Influence of Implant Drill Materials on Wear, Deformation, and Roughness After Repeated Drilling and Sterilization

Purpose:The aim of this study was to evaluate deformation, roughness, and mass loss of stainless steel, diamond-like carbon (DLC)-coated and zirconia drills after multiple osteotomies with sterilization procedures.Materials and Methods:Drilling procedures were performed using stainless steel (G1), DLC-coated (G2), and zirconia (G3) drills. All groups were divided in subgroups 1, 2, 3, 4, and 5, corresponded to drills used 0, 10, 20, 30, and 40 times, respectively.Results:No significant differences in mass and roughness were detected among all groups and subgroups. In SEM images, all groups revealed signs of wear while coating delamination was detected in G2. Drills from G1 displayed more irregular surface, whereas cutting edges were more regular in G3.Conclusion:Zirconia drills presented more regular surfaces whereas stainless steel drills revealed more severe signs of wear. Further studies must be performed to evaluate the putative influence of these findings in heat generation.

Evaluation of Bone Heating, Drill Deformation, and Drill Roughness After Implant Osteotomy: Guided Surgery and Classic Drilling Procedure

Purpose: This study evaluated and compared bone heating, drill deformation, and drill roughness after several implant osteotomies in the guided surgery technique and the classic drilling procedure. Materials and Methods: The tibias of 20 rabbits were used. The animals were divided into a guided surgery group (GG) and a control group (CG); subgroups were then designated (G0, G1, G2, G3, and G4, corresponding to drills used 0, 10, 20, 30 and 40 times, respectively). Each animal received 10 sequential osteotomies (5 in each tibia) with each technique. Thermal changes were quantified, drill roughness was measured, and the drills were subjected to scanning electron microscopy. Results: Bone temperature generated by drilling was significantly higher in the GG than in the CG. Drill deformation in the GG and CG increased with drill use, and in the CG a significant difference between GO and groups G3 and G4 was observed. In the GG, a significant difference between GO and all other groups was found. For GG versus CG, a significant difference was found in the 40th osteotomy. Drill roughness in both groups was progressive in accordance with increased use, but there was no statistically significant difference between subgroups or between GG and CG overall. Conclusion: During preparation of implant osteotomies, the guided surgery technique generated a higher bone temperature and deformed drills more than the classic drilling procedure. The increase in tissue temperature was directly proportional to the number of times drills were used, but neither technique generated critical necrosis-inducing temperatures. Drill deformation was directly proportional to the number of times the drills were used. The roughness of the drills was directly proportional to the number of reuses in both groups but tended to be higher in the GG group.

Uso do copolímero de PLA/PGA no processo de reparo de defeitos ósseos em tíbia de coelhos: análise histomorfométrica

Pós-graduação em Odontologia - FOA

Utilization of Ethyl Cyanoacrylate and 2-Octyl Cyanoacrylate Adhesives for Autogenous Bone Graft Fixation: Histomorphometric Study in Rats

The present study analyzes the repair process of autogenous bone graft in a block fixed with ethyl cyanoacrylate and 2-octyl cyanoacrylate adhesives in rat calvaria. Forty-eight rats, divided into 3 groups, received round osteotomies at the right parietal bone for the attainment of autogenous bone graft fragment, which was fixed at the opposite side to the donor site with ethyl cyanoacrylate (ethyl group) and 2-octyl cyanoacrylate (octyl group) adhesives. In the control group, bone fragment was only juxtaposed at the parietal bone surface without any fixation material. The animals were euthanized after 10 and 60 postoperative days. The calvariae were processed in a laboratory for the attainment of slides stained through the hematoxylin and eosin technique for histological and histometric analysis. The qualitative analysis showed a discrete inflammatory infiltrate in the control group and moderate inflammatory infiltrate in the ethyl and octyl groups at the 10-day period, which remained at the 60-day period, mainly in the octyl group. The bone fragment remained bonded to the recipient site through the adhesive, but graft incorporation was not observed in any of the specimens. Resorption was higher in the octyl group followed by the ethyl and control groups, both at the 10-and 60-day periods, but with no statistical significance (P < .05). Although promoting graft fixation and its maintenance at the recipient site, both studied adhesives did not allow the graft incorporation, producing a localized and discrete inflammatory reaction, which persisted at 60 days, being more intense in the octyl cyanoacrylate group.

