A Thermal Perspective on Unexplained Implant Failures: A Finite Element Analysis Study (Methodological and Validation Study)

Objective: The aim of this study was to measure the heat generated in bones of different densities during osteotomy by finite element analysis, to calculate the cooling time of the bone, to evaluate the effect of irrigations at different temperatures on the heat generated in the bone, and to observe the thermal changes in the adjacent implant socket while drilling the primary implant socket. Material and Methods: Cortical and spongiosis bone models were created according to Misch classification with D1, D2/D3 and D4 densities. Each model was drilled with 2.8, 3.5 and 4.2 mm diameter drills under 25 °C and 10 °C irrigation and without irrigation. Results: In primary implant socket osteotomies in all cortical bone models, the bone temperature did not exceed 47 °C with irrigation. When a 10 °C irrigation solution was used, an effective temperature reduction was seen compared to 25 °C irrigation. Continued irrigation after drilling reduced the bone temperature below the critical threshold. Conclusion: During implant osteotomy, it is recommended to use cooled irrigation and to continue irrigation to cool the bone between drilling, and to place the implants after all implant sockets have been prepared in cases where more than one implant is to be placed. Thus, thermal damage to the bone can be minimized.