title: Guided implant surgery: what is the influence of this new technique on bone cell viability?
abstract: OBJECTIVE
  To evaluate the effect of implant osteotomy on immediate bone cell viability, comparing guided surgery for implant placement with the classic drilling procedure.
  
  
  METHODS
  For this study, 20 rabbits were used. The animals were divided into a guided surgery group (GG) and a control group (CG) and were then divided into 4 subgroups--subgroups 1, 2, 3, and 4--corresponding to drills used 10, 20, 30, and 40 times, respectively. All animals received 5 osteotomies in each tibia, by use of the classic drilling procedure in one tibia and guided surgery in the other tibia. The osteotomized areas were removed and processed immunohistochemically for detection of osteocalcin, receptor activator of nuclear factor κB ligand (RANKL), osteoprotegerin (OPG), and caspase 3.
  
  
  RESULTS
  Immunohistochemical analysis showed that osteocalcin expression was initially higher in the CG and remained constant after drill reutilization. Although the expressions of RANKL and OPG were not statistically different for the GG and CG, the RANKL/OPG ratio tended to be higher for the GG. Moreover, caspase 3 expression was elevated in the GG, proportionally to the number of osteotomies, indicating an increase in the apoptosis index in the GG.
  
  
  CONCLUSIONS
  The classic drilling procedure is more favorable to cell viability than guided surgery.
authors.affiliation: Department of Surgery and Integrated Clinic, Discipline of Oral and Maxillofacial Surgery, Universidade Estadual Paulista-UNESP, Araçatuba, Brazil. pamelalsantos@hotmail.com
authors.forename: Pâmela Letícia
authors.initials: PL
authors.lastname: dos Santos
authors.forename: Thallita Pereira
authors.initials: TP
authors.lastname: Queiroz
authors.forename: Rogério
authors.initials: R
authors.lastname: Margonar
authors.forename: Abrahão Cavalcante
authors.initials: AC
authors.lastname: Gomes de Souza Carvalho
authors.forename: Roberta
authors.initials: R
authors.lastname: Okamoto
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: de Souza Faloni
authors.forename: Idelmo Rangel
authors.initials: IR
authors.lastname: Garcia
mesh_terms: D000818:Animals; D001842:Bone and Bones / Q000166:cytology* / Q000378:metabolism; D053148:Caspase 3 / Q000096:biosynthesis / Q000235:genetics; D002470:Cell Survival; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods*; D006358:Hot Temperature / Q000009:adverse effects; D008297:Male; D008953:Models, Anatomic; D015675:Osteocalcin / Q000096:biosynthesis / Q000235:genetics; D053244:Osteoprotegerin / Q000096:biosynthesis / Q000235:genetics; D053245:RANK Ligand / Q000096:biosynthesis / Q000235:genetics; D011817:Rabbits; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D013977:Tibia / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D053244:Osteoprotegerin; D053245:RANK Ligand; D015675:Osteocalcin; D053148:Caspase 3