0.0059) and dry volume %(P = 0.0272) than in Group A. Conclusions: The drilling speed influenced the composition of particle size in collected drilling bone debris. The drilling in 800 rpm produced the more percentage of large particles than in 1,500 rpm. However, the drilling speed didn't effect on total volume of and weight of bone debris.

Thermal changes during implant site preparation with a digital surgical guide and slot design drill: an ex vivo study using a bovine rib model

  • Choi, Yoon-Sil;Oh, Jae-Woon;Lee, Young;Lee, Dong-Woon
    • Journal of Periodontal and Implant Science
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    • v.52 no.5
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    • pp.411-421
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    • 2022
  • Purpose: In this study, we aimed to evaluate the degree of heat generation when a novel drill design with an irrigation slot was used with metal sleeve-free (MF) and metal sleeve-incorporated (MI) surgical guides in an environment similar to that of the actual oral cavity. Methods: A typodont with a missing mandibular right first molar and 21 bovine rib blocks were used. Three-dimensional-printed MF and MI surgical guides, designed for the placement of internal tapered implant fixtures, were used with slot and non-slot drills. The following groups were compared: group 1, MI surgical guide with slot drill; group 2, MI surgical guide with a non-slot drill; and group 3, MF surgical guide with a slot drill. A constant-temperature water bath at 36℃ was used. The drilling was performed in 6 stages, and the initial, highest, and lowest temperatures of the cortical bone were measured at each stage using a non-contact infrared thermometer. Results: There were no temperature increases above the initial temperature in any drilling procedure. The only significant difference between the non-slot and slot groups was observed with the use of the first drill in the MI group, with a higher temperature in the non-slot group (P=0.012). When the heat generation during the first and the second drilling was compared in the non-slot group, the heat generation during the first drilling was significantly higher (P<0.001), and there was no significant difference in heat generation between the drills in the slot group. Conclusions: Within the limitations of this study, implant-site preparation with the surgical guide showed no critical increase in the temperature of the cortical bone, regardless of whether there was a slot in the drill. In particular, the slotted drill had a cooling effect during the initial drilling.

Effects of drilling process in stability of micro-implants used for the orthodontic anchorage (고정원을 위한 micro-implant 매식시 drilling 유무에 따른 안정성에 관한 연구)

  • Chang, Young-Il;Kim, Jong-Wan
    • The korean journal of orthodontics
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    • v.32 no.2 s.91
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    • pp.107-115
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    • 2002
  • The aim of this study was to investigate experimentally the mechanical and histological effect of drilling process on the stability of micro-implant used for the orthodontic anchorage. For this purpose, 32 micro-implants(Osas$^{(R)}$, Epoch medical, ${\phi}$1.6 mm) were inserted into maxilla, mandible and palate in two beagle dogs. 16 micro-implants(8 per dog) were inserted after drilling with pilot drilling bur (drill method group). 16 micro-implants(8 per dog) were inserted without drilling (drill-free method group). After 1 week, micro-implants were loaded by means of Ni-Ti coil spring (Ni-Ti springs-extension$^{(R)}$, Ormco) with 200-300 gm force. Following 12 weeks, the micro-implants and the surrounding bone were removed. Before sacrifice, the mobilities were tested with Periotest$^{(R)}$(Siemens). Undecalcified serial sections with the long axis were made and the histologic evaluations were done. The results of this study were as follow ; 1. The osseointegration was found in both of drill-free method group and drill method group 2. Two of drill method group and one of drill-free method group in 32 micro-implants were lost after loading. 3. The mobilities of drill-free method group were less than drill method group 4. The bone contact on surface of micro-implants in drill-free method group was more than drill method group but there was no significant difference between groups. 5. The bone density in threads of micro-implants in drill-free method group was more than drill method group and there was significant difference between groups. These results suggest that drill-free method in insertion of micro-implants is superior to drill method on the stabilities, bone remodeling and osseointegrations under early loading.

THE INFLUENCE OF THE INITIAL STABILITY AFTER DENTAL IMPLANT INSTALLATION ON THE OSSEOINTEGRATION (임프란트 식립시 초기 안정성이 골유착에 미치는 영향)

