Tooth sectioning for coronectomy: how to perform?
- 167 Downloads
The aim of this study was to determine the increase in heat production, preparation time, and cutting surface quality of conventional, high-speed rotating instruments and piezoelectric preparation for coronectomy procedures.
Materials and methods
One hundred intact extracted molars were sectioned horizontally, sub-totally, 1 mm under the cemento-enamel line with five methods: (1) tungsten carbide torpedo (TcT), (2) round (TcR) drills using a conventional speed surgical straight handpiece (< 40,000 min−1), (3) tungsten carbide fissure (TcF), (4) diamond torpedo (DT) drills using a surgical high-speed, contra-angle handpiece (~ 120,000 min−1), or (5) a saw-like piezoelectric tip (PT). Temperatures, preparation times, and cutting surface irregularities were registered and the differences were analyzed with ANOVA, Tukey’s HSD post hoc test (temperature, time) and with chi-square test (irregular surface).
Rotating instruments produced a maximal temperature increase of less than 1 °C. TcF produced the least heat (ΔT = − 3.92 °C to the baseline), while PT produced significantly the highest temperature increases (ΔT = 12.38 °C, p < 0.001). Tungsten carbide drills were the fastest for coronectomy (from 55.9 to 64.3 s), while DT (169.7 s) while PT (146.8 s) were significantly slower. TcT and TcR drills produced an irregular root surface more frequently.
During coronectomy, rotating instruments produced entirely acceptable heat, while PT produced unacceptable temperatures. Tungsten carbide drills performed coronectomies effectively, but the diamond torpedo and PT seemed clinically questionable. Considering heat, speed, and the cutting surface quality simultaneously, TcF in a surgical high-speed handpiece seems to be the best choice for coronectomy.
The correct insert can significantly reduce excessive heat and operation time during coronectomy procedures.
KeywordsThird molar Coronectomy Temperature Tungsten carbide drill Diamond drill
We would like to thank Dr. Bálint Lovász for the language corrections. The present scientific contribution is dedicated to the 650th anniversary of the founding of the University of Pécs, Hungary.
This study was supported by the Hungarian Dental Association-NSK (MFE-NSK) “Young Researcher” grant and the Bolyai János Research Scholarship (BO/00074/16/5) of the Hungarian Academy of Sciences.
Compliance with ethical standards
Conflict of interests
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.
- 4.Ghaeminia H, Gerlach NL, Hoppenreijs TJ, Kicken M, Dings JP, Borstlap WA, de Haan T, Bergé SJ, Meijer GJ, Maal TJ (2015) Clinical relevance of cone beam computed tomography in mandibular third molar removal: a multicentre, randomised, controlled trial. J Craniomaxillofac Surg 43:2158–2167CrossRefGoogle Scholar
- 26.Alvira-González J, Figueiredo R, Valmaseda-Castellón E, Quesada-Gómez C, Gay-Escoda C (2017) Predictive factors of difficulty in lower third molar extraction: a prospective cohort study. Med Oral Patol Oral Cir Bucal 22:e108–e114Google Scholar
- 28.Rullo R, Addabbo F, Papaccio G, D'Aquino R, Festa VM (2013) Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery: relationships between surgical difficulty and postoperative pain with histological evaluations. J Craniomaxillofac Surg 41:e33–e38CrossRefGoogle Scholar
- 30.Berman AT, Reid JS, Yanicko DR Jr, Sih GC, Zimmerman MR (1984) Thermally induced bone necrosis in rabbits. Relation to implant failure in humans. Clin Orthop Relat Res 186:284–292Google Scholar
- 40.Stelzle F, Frenkel C, Riemann M, Knipfer C, Stockmann P, Nkenke E (2014) The effect of load on heat production, thermal effects and expenditure of time during implant site preparation—an experimental ex vivo comparison between piezosurgery and conventional drilling. Clin Oral Implants Res 25:e140–e148CrossRefGoogle Scholar
- 41.Stelzle F, Neukam FW, Nkenke E (2012) Load-dependent heat development, thermal effects, duration, and soft tissue preservation in piezosurgical implant site preparation: an experimental ex vivo study. Int J Oral Maxillofac Implants 27:513–522Google Scholar
- 42.Möhlhenrich SC, Ayoub N, Fritz U, Prescher A, Hölzle F, Modabber A (2017) Evaluation of ultrasonic and conventional surgical techniques for genioplasty combined with two different osteosynthesis plates: a cadaveric study. Clin Oral Investig 21:2437–2444. https://doi.org/10.1007/s00784-016-2040-8 CrossRefGoogle Scholar