Implant removal using thermal necrosis—an in vitro pilot study

Clinical Oral Investigations, vol. 25, pp. 265–273

Abstract

OBJECTIVES: The purpose of this pilot porcine cadaver study was to evaluate the feasible temperature thresholds, which affect osteocyte viability and bone matrix in a preclinical setup, assessing the potential of thermal necrosis for implant removal for further in vivo investigations. MATERIALS AND METHODS: After implant bed preparation in the upper and lower jaw, temperature effects on the bone were determined, using two tempering pistons with integrated thermocouples. To evaluate threshold temperature and time intervals leading to bone necrosis, one piston generated warm temperatures at 49 to 56 °C for 10 s and the other generated cold temperatures at 5 to 1 °C for 30 s. Effects were assessed by a semi-quantitative, histomorphometrical scoring system, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and transmission electron microscopy (TEM). RESULTS: The bone matrix was significantly degenerated starting at 51 °C for 10 s and 5 °C for 30 s. The osteocyte condition indicated significant bone damage beginning at cold temperatures of 2 °C. Temperature inputs starting at 53 °C led to decalcification and swollen mitochondria, which lost the structure of their inner cristae. CONCLUSIONS: This study identified temperatures and durations, in both heat and cold, so that the number of samples may be kept low in further studies regarding temperature-induced bone necrosis. Levels of 51 °C for 10 s and 5 °C for 30 s have presented significant matrix degeneration. CLINICAL RELEVANCE: Temperature thresholds, potentially leading to thermo-explantation of dental implants and other osseointegrated devices, were identified.

Authors 8

1. Kristian Kniha corresponding Aachen Department of Oral and Cranio-Maxillofacial Surgery

   RWTH Aachen University

   Affiliation as printed

   Department of Oral and Cranio-Maxillofacial Surgery, RWTH Aachen University, Pauwelstraße 30, 52074, Aachen, Germany. kkniha@ukaachen.de

   Department of Oral and Cranio-Maxillofacial Surgery, RWTH Aachen University, Pauwelstraße 30, 52074, Aachen, Germany

2. Eva Miriam Buhl Aachen Institute of Pathology, Electron Microscopy Facility

   RWTH Aachen University

   Affiliation as printed

   Institute of Pathology, Electron Microscopy Facility, RWTH Aachen University, Aachen, Germany

3. Benita Hermanns‐Sachweh
   Affiliation as printed

   Private Institute for Implant Pathology, ZBMT, Campus Melaten, Pauwelsstaße 17, 52074, Aachen, Germany

4. Faruk Al‐Sibai Aachen Institute of Heat and Mass Transfer

   RWTH Aachen University

   Affiliation as printed

   Institute of Heat and Mass Transfer, RWTH Aachen University, Augustinerbach 6, 52056, Aachen, Germany

5. Anna Bock Aachen Department of Oral and Cranio-Maxillofacial Surgery

   RWTH Aachen University

   Affiliation as printed

   Department of Oral and Cranio-Maxillofacial Surgery, RWTH Aachen University, Pauwelstraße 30, 52074, Aachen, Germany

6. Florian Peters Aachen Department of Oral and Cranio-Maxillofacial Surgery

   RWTH Aachen University

   Affiliation as printed

   Department of Oral and Cranio-Maxillofacial Surgery, RWTH Aachen University, Pauwelstraße 30, 52074, Aachen, Germany

7. Frank Hölzle Aachen Department of Oral and Cranio-Maxillofacial Surgery

   RWTH Aachen University

   Affiliation as printed

   Department of Oral and Cranio-Maxillofacial Surgery, RWTH Aachen University, Pauwelstraße 30, 52074, Aachen, Germany

8. Ali Modabber Aachen Department of Oral and Cranio-Maxillofacial Surgery

   RWTH Aachen University

   Affiliation as printed

   Department of Oral and Cranio-Maxillofacial Surgery, RWTH Aachen University, Pauwelstraße 30, 52074, Aachen, Germany