Surgical Trauma in Dental Implants

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).
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Demineralized Dentin Matrix on Alveolar Bone with Implant

One study in Korea, describes the use of autogenous demineralized dentin matrix as material for repair of various alveolar bone defect. According to the study, several cases of tooth and alveolar bone loss were treated with titanium implants with demineralized dentin matrix as bone grafts.

Wounds were classified:
1. Guided Bone Regeneration with demineralized dentin matrix powder.
2. One or two wall repair with root form.
3. Volume or anatomic defect repair with root on.
4. Socket preservation.
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Stages of Healing Around Dental Implants

According to Principles and Practice of Implant Dentistry by Weiss C and Weiss A, the Osseous Stages of Healing Around Endosteal Dental Implants are:

1. Vascular Sprouting Stage
2. Early Bone Formation Stage
3. Bone Growth Stage
4. Bone Maturation Stage