  • Lee, Young-Hoon;Kim, Yeo-Gab;Choi, Byung-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.518-528
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    • 2008
  • Purpose: The long-term experience of using osseointegrated implants for prosthetic rehabilitation of the edentulous patients shows that high success rates can be predictably achieved. Primary implant stability has been identified to be a prerequisite to achieve osseointegration. In this study, we set up the amount of removed bone so that it differed on implant installation site for each group. The influence of each initial stability on secondary stability and osseointegration was compared with time lapse using resonance frequency analysis and histomorphometric analysis. Materials and methods: A total 27 US $II^{(R)}$ (Osstem, Korea) implants were placed in the mandibular edentulous area of 3 beagle dogs. The implant site was prepared by the conventional technique with drills, and three experimental groups were divided into under-drilling group, normal-drilling group and over-drilling group. The Implant Stability Quotient (ISQ) was measured at intervals of immediately, 4, 8, 12 weeks after placement using $Osstell^{(R)}$ mentor RFA. After the animals were sacrificed, histomorphometric evaluation was executed for measuring BIC and BD. Results: 1) The under-drilled group showed most high ISQ value for whole experiment period. 2) Bone-to-implant-contact(BIC) showed the tendency to be increased gradually as the experiment period passed except the 8 weeks of the normal group. 3) The under-drilled group showed most high bone density(BD) level for whole experiment period, and it was expressed the aspect to be increased gradually according to an experiment period passage in the average of all group. 4) Resonance frequency analysis and histomorphometric analysis are presumed by generally proportional. Conclusions: As this research result, it seems that there are some correlation between resonance frequency analysis and histomorphometric analysis. As are accomplished osseointegration stably so that more superior at the region which the overpressure comes to add, it will be applicable method in clinical field.

The occurrence of dental implant malpositioning and related factors: A cross-sectional cone-beam computed tomography survey

  • Safi, Yaser;Amid, Reza;Zadbin, Fariba;Ahsaie, Mitra Ghazizadeh;Mortazavi, Hamed
    • Imaging Science in Dentistry
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    • v.51 no.3
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    • pp.251-260
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    • 2021
  • Purpose: Dental implants are widely used for the rehabilitation of edentulous sites. This study investigated the occurrence of dental implant malpositioning as shown on post-implantation cone-beam computed tomography (CBCT) and to identify related factors. Materials and Methods: Samples with at least 1 malpositioned dental implant were collected from a central radiology clinic in Tehran, Iran from January 2017 to January 2019. Variables such as demographic characteristics, length and diameter of implants, type of implant, sites of implant insertion, different types of implant malpositioning problems (cortical plate perforation, interference with anatomical structures), angulation of the implant, and the severity of malpositioning were assessed. In addition, the incidence of implant fracture and over-drilling was evaluated. Data were statistically analyzed using the chi-square test, 1-sample t-test, and Spearman correlation coefficients. Results: In total, 252 patients referred for implant postoperative CBCT evaluations were assessed. The cases of implant malpositioning included perforation of the buccal cortical plate (19.4%), perforation of the lingual cortical plate (14.3%), implant proximity to an adjacent implant (19.0%), implant proximity to an adjacent tooth (3.2%), interference with anatomical structures(maxillary sinus: 18.3%, mandibular canal: 11.1%, nasal cavity: 6.3%, mental foramen: 5.6%, and incisive canal: 0.4%). Implant fracture and over-drilling were found in 1.6% and 0.8% of cases, respectively. Severity was categorized as mild (9.5%), moderate (35.7%), severe (37.7%), and extreme (17.1%), and 52.4% of implants had inappropriate angulation. Conclusion: CBCT imaging is recommended for detecting dental implant malpositioning. The most common and severe type of malpositioning was buccal cortex perforation.

A STUDY ON THE TEMPERATURE CHANGES OF BONE TISSUES DURING IMPLANT SITE PREPARATION (임플랜트 식립부위 형성시 골조직의 온도변화에 관한 연구)

