The effects of operator technique and bur design on temperature during osseous preparation for osteosynthesis self-tapping screws
The effects of operator technique and bur design on temperature during osseous preparation for osteosynthesis self-tapping screws
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DOI：
10.1016/s1079-2104(99)70108-3
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发表时间：
1999-08-01
影响因子：
--
通讯作者：
Williams, ED
中科院分区：
文献类型：
--
作者：
Kerawala, CJ;Martin, IC;Williams, ED
目标。虽然长期以来人们一直强调在植入骨整合种植体之前进行无创骨准备的重要性，但自攻螺钉植入期间的情况却很少受到关注。由于已知骨钻孔过程中产生的过高温度会损害骨再生，因此为植入物设置的严格热标准理论上应该扩展到创伤和正颌内固定。研究设计。在体内用热电偶测量了在植入植骨自攻螺钉之前，在解冻的人尸骨钻孔过程中获得的温度。研究了两种钻井系统和两种bur设计的组合。通过改变操作者施加的力和冲洗剂的应用，结合了手术技术的变化。通过使用学生t检验来检验统计显著性。两种设计中的一种和谨慎的操作技术与明显较小的温度升高有关。冲洗对记录的温度影响最大，缺乏冲洗导致温度超过70℃。结论：这些发现强调了在骨准备过程中谨慎的手术技术和持续的冲洗的重要性，以最大限度地发挥骨合成自攻螺钉周围骨再生的潜力。
Objective. Although the importance of atraumatic preparation of bone before the placement of osseointegrated implants has long been emphasized, the situation during placement of self-tapping screws has received little attention. Because the production of excessively high temperatures during osseous drilling is known to impair bony regeneration, the strict thermal criteria that are set for implant placement should theoretically be extended to trauma and orthognathic internal fixation.Study design. Temperatures achieved during the drilling of thawed human cadaveric bone before the insertion of osteosynthesis self-tapping screws were measured in vivo with thermocouples. Combinations of 2 drilling systems and 2 bur designs were studied. Variations in surgical technique were incorporated by altering both the force applied by the operator and the application of irrigant. Statistical significance was examined through use of a Student t test.Results. One of the 2 bur designs and careful operator technique were associated with significantly smaller increases in temperature. Irrigation had the greatest effect on temperature recorded, the absence of irrigant resulting in temperatures in excess of 70 degrees C.Conclusions, These findings emphasize the importance of careful surgical technique and constant irrigation during osseous preparation ii the potential for bone regeneration around osteosynthesis self-tapping screws is to be maximized.