Evaluation of increase in bone temperature during the crestal approach maxillary sinus augmentation with using piezosurgery system: In vitro study

The application of dental implants, which are widely used in the treatment of tooth deficiencies today, creates difficulties for physicians in the maxillary posterior region where bone height is insufficient as a result of sagging of the sinus floor and resorption of the alveolar bone. The use of piezosurgical systems has come to the fore instead of osteotomes used in the crestal approach sinus augmentation technique, which is recommended in cases where the existing bone height is 6 mm or more. In these devices, which work with ultrasonic vibrations, the temperature increase that occurs when the cutting tip comes in contact with the bone can be controlled by using the external cooling system. When the temperature increase that may occur in the bone tissue exceeds 10 °C, the necrosis potential of the bone increases, as a result of which bone homeostasis may change or be delayed. In piezosurgical systems, inability of irrigation solution to reach the cutting tip progresses area while the through the bone, due to that may increased in bone temperature with the thought the this in vitro study was designed. In our study, 6 mm (Group 1; n=15) and 8 mm (Group 2; n=15) height cancellous bone models with 1 mm cortical bone at the tip prepared from lamb pelvis bone were used. The osteotomy was started from the cancellous bone with the cutting tips of the piezosurgical system in accordance with the manufacturer's instructions and continued until the cortical bone representing the floor of the maxillary sinus was removed. In this process, the temperature increase in the bone models was measured and evaluated with the help of a thermal camera. While the mean maximum temperature increase was 88.72 °C in the 2nd group, it was 83.33 °C in the 1st group (p>0.05). Although the difference between the two groups was not statistically significant, it was observed that the mean maximum temperature value increased as the working depth increased and the temperature increase measured in both groups was well above the critical values reported in terms of necrosis formation.