  • Kim Pyung-Il;Kim Yung-Soo;Jang Kyung-Soo;Kim Chang-Whe
    • The Journal of Korean Academy of Prosthodontics
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    • v.40 no.1
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    • pp.1-17
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    • 2002
  • The purpose of this study is to examine the possibility of thermal injury to bone tissues during an implant site preparation under the same condition as a typical clinical practice of $Br{\aa}nemark$ implant system. All the burs for $Br{\aa}nemark$ implant system were studied except the round bur The experiments involved 880 drilling cases : 50 cases for each of the 5 steps of NP, 5 steps of RP, and 7 steps of WP, all including srew tap, and 30 cases of 2mm twist drill. For precision drilling, a precision handpiece restraining system was developed (Eungyong Machinery Co., Korea). The system kept the drill parallel to the drilling path and allowed horizontal adjustment of the drill with as little as $1{\mu}m$ increment. The thermocouple insertion hole. that is 0.9mm in diameter and 8mm in depth, was prepared 0.2mm away from the tapping bur the last drilling step. The temperatures due to countersink, pilot drill, and other drills were measured at the surface of the bone, at the depths of 4mm and 8mm respectively. Countersink drilling temperature was measured by attaching the tip of a thermocouple at the rim of the countersink. To assure temperature measurement at the desired depths, 'bent-thermocouples' with their tips of 4 and 8mm bent at $120^{\circ}$ were used. The profiles of temperature variation were recorded continuously at one second interval using a thermometer with memory function (Fluke Co. U.S.A.) and 0.7mm thermocouples (Omega Co., U.S.A.). To simulate typical clinical conditions, 35mm square samples of bovine scapular bone were utilized. The samples were approximately 20mm thick with the cortical thickness on the drilling side ranging from 1 to 2mm. A sample was placed in a container of saline solution so that its lower half is submerged into the solution and the upper half exposed to the room air, which averaged $24.9^{\circ}C$. The temperature of the saline solution was maintained at $36.5^{\circ}C$ using an electric heater (J. O Tech Co., Korea). This experimental condition was similar to that of a patient s opened mouth. The study revealed that a 2mm twist drill required greatest attention. As a guide drill, a twist drill is required to bore through a 'virgin bone,' rather than merely enlarging an already drilled hole as is the case with other drills. This typically generates greater amount of heat. Furthermore, one tends to apply a greater pressure to overcome drilling difficulty, thus producing even greater amount heat. 150 experiments were conducted for 2mm twist drill. For 140 cases, drill pressure of 750g was sufficient, and 10 cases required additional 500 or 100g of drilling pressure. In case of the former. 3 of the 140 cases produced the temperature greater than $47^{\circ}C$, the threshold temperature of degeneration of bone tissue (1983. Eriksson et al.) which is also the reference temperature in this study. In each of the 10 cases requiring extra pressure, the temperature exceeded the reference temperature. More significantly, a surge of heat was observed in each of these cases This observations led to addtional 20 drilling experiments on dense bones. For 10 of these cases, the pressure of 1,250g was applied. For the other 10, 1.750g were applied. In each of these cases, it was also observed that the temperature rose abruptly far above the thresh old temperature of $47^{\circ}C$, sometimes even to 70 or $80^{\circ}C$. It was also observed that the increased drilling pressure influenced the shortening of drilling time more than the rise of drilling temperature. This suggests the desirability of clinically reconsidering application of extra pressures to prevent possible injury to bone tissues. An analysis of these two extra pressure groups of 1,250g and 1,750g revealed that the t-statistics for reduced amount of drilling time due to extra pressure and increased peak temperature due to the same were 10.80 and 2.08 respectively suggesting that drilling time was more influenced than temperature. All the subsequent drillings after the drilling with a 2mm twist drill did not produce excessive heat, i.e. the heat generation is at the same or below the body temperature level. Some of screw tap, pilot, and countersink showed negative correlation coefficients between the generated heat and the drilling time. indicating the more the drilling time, the lower the temperature. The study also revealed that the drilling time was increased as a function of frequency of the use of the drill. Under the drilling pressure of 750g, it was revealed that the drilling time for an old twist drill that has already drilled 40 times was 4.5 times longer than a new drill The measurement was taken for the first 10 drillings of a new drill and 10 drillings of an old drill that has already been used for 40 drillings. 'Test Statistics' of small samples t-test was 3.49, confirming that the used twist drills require longer drilling time than new ones. On the other hand, it was revealed that there was no significant difference in drilling temperature between the new drill and the old twist drill. Finally, the following conclusions were reached from this study : 1 Used drilling bur causes almost no change in drilling temperature but increase in drilling time through 50 drillings under the manufacturer-recommended cooling conditions and the drilling pressure of 750g. 2. The heat that is generated through drilling mattered only in the case of 2mm twist drills, the first drill to be used in bone drilling process for all the other drills there is no significant problem. 3. If the drilling pressure is increased when a 2mm twist drill reaches a dense bone, the temperature rises abruptly even under the manufacturer-recommended cooling conditions. 4. Drilling heat was the highest at the final moment of the drilling process.

