Heat produced during the time of drilling, elevation from the periosteal flap and excessive pressure in the crestal region throughout implant positioning may lead to implant bone loss throughout the recovery.
Heat generation and excessive pressure
Eriksson and Albrektsson reported the critical temperature for implant site preparation was 47 degrees Celcius for just one minute or 40 degrees Celcius for seven minutes. Matthews and Hirsch shown that temperature elevation was affected more through the pressure applied than drill speed. When both drill speed and applied pressure were elevated, no significant rise in temperature was observed because of efficient cutting.
Sharawy et al. in comparison the heat produced through the drills of 4 different implant systems run at speeds of just 1,225, 1,667 and 2,500 revoltions per minute. All the drill systems could prepare an 8 mm site with no temperature rising by a lot more than 4 Celcius (to 41 Celcius).
For those drill systems, the 1,225 revoltions per minute drill speed needed a thirty to forty percent longer drilling time when in comparison with 2,500 revoltions per minute along with a 20 to 40 % decrease in time needed for bone temperature to normalise. With greater depth of preparation and inadequate time between drill changes, a harmful temperature rise to 47 degrees Celcius or greater might be arrived at. The authors suggest that surgeons interrupt the drilling cycle every 5 to 10 seconds to permit irrigant time for you to awesome the osteotomy.
The periosteal elevation continues to be recommended among the possible adding factors to crestal implant bone loss. Wilderman et al. reported the mean horizontal bone loss after osseous surgery with periosteal elevation is roughly .8 mm, and also the reparative potential is extremely based mostly on the quantity of cancellous bone (not cortical bone) beneath the cortical bone. The bone loss at stage II implant surgery in effectively osseointegrated implants is usually vertical and noted only round the implant characterised by saucerisation, not the nearby bone despite the fact that throughout surgery all of the bone was uncovered.
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Albretsson T, Zarb G, Worthington P, Eriksson A: The long term efficacy of currently used implants. A review and proposed criteria of success. Int J of Oral Maxillofac Imp, 1:11-25, 1986
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