title: Heat generation and drill wear during dental implant site preparation: systematic review.
abstract: To identify factors that minimise damage during the drilling of sites for dental implants, we reviewed published papers on the amount of heat that is generated. We systematically searched English language studies published between January 2000 and February 2014 on MEDLINE/PubMed and found 41 articles, of which 27 related to an increase in temperature during preparation of the site. We found only basic research with a low level of evidence. Most of the studies were in vitro, and osteotomies were usually made in non-vital bone from cows or pigs. To measure heat in real time, thermocouples were used in 18 studies and infrared thermographs in 7. Three studies reported the use of immunohistochemical analysis to investigate immediate viability of cells. The highest temperature measured was 64.4°C and the lowest 28.4°C. Drill wear was reported after preparation of 50 sites, and there was a significant increase in temperature and a small change in the physiological balance of the proteins in the bone cells. Differences in the study designs meant that meta-analysis was not appropriate. For future work, we recommend the use of standard variables: an axial load of 2kg, drilling speed of 1500rpm, irrigation, standard artificial bone blocks, and the use of infrared thermography.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany. Electronic address: smoehlhenrich@ukaachen.de.
authors.forename: S C
authors.initials: SC
authors.lastname: Möhlhenrich
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Modabber
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Steiner
authors.affiliation: Department of Oral and Maxillofacial Surgery, Oral and Facial Specialties Mid-Yorkshire Hospitals, Pinderfields Hospital, Aberford Road, Wakefield, West Yorks WF1 4DG, England, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Mitchell
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Hölzle
mesh_terms: D000818:Animals; D001831:Body Temperature; D002417:Cattle; D003757:Dental Implantation / Q000295:instrumentation / Q000379:methods; D015921:Dental Implants / Q000706:statistics & numerical data*; D003762:Dental Instruments; D006361:Heating / Q000009:adverse effects; D006801:Humans; D013552:Swine; D013817:Thermography
chemical_list: D015921:Dental Implants
keywords: Heat generation; Implant site preparation; Infrared thermography; Irrigation methods; Osseous models; Thermocouple