ABSTRACT
Introduction: A precise drilling-sequence-protocol is essential for long-term dental implant success in high bone density (mandibular cortical bone of D1-quality). Cone beam computed tomography (CBCT) radiographic imaging and CBCT-based construction of surgical guides have been substantial for diagnosis and treatment planning.
Objectives: The study aimed to measure the effect of different guided drilling techniques on the amount of heat generated during implant placement in high density.
Materials and Methods: Twenty-four osteotomies for implant placement, divided equally into three groups, to test the effect of the three drilling techniques " Undersized Drilling (UD), Undersized Drilling + Ridge Spreader size 4 (UD+RS4) and Undersized Drilling + counter sink size 4 (UD+CS4) techniques". Heat generation was assessed using K-type thermocouple. Drilling and thermocouple canals were guided by the surgical template. Bone assessment, virtual planning of the implants and surgical guide construction were based on radiographic CBCT-imaging and software-based processing. Insertion torque values (ITVs) were recorded from readings of a geared motor.
Results: The thermocouple results showed the least significant difference at 10 mm depth. At 5mm depth, a significant decrease in the temperature difference of the UD+RS4 group and UD+CS4 group compared to UD group was observed. At 1mm depth, there was a significant difference between the UD group and the two other groups.
The UD group showed the maximum peak ITV.
Conclusion: the results suggest possible advantages when self-tapping implants are inserted into high density cortical bone of D1-quality by a countersink drill since it provides lesser temperature increase at insertion.