Heat generation and histological analysis of peri-implant bone cutting using piezoelectric surgery for implant removal: an in vitro study.

PURPOSE: This study aimed to evaluate the safety of piezoelectric surgery for bone cutting during implant removal in terms of heat generation and histological changes.

METHODS

The bone model experiments involved titanium implants or non-metal dummy implants placed in bone models. Bone cutting using a piezoelectric surgery with irrigation was performed at distances of 0, 1, and 2 mm from the implant, and the temperature was recorded using a contact thermometer placed at the tip of the implant. Using procine mandible models, histological analysis was performed using hematoxylin and eosin-stained images to evaluate the risk of thermal injury.

RESULTS

When bone cutting was performed at distances of 0 mm from the implants continuously, a significantly greater temperature increase was observed with the titanium implants compared to the non-metal dummy implants. The increase in temperature decreased as the distance between the implant and the cutting position increased. Comparing the cutting patterns, a greater temperature increase was observed with continuous and 10 s intermittent cutting. In contrast, it was suppressed with intermittent cutting for 3 and 5 s. In the histological analysis with porcine mandibles, findings suggest that thermal injury was not observed in any of the samples.

CONCLUSIONS

No bone damage was observed in the histological analysis. In contrast, piezoelectric peri-implant bone cutting caused a significant increase in temperature, especially for continuous bone cutting during implant adjustments. However, intermittent cutting for 3 and 5 s significantly suppressed the temperature increase. The results suggest that shortening the continuous cutting time may be effective in preventing heat generation when using piezoelectric surgery for peri-implant bone cutting.