Development And Preliminary Clinical Application Of A Bur For Alveoloplasty And Location In Dental Implantation

Objective:This study aims to develop a bur for alveoloplasty and location, and to explore the clinical applications of the bur in dental implantation.Methods: Part 1, Development of a novel bur for alveoloplasty and location in dental implantationW18Cr4V high speed steel was selected as material for the bur for alveoloplasty and location. The bur for alveoloplasty and location consists of a connecting rod and a drill bit. A slot was installed at one end of the connecting rod, the diameter of the connecting rod and the shape of the slot matched with the chuck of dental handpiece for implantation. The drill bit consists of the polish bur and the location needle which is fixed at the centre of the polish bur. The bottom surface of the polish bur is a plane structure, on which the blade is arranged. The diameter of the polish bur can be set at 3.3mm,3.75 mm,4.2mm or 5.0mm,matching with the implant’s diameter. The blade on the polish bur can be used to polish the protrusion of the alveolar bone surrounding the implant cavity surface. The location needle fixed at the centre of the polish bur is prismatoidal, the height of the location needle is 3mm,and the imaginary connecting surface between the location needle and the polish bur is an equilateral triangle which side length is 2mm,the pinpoint of the location needle can be fixed steadily in the implant position of the alveolar ridge. Part 2, Clinical ApplicationsPatients with dentition defect were enrolled to our hospital from November 2013 to November 2014,receiving dental implant surgical treatment by using the bur for alveoloplasty and location. A total of 46 patients with dentition defect were recruited. Dentition defect type were that single tooth missing, more than one tooth missing in non-adjacent parts, two teeth missing in adjacent parts etc. The total number of missing teeth was 62, implant amount was 62, out of which, 20 were implanted in the anterior teeth area and 42 were implanted in the posterior teeth area. The dentition defect type for 12 out of the 46 patients was two teeth missing in adjacent parts, and the dentition defect type for 34 out of the 46 patients was single tooth missing or more than one tooth missing in non-adjacent parts. Of all the patients enrolled, 25 were males and 21 were females. The age range was 19-85 years, with average at 39.85 years. Comprehensive preoperative evaluations were performed, no absolute implant surgical contraindications were detected, panoramic radiographs and dental films were taken, treatment plans were designed. All surgeries were operated under local infiltration anesthesia using Articaine Hydrochloride and Epinephrine Tartrate Injection in the implant area. Crestal or lingually middlemost incision surgery was used upon the mandibular while crestal or palatally middlemost incision surgery was used at the maxillary. If there were natural teeth existing on the both sides of the dentition defect area, mesial and distal gingival crevicular incisions were conducted; and if there was no natural tooth on either side of the dentition defect area, vertical incision towards the crestal incision was conducted in the non-natural tooth side. Incision was conducted at the gingival mucosa, mucoperiosteal flap was inflected, the bur for alveoloplasty and location was enrolled to locate after the implant position confirmed, then the alveolar bone was polished to create implantation position. Next, sequence implant drilling was executed.0.9% saline was used to flush the implant cavity, implant placement was carried out, and the healing cap was fixed. Flaps were repositioned, and sutured. Postoperative cares include taking panoramic radiographs and dental films, the use of antibiotics, intake of semi-liquid food, and maintenance of oral hygiene. Stitches were removed after seven days. Regular subsequent visits were reported, second stage operation was performed after 4-6 moths.Results:This group of 46 patients(62 teeth missing) underwent smooth implant surgery, the location needle can be fixed steadily on the implant position,and the location was accurate.No displacement,slide,damage of adjacent teeth or soft tissue were observed. The implantation location of two or more missing teeth in adjacent parts was also accurate. The polish bur polished the protrusion of the alveolar bone around the surface of the implant cavity desirably, and formed a circular flat area around the implant position which helped to create the basis for applying the stop ring of planting fissure bur. The polish bur solely removed a certain alveolar bone around the implant position which was consistent with the implant diameter, causing no additional bone loss. The placement of all implants were accurate and the wounds healed smoothly.Conclusion:The application of the self-developed bur for alveoloplasty and location in dental implantation proved to be simple, safe and reliable. Thus, operation time was shortened, the location was accurate, meanwhile, the protrusion of the alveolar bone around the surface of the implant cavity was polished efficiently, and the possibilities of post-operative complications were lowered, measuring of auxiliary implant position could also be achieved, meeting the needs for dental implant surgery.