Planning of Multiple Tooth Implant Placement Using the Standardized Data in Teeth Size and Position (표준 치아 크기 및 배열 정보를 이용한 다중 치아 임플란트 식립계획 방안)

  • Park, Hyung-Wook;Park, Sang-Jin;Park, Hyungjun
    • Korean Journal of Computational Design and Engineering
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    • v.20 no.4
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    • pp.348-356
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    • 2015
  • It is important to devise methods for assisting dentists to consistently determine implant positions and directions and to accurately perform drilling tasks during dental implant surgery. In this paper, we propose a novel approach to tooth implant placement planning which deals with the determination of the positions and directions of multiple implant fixtures for a set of missing mandibular teeth and suggests the selection of the sizes and types of the implant fixtures. We combine Korean standard data in the sizes and positions of human teeth with the patient specific 3D models of mandibular jawbones, nerve curves, and neighboring teeth around the missing teeth in order to determine the positions and directions of the implant fixtures for the missing teeth. Using the geometric and spatial information of the jawbones, the teeth and the implant fixtures, we can construct the 3D models of surgical guide stents which are crucial to perform drilling tasks with ease and accuracy. Adopted in 3D simulation of dental implant placement, the approach can provide surgeon students with good educational contents. We also expect that, with further work, the approach can be used as a useful tool to plan for dental implant surgery.

Temperature change and performance of bur efficiency for two different drill combinations (두 가지 임플란트 드릴 조합에 따른 온도 변화 및 효율 비교)

  • Hwang-Bo, Heung;Park, Jae-Young;Lee, Sang-Youn;Son, Keunbada;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.143-151
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    • 2022
  • Purpose. The purpose of this study was to evaluate the performance efficiency of two different drill combinations according to the heat generated and drilling time. Materials and methods. In this study, cow ribs were used as research materials. To test the specimen, cow bones were rid of fascia and muscles, and a temperature sensor was mounted around the drilling area. The experimental group was divided into a group using a guide drill and a group using a Lindmann drill according to the drill used before the initial drilling. The drilling sequence of the guide drilling group is as follows; guide drill (ø 2.25), initial drill (ø 2.25), twist drill (ø 2.80), and twist drill (ø 3.20). The drilling sequence of the Lindmann drilling group is as follows; Lindmann drill (ø 2.10), initial drill (ø 2.25), twist drill (ø 2.80), and twist drill (ø 3.20). The temperature was measured after drilling. For statistical analysis, the difference between the groups was analyzed using the Mann-Whitney U test and the Friedman test was used (α = .05). Results. The average performance efficiency for each specimen of guide drilling group ranged from 0.3861 to 1.1385 mm3/s and that of Lindmann drilling group ranged from 0.1700 to 0.4199 mm3/s. The two drill combinations contained a guide drill and Lindmann drill as their first drills. The combination using the guide drill demonstrated excellent performance efficiency when calculated using the drilling time (P < .001). Conclusion. Since the guide drill group showed better performance efficiency than the Lindmann drill group, the use of the guide drill was more suitable for the primary drilling process.

A STUDY ON THE HEAT GENERATION OF BONE DRILLING BURS ACCORDING TO IRRIGATION DURING IMPLANTATION OF DENIAL IMPLANT (치과 임플랜트 식립시 관주에 따른 골 천공 기구의 열 발생에 관한 연구)

  • Moon, Eun-Soo;Lim, Heun-Song;Cho, In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.4
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    • pp.433-453
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    • 1999
  • There are a lot of elements affecting the success of implant prosthesis. The quality of surgical procedure is considered as one of the key factors. To avoid the excess heat generation is an important element of successful osseointegration and it can be achieved by using a gentle surgical technique with a sharp instrument in bone drilling. This study was performed to measure and analyze comparatively the heat transmitted to sur-rounding bone at a distance of 0.5mm from the periphery of the drill hole in each drilling stage. The results were as follows. In standard system, the temperature of surrounding bone tissue ranged from $29.2^{\circ}C\;to\;48.3^{\circ}C$ with irrigation and from $34.6^{\circ}C\;to\;84.3^{\circ}C$ without irrigation. And in wide system, the temperature of surrounding bone tissue ranged from $29.5^{\circ}C\;to\;52.5^{\circ}C$ with irrigation and from $34.8^{\circ}C\;to\;87.8^{\circ}C$ without irrigation. And the temperature ranges exceeded the threshold without irrigation, while showing less than the threshold by the cooling effect of irrigation. In comparing standard system with wide system, although there was no significant difference, ${\phi}4.3mm$ pilot and ${\phi}4.3mm$ twist drill of wide system showed high value and wide system showed slightly high elevation of temperature in all depth in fixture installation. In the finite element analysis, the calculated value by the Fourier's cooling law were applied to the bone drilling surface. And through analysis using different irrigation temperatures at $28^{\circ}C,\;15^{\circ}C\;and\;5^{\circ}C$, and according to the time. The result was that the cooling water at least below $15^{\circ}C$ was required to maintain the temperature of surrounding bone less than threshold in bone drilling, the cooling water below $5^{\circ}C$ was required to gain more sufficient cooling effect, and cooling over 5 seconds was needed after bone drilling for sufficient effect.

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