Dental İmplant Cerrahisinde Kullanılan Farklı Tasarımlardaki Cerrahi Rehberlerin Kemik Isı Artışına Etkisinin İn Vitro Ortamda İncelenmesi

Abstract

Tooth loss is a condition that affects people both psychologically and physiologically, so throughout history, attempts have been made to find solutions to tooth deficiencies. Today, the gold standard treatment method to compensate for missing teeth is dental implants. Recently, with the development of technology, it has become common for dental implant surgeries to be performed using guides. In these procedures, first of all, the records taken from the patients are transferred to the computer environment and the dental implant surgery of the patients is planned using these data. Surgical guides are produced to ensure that the planning is correctly transferred to the surgery to be performed. Thus, dental implants can be placed in accordance with the plan created for the patient. However, surgical guides also have disadvantages. The most important of these is the increase of temperature in the bone. The temperature increase that occurs when opening the implant socket damages the alveolar bone and may cause bone necrosis, implant loss and bone resorption. This temperature increase is affected by many factors. There are many studies showing that the use of surgical guides in dental implant surgeries increases the temperature rise that occurs during implant slot opening. Our study aims to investigate the effects of surgical guides of different designs on the temperature rise during the opening of dental implant sockets. In our study, two different surgical guides, traditional and windowed, as well as artificial bone models in which the implant slots will be drilled, were designed in the computer environment. These surgical guides were produced with polymer resin using a 3D printer. The artificial bone models were made of polyurethane with a spongy interior and cortical bone characteristics on the exterior. In our study, flap and non-flap groups were also used as variables. Six study groups were formed with all variables and 10 implant slots for each group were opened with 1200rpm speed and 50Ncm torque under saline physiological cooling. For each implant slot, statistical analysis was performed with the temperature measurements obtained from both the apical and neck region using a thermocouple device. According to the results of the analysis, while both surgical guides increased the temperature in the neck region, the windowed surgical guide caused less temperature increase compared to the traditional surgical guide. In the apical region, there was no significant difference between the two designs in terms of temperature increase. As a result, the use of a surgical guide in dental implant surgeries reduces the effectiveness of irrigation and causes an increase in temperature. The windowed surgical guide, which we designed with the aim of reaching irrigation more effectively to the implant sockets created using a surgical guide, caused a lower temperature increase compared to the traditional surgical guide, especially by allowing irrigation to reach the neck region. Since our study was performed in-vitro, clinical studies on the subject are needed.