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    In-Vitro Heat Generation During Removal of a Fractured Screw Segment From a Dental Implant

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    Authors
    Arias, Sergio R.
    Issue Date
    2013-11
    URI

    http://hdl.handle.net/10675.2/624160
    
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    Abstract
    Objective: To compare in-vitro, peak temperature rise during removal of a fractured abutment screw segment from implants placed in a porcine mandible when using two commonly used drilling speeds: 600 or 2,000 RPM. Material and Methods: Twenty 4.3 x 13 mm implants (Nobel Replace Tapered, Nobel Biocare, Yorba Linda, CA) were placed m ten dissected porcine mandibles (two implants per mandible), one on each s1de. Localized defects were created in twenty surface-treated abutment screws (Nobel Biocare, Yorba Linda, CA), which were then torqued into each implant until a reproducible fracture occurred in each screw. Three Type-K thermocouples (Omega Engineering, Stamford, CT) were inserted through the buccal bone to contact the implant surface at 3 mm (crestal), 6 mm (mid-body) and 9 mm (apical) depths from the implant platform. The fractured screws were removed utilizing a handpiece removal kit (Broken Screw Extractor Kit, Rhein83, New Rochelle, NY) and room temperature water irrigation using either 600 or 2,000 RPM. Real-time temperature data were obtained at the three locations, and local peak temperature values were recorded. A 2-way ANOVA was performed, using Tukey's post-hoc test at a preset alpha of 0.05. Results: Mean peak temperatures were significantly higher using 2,000 RPM than at 600 RPM at the mid-body (p < 0.001) and crestal (p = 0.003) regions, but not at the apical (p = 0.225) locations. No statistical differences in mean peak temperatures were found among the three locations using 600 RPM (p = 0.179). In the 2,000 RPM group, mean peak temperature at the mid-body was consistently h1gher than that at the apical (p < 0.001) area, and more instances of temperature rise above 56" and 60" were observed. In one implant from this group, estimated peak temperature exceeded the bone-damage threshold value (50°C for 30 sec). Conclusion: Removal of fractured abutment screw segments should be performed using low speed (600 RPM) rather than at 2,000 RPM, to minimize temperature rise in adjacent bone.
    Affiliation
    Dental College of Georgia
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