A comparative study to evaluate the heat generated during osteotomy with conventional drill, trephine and alveolar expander.

Abstract

Purpose: Excessively produced heat could lead to clinical failure of osseointegration. This study was done to compare the heat generated during osteotomy with the conventional drill, trephine, and alveolar expander .

Materials and methods: This in vitro study was performed on ten bovine femoral bones. In each femoral bone, three osteotomy sites were prepared at a distance of 1.5cm using the conventional drill, trephine, and alveolar expander. During osteotomy, the site was irrigated with a copius amount of normal saline. Osteotomy sites of 3.6 mm in diameter and 11.5 mm in length were prepared using the conventional drill and bone trephines. The alveolar expander used for preparing the osteotomy site was 3.5mm, the nearest dimensions available. The temperature rise was measured using a thermocouple thermometer. Repeated measures ANOVA and Fisher's least significant difference pairwise comparison test was done for statistical analysis.

Results: Repeated measures ANOVA revealed a significant difference in the heat generation with the conventional drill, trephine, and alveolar expander (p<0.001). The mean heat generated was maximum with the trephine (28.26±0.246 0C) followed by the conventional drill (27.27±0.297 0C) and least with alveolar expander (25.64±0.142 0C). Pairwise comparison showed a significant difference in heat generated during osteotomy with conventional drill compared to trephine (P=0.023), conventional drill compared to alveolar expander (P=0.014), and trephine compared to alveolar expander (P<0.001).

Conclusion: The heat generated with trephine was maximum compared to the alveolar expander and conventional drills. If in case trephine is to be used, both internal and external irrigation must be used. Less heat generation during osteotomy by alveolar expander seems very promising and advantageous for better osseointegration.