Novel hybrid drilling protocol: evaluation for the implant healing - thermal changes, crestal bone loss, and bone-to-implant contact

作者：Luis Calvo Guirado Jose; Delgado Pena Jorge; Mate Sanchez Jose E; Mareque Bueno Javier; Delgado Ruiz Rafael Arcesio; Romanos Georgios E

来源：Clinical Oral Implants Research, 2015, 26(7): 753-760.

DOI：10.1111/clr.12341

• animal studies
• biologic drilling
• bone-to-implant contact
• crestal bone loss
• histomorphometry
• incremental drilling

ObjectivesTo evaluate a new hybrid drilling protocol, by the analysis of thermal changes in vitro, and their effects in the crestal bone loss and bone-to-implant contact in vivo.
Materials and MethodsTemperature changes during simulated osteotomies with a hybrid drilling technique (biologic plus simplified) (test) versus an incremental drilling technique (control) were investigated. One hundred and twenty random osteotomies were performed (60 by group) in pig ribs up to 3.75-mm-diameter drill to a depth of 10mm. Thermal changes and time were recorded by paired thermocouples. In a parallel experiment, bilateral mandibular premolars P-2, P-3, P-4, and first molar M-1 were extracted from six dogs. After 2-month healing, implant sites were randomly prepared using either of the drilling techniques. Forty eight implants of 3.75mm diameter and 10mm length were inserted. The dogs were euthanized at 30 and 90days, and crestal bone loss (CBL) and bone-to-implant contact (BIC) were evaluated.
ResultsThe control group showed maximum temperatures of 35.3 degrees C1.8 degrees C, T of 10.4 degrees C, and a mean time of 100s/procedure; meanwhile, the test group showed maximum temperatures of 36.7 degrees C +/- 1.2 degrees C, T of 8.1 degrees C, and a mean time of 240s/procedure. After 30days, CBL values for both groups (test: 1.168 +/- 0.194mm; control: 1.181 +/- 0.113mm) and BIC values (test: 43 +/- 2.8%; control: 45 +/- 1.3%) were similar, without significant differences (P>0.05). After 90days, CBL (test: 1.173 +/- 0.187mm; control: 1.205 +/- 0.122mm) and BIC (test: 64 +/- 3.3%; control: 64 +/- 2.4%) values were similar, without significant differences (P>0.05). The BIC values were increased at 90days in both groups compared with the 30-day period (P<0.05).
ConclusionsWithin the limitations of this study, the new hybrid protocol for the preparation of the implant bed without irrigation, increase the temperature similarly to the incremental conventional protocol, and requires twice the time for the completion of the drilling procedure in vitro. Crestal bone loss and bone-to-implant contact in the hybrid drilling protocol are comparable with the conventional drilling protocol and do not affect the osseointegration process in vivo.

• 出版日期2015-7