Comparative Evaluation of Intraosseous Temperature Change during Osteotomy Preparation without and with the Use of Implant Surgical Guides- An Ex Vivo Study

Abstract

Introduction. An intimately fitting surgical guide and insertion instrumentation leads to concerns about whether cooling irrigation is able to reach the osteotomy site when using guided surgery; and if it not, overheating the bone becomes a major concern. The use of a surgical stent could be an obstacle to proper irrigation and cooling during implant site preparation.

Aim. The aim of this porcine model study was to evaluate and compare the intraosseous temperature change during osteotomy preparation without and with the use of implant surgical guides.

Methodology. Freshly obtained pig femurs were used in which osteotomy preparation was done, with and without the use of implant surgical guide (experimental groups I and II). A sample size of 30 was calculated at 95% confidence interval. Each group was allotted 15 specimens each.  A constant drill load of 2.0 kg was applied at 1000 rpm, maintaining constant external irrigation using normal saline at room temperature. Temperature changes were recorded at a distance of 1 mm from the periphery of the osteotomy site by 2 temperature sensors at depths of 2 mm (point A) and 10 mm (point B).

Results. Using implant surgical guides, the mean temperature change (ΔT) at the depth of 2 mm was 8.19 °C and at the depth of 10 mm was 3.68 °C. And without the use of implant surgical guides, the value at the depth of 2 mm was 4.28 °C and at 10 mm was 0.91 °C. A statistically significant difference was found between using implant surgical guides and not using them.

Conclusions. Surgical guides used for implant osteotomies generated higher bone temperatures compared to osteotomies done without the same, thus, posing to be a barrier for osteotomy site irrigation.