Research of heat generation and irrigation in digital guided dental implant surgery
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摘要: 目的 研究数字化导板种植牙手术中钻孔时骨骼的产热机理,并探究分析在使用内冷却、常规外冷却及喷头冷却等3种不同冷却方法下的冷却效果。 方法 选用DuraForm尼龙模拟皮质骨骨块,选定2 mm直径的钻头,备孔深度10 mm,模拟数字化种植手术过程。搭建数控平台用于控制种植手机钻孔时的钻入速度,同时在距离模拟骨块的备孔窝洞壁0.5~6.0 mm范围内按0.5 mm为间隔埋入深度为4、6、8、10 mm的细直径热电偶,通过温度测量仪和温度记录软件记录各测量点在备孔过程中的实时温度,并分别比较使用内冷却、常规冷却和喷头冷却3种冷却方法的冷却效果。 结果 在制备10 mm深种植窝时,骨骼的热影响区域分布在距离备孔窝洞(直径2 mm)壁半径6 mm的范围内,其中在深度6 mm处所产生的温度最高。并且在3种冷却方式中,常规冷却的最高温度可达到46.2℃,利用喷头冷却的最高温度达到24.6℃,内冷却的最高温度为12.5℃。 结论 在利用导板备孔中使用内冷却钻头能够起到最佳冷却效果,采用常规钻头冷却效果最不理想;但是在利用喷头冷却进行备孔时,如果辅助在导板上开设冷却孔并和喷头配合使用可获得良好的冷却效果,能显著降低钻孔时骨组织的温度;另外在利用常规钻头进行备孔的过程中,通过多次提拉钻头,也可得到一定的散热条件,获得一定程度的冷却效果。Abstract: Objective To study the Thermogenesis mechanism of bone during digital dental implant surgery with guide plates and to analyse the cooling effect of bone under three kinds of different irrigation methods (internal cooling, regular external cooling and jet cooling). Methods Using DuraForm nylon to replace cortical bone, a 2 mm diameter drill was selected to prepare a hole with depth of 10 mm, and simulating procedure of digital plant operation. A NC platform was built to control the drilling rate. At the same time, the small thermocouples were embedded at a serials deepness of 4, 6, 8 and 10 mm, and in the direction of radius the couples were distributed from 0.5 mm to 6.0 mm away from hole wall at intervals of 0.5 mm. Through temperature measurement instrument and the temperature record software,every measuring point temperature during the process of drilling was recorded, and the cooling effect between internal cooling, regular cooling and jet cooling was compared. Results When preparing a hole at the depth of 10 mm, the heat-affected zone was in the scope of 6 mm being away from hole wall(2 mm in diameter), and there was a highest temperature at the depth of 6 mm, and the highest temperature arrived 46.2℃ in regular cooling group, the highest temperature of internal cooling group and the jet cooling group was 24.6℃ and 12.5℃ respectively. Conclusion Drilling a hole with guide plates,the internal cooling have the best cooling effect, while cooling effect of the conventional drill bit is not good. But using jet cooling,combined with designed cooling channel on the guide template can be matched with obtain favorable result and significantly reduce the temperature of bone tissue in the process of drilling hole. In addition, using conventional to drill hole in the process of pulling the drill bit by several times, can get a certain cooling conditions and obtain a certain degree of cooling effect.
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Key words:
- Guided implant surgery /
- Irrigation /
- Temperature
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