Eksperimentalno i kliničko ispitivanje uticaja hirurške tehnike na temperaturu kosti male gustine tokom preparacije ležišta i ugradnje implantata

Abstract

Bočni segment gornje vilice čini kost male gustine u kojoj je teško postići primarnu stabilnost implantata neophodnu za neomeano zarastanje...

The posterior maxilla consists of low density bone in which primary stability of the implant which is necessary for unobstructed healing is difficult to obtain. In order to achieve good implant primary stability, the placement of self tapping implants after lateral bone condensing is recommended. During surgical implant procedures, friction heat is generated in the implant site. Bone temperature of 47°C lasting for 1 min destroys the regenerative potential of the bone tissue, causes resorption of the bone and diminishes the mechanic features which can result in early failure of implant therapy. The prevention of excessive heating of the bone tissue during implant site preparation and implant placement is a key requirement for successful osseointegration. The aims of the dissertation are: 1. To compare the bone thermal changes in lateral bone condensing and bone drilling technique. 2. To examine the effect of the temperature of the saline solution for cooling the bone during implant site preparation and implant placement. 3. To compare the bone thermal changes during implant placement after lateral bone condensing technique and bone drilling technique. 4. To compare the bone thermal changes during implant placement using Insertion torque value of 30, 35, 40 Ncm. 5. To compare the bone thermal changes during placement of self tapping and non self tapping implants. 6. To examine the influence of age and gender of the patients on the bone thermal change during implant placement. 7. To examine the influence of bone density at the recipient site as well as region of the implantation on the bone thermal changes during implant placement. In order to study and examine the influence of surgical technique on the temperature of the low density bone in implant site preparation and implant placement, experimental and clinical research has been conducted. In the experimental study as a bone model, a pig rib was used with uniform thickness of the cortical layer of 2mm. The temperature was measured using 3 thermocouples placed in distance of 0,5mm from the implant site, with vertical depth of 1mm, 5mm, 10mm. Two sets of experiments have been conducted. In the first set of experiments, the effect o surgical technique on the bone thermal change was examined during implant site preparation in which lateral bone condensing technique (experimental group) and standard bone drilling technique ( control group ) were compared. Implant site preparation was conducted without irrigation, with irrigation using room temperature saline solution and saline solution of 5 °C. The second set of experiments were conducted with the aim of examining the effect of surgical technique (lateral bone condensing technique and bone drilling) on bone temperature during implant site preparation and implant placement. In the randomized, controlled clinical study, 14 patients were included of both gender (8 women and 6 men) and average age 51.3 ( from 30 to 63), in whose posterior maxilla a total of 30 implants were placed: 15 after lateral bone condensing (study group) and 15 after bone drilling ( control group )...