Treatment of severe facial asymmetry secondary to osteochondroma of the mandibular condyle: case report

Osteochondroma (OC) is the most common benign tumor of long bones. However it is rarely found in the facial skeleton, being the coronoid process and mandibular condyle the most affected sites in this region. It basically consists in bone growth covered by cartilage. The etiology is still controversial: neoplastic, developmental, reparative and traumatic origins have been discussed in literature. The treatments of these lesions include total condylectomy or local resection of the lesion. This paper aims to report a case of a patient with history of trauma and possible fracture of the mandibular condyle in childhood, which in youth developed dentofacial deformity with severe facial asymmetry. The treatment consisted of resection of lesion both with maxillary and mandibular osteotomies associated with graft from the iliac crest bone. Actually, the patient is with a favorable aesthetic, without functional deficit and absence of lesion’s recurrence.

Influence of bone marrow on osseointegration in long bones: an experimental study in sheep

Aim To evaluate the influence of yellow bone marrow on osseointegration of titanium oral implants using a long bone model.Material and methodsThe two tibiae of eight sheep were used as experimental sites. Two osteotomies for implant installation were prepared in each tibia. At the control sites, no further treatments were performed while, at the test sites, bone marrow was removed from the osteotomy site with a curette to an extent that exceeded the implant dimensions. As a result, the apical portion of the implants at the control sites was in contact with bone marrow while, at the test sites, it was in contact with the blood clot. After 2months, the same procedures were performed in the contralateral side. After another month, the animal was sacrificed. Ground sections were obtained for histological analysis.ResultsAfter 1month of healing, no differences between test and control sites were found in the apical extension of osseointegration and the percentage of new bone-to-implant contact. However, after 3months of healing, a higher percentage of new bone-to-implant contact was found at the test compared to the control sites in the marrow compartment. The apical extension of osseointegration, however, was similar to that found at the 1-month healing period both for test and control sites.ConclusionsOsseointegration appeared to be favored by the presence of a blood clot when compared to the presence of yellow fatty bone marrow. Moreover, the contact with cortical bone appeared to be a prerequisite for the osseointegration process in the long bone model.

Healing at implant sites prepared conventionally or by means of Sonosurgery (R): an experimental study in dogs

ObjectiveTo compare peri-implant tissue healing at implants installed in sites prepared with conventional drills or a sonic device.Material and methodsIn six Beagle dogs, the mandibular premolars and first molars were extracted bilaterally. After 3 months, full-thickness muco-periosteal flaps were elevated and recipient sites were prepared in both sides of the mandible. In the right side (control), the osteotomies were prepared using conventional drills, while, at the left side (test), a sonic device (Sonosurgery((R))) was used. Two implants were installed in each side of the mandible. After 8weeks of non-submerged healing, biopsies were harvested and ground sections prepared for histological evaluation.ResultsThe time consumed for the osteotomies at the test was more than double compared to the conventional control sites. No statistically significant differences were found for any of the histological variables evaluated for hard and soft tissue dimensions. Although not statistically significant, slightly higher mineralized bone-to-implant contact was found at the test (65.4%) compared to the control (58.1) sites.ConclusionsSimilar healing characteristics in osseointegration and marginal hard tissue remodeling resulted at implants installed into osteotomies prepared with conventional drills or with the sonic instrument (Sonosurgery((R))).

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts (R) total joint prostheses Part I - Skeletal and dental stability

The purpose of this study was to evaluate skeletal and dental stability in patients who had temporomandibular joint (TMJ) reconstruction and mandibular counterclockwise advancement using TMJ Concepts total join, prostheses (TMJ Concepts Inc. Ventura, CA) with maxillary osteotomies being performed at the same operation. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). Forty-seven females were studied; the average post-surgical follow-up was 40.6 months. Lateral cephalograms were analyzed to estimate surgical and post-surgical changes. During surgery, the occlusal plane angle decreased 14.9 +/- 8.0 degrees. The maxilla moved forward and upward. The posterior nasal spine moved downward and forward. The mandible advanced 7.9 +/- 3.5 mm at the lower incisor tips, 12.4 +/- 5.4 mm at Point B, 17.3 +/- 7.0 mm at menton, 18.4 +/- 8.5 mm at pogonion, and 11.0 +/- 5.3 mm at gonion. Vertically, the lower incisors moved upward -2.9 +/- 4.0 mm. At the longest follow-up post surgery, the maxilla showed minor horizontal changes while all mandibular measurements remained stable. TMJ reconstruction and mandibular advancement with TMJ Concepts total joint prosthesis in conjunction with maxillary osteotomies for counter-clockwise rotation of the rnaxillo-mandibular complex was a stable procedure for these patients at the longest follow-up.

Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

Laser terapêutico no reparo ósseo de ratos submetidos à ausência de carga

Low-intensity laser has been used as a physical agent in various fields of medical sciences such as bone and tissue repair. Meanwhile little is known about its effects in adverse conditions such as abolition of load and osteopenic. With the assumption that the laser Ga-Al-As accelerates the process of bone consolidation, goal of this study was to evaluate bone mineral density (BMD) in incomplete transverse osteotomies of tibia in adult rats, treated with low power laser therapy in three different groups: G1 (n = 10), reference 15 days; G2 (n=10), suspended by the tail and, accordingly, treated with laser for 12 days; G3 (n = 10), suspended by the tail by 36 days and that after 21 days, there was laser treatment for 12 days. The right tibia treated with laser and left served as control. The laser was used to Ga-Al-As, DMC - Flash Lase® III, with wavelength 830nm, 100 mW, 4J, 140 J / cm ², 40s of application in 12 sessions. It was used densitometer-Lunar DPX®, with computer program for "small animals", and the analysis of BMD was made in the bone throughout the region and the osteotomy. The results showed no efficacy of laser therapy in the process of bone repair, both in animals of group 1, as in group 2 and 3. It follows that either the low-power laser was not an effective performance or the effects of laser therapy is not only manifested at the site of irradiation as well as the systemic level.

Correção da deficiência transversa da maxila por meio da expansão rápida da maxila cirurgicamente assistida

Fundamentation: The correction of maxillary transverse deficiencies involves orthodontic and surgical procedures that can be performed before or after skeletal maturity. The surgically assisted rapid maxillary expansion (SAR ME) is performed by osteotomies through the lateral walls of the maxilla, zygomatic and canines buttresses, palatal and pterygomaxillary sutures, causing the maxillary disjunction. Followed by activation of the expander to the desired over-expansion in order to correct intercuspal later. Objective: The purpose of this study was to discuss the issues involved in the diagnosis of maxillary atresia, SAR ME indications, as well as surgical technique, through a case study. Methods: The male patient, 19 years old, had severe transverse maxillary deficiency with facial pattern III , Class III , with great lip incompetence. The patient underwent general anesthesia in a hospital environment, the osteotomies was done according to the technique described by Epker and Wolford (1980). Postoperatively, the patient underwent activations daily for 15 days and after 6 months, the orthodontist installed fixed orthodontic appliance to prepare the patient to orthognathic surgery later. Conclusion: The diagnosis by clinical evaluation and models study is essential for the indication of SAR ME and this procedure provides good predictability in the correction of transverse deficiency, with minimal morbidity.

Osteotomia com brocas de alta e baixa rotação, com e sem refrigeração líquida: estudo histopatológico duplo cego em suínos

Nine swines of the White Large race were used for study of the process of bony repair after osteotomy with rotating instruments of low and high-speed, with and without liquid refrigeration. The authors observed, through double blind histopathological analysis, that in every analyzed operative time, the bony repair was processed more appropriately when the osteotomies were accomplished with liquid refrigeration. In the final postoperative times, of fourteen and twenty-eight days, the best results of bony repair were observed in the osteotomy accomplished with drills of low rotation and with liquid refrigeration, while in the postoperative time of seven days, the results of the bony repair of osteotomy accomplished with drills of high rotation and with liquid refrigeration they were better. The authors consider, still, that the process of bony repair in swine display larger proximity in the histological pictures among the studied variables, when compared with other biological models. As most of the works told in the literature it refers the use of dogs, the authors consider that the present work guarantees your importance in the sense of looking for a closer model of the man.

Particularities in the technique of calvaria graft

Calvaria grafts provide good bone quantity for the reconstruction of the atrophic maxilla, and have lower morbidity and resorption rates when compared to iliac crest. The aim of this paper is to present the technique for obtaining a graft of the skull. Initially, the depth of the osteotomy is determined by a manually conducted bur, which establishes the limits of the structures of the skull (outer table, diploe and inner table), making the removal of bone blocks easier and safer. Thus, osteotomies of the blocks are made with greater security, avoiding the complications inherent to surgical technique. The case that will be presented it is from a male patient of 65 years who refused to submit to the iliac crest graft, opting for the calvaria, despite being bald, that is a contraindication for this treatment modality. A delicate suture associated with placement of titanium mesh to maintain the conformation of the patient's skull in the region of the bone defect, created after removal of the graft, provided a good cosmetic result at the donor site. The use of titanium mesh for re-anatomization of bone defects created in the grafts is well indicated for bald patients.