title: Material attrition and bone micromorphology after conventional and ultrasonic implant site preparation.
abstract: OBJECTIVE
  Little is known about the recently introduced ultrasonic implant site preparation. The purpose of this study was to compare material attrition and micromorphological changes after ultrasonic and conventional implant site preparations.
  
  
  METHODS
  Implant site preparations were performed on fresh bovine ribs using one conventional (Straumann, Freiburg, Germany) and two ultrasonic (Piezosurgery; Mectron Medical Technology, Carasco, Italy and Variosurg; NSK, Tochigi, Japan) systems with sufficient saline irrigation. Sections were examined by environmental scanning electron microscopy (ESEM). Energy-dispersive X-ray spectroscopy (EDX) was performed to evaluate the metal attrition within the bone and the irrigation fluid.
  After conventional osteotomy, partially destroyed trabecular structures of the cancellous bone that were loaded with debris were observed, whereas after ultrasonic implant site preparations, the anatomic structures were preserved. EDX: None of the implant site preparation methods resulted in metal deposits in the adjacent bone structures. However, within the irrigation liquid, there was significantly higher metal attrition with ultrasonic osteotomy (P < 0.0001 and P < 0.0001 for Mectron and NSK, respectively). Whereas for Straumann system used, 15.5% of the SEM/EDX findings were drill-origin metals, this percentage increased to 37.3% and 37.9% with the application of Mectron and NSK, respectively.
  
  
  CONCLUSIONS
  Ultrasonic implant site preparation is associated with the preservation of bone microarchitecture and with the increased attrition of metal particles. Therefore, copious irrigation seems to be even more essential for ultrasonic implant site preparation than for the conventional method.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Klinikum Reinkenheide-Bremerhaven gGmbH, Postbrookstraße 103, 27574, Bremerhaven, Germany.
authors.forename: Ashkan
authors.initials: A
authors.lastname: Rashad
authors.forename: Pooyan
authors.initials: P
authors.lastname: Sadr-Eshkevari
authors.forename: Markus
authors.initials: M
authors.lastname: Weuster
authors.forename: Inge
authors.initials: I
authors.lastname: Schmitz
authors.forename: Nora
authors.initials: N
authors.lastname: Prochnow
authors.forename: Peter
authors.initials: P
authors.lastname: Maurer
mesh_terms: D000818:Animals; D002417:Cattle; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D020007:Implants, Experimental; D008855:Microscopy, Electron, Scanning; D010027:Osteotomy / Q000379:methods*; D059745:Piezosurgery / Q000379:methods*; D012272:Ribs / Q000601:surgery*; D013052:Spectrometry, X-Ray Emission; D013499:Surface Properties
chemical_list: D015921:Dental Implants