A minimally invasive approach to osseo-disintegrate implants via thermal energy. An in-vivo pilot study

Aim This pilot preclinical study assessed applying thermal energy to osseo-disintegrate dental implants, minimizing collateral damage. 

Materials and methods Two experiments were designed. In the first one, thermal energy from a commercially available dental monopolar electro-scalpel (PerFect® TCS II)  was applied to 55 Neodent® Titamax implants inserted in pig ribs (ex vivo), assessing temperature rise on the surrounding bone. The second one used the same thermal energy source and dental implants on an in vivo rabbit tibiae model (8 rabbits, 2 implants per tibiae, 5 months healing). Osseointegration measurements were ISQ, and removal torque values (RTV). After healing, implants from the first 5 rabbits were randomly treated with no thermal energy, 5 and 10s application. Seven days later, implants were measured, rabbits euthanized, and histology samples obtained. Three rabbits went through a second thermal application (15s).

Results Temperatures after 5s were 84.6 ± 18.6°C, and 94.3 ± 22.0°C for 10s application (p<0.001). RTV and ISQ remained unchanged after 5s or 10s of thermal energy application. Nevertheless, after 15s, a tendency for a lower RTV could be observed. Histology confirmed an area of bone destruction. 

Conclusions Temperatures produced by different thermal application protocols are reported, thus filling a knowledge void. Extended time applications, monocortical insertion, and waiting more than one week for bone necrosis could decrease RTV in further studies. These data are essential in developing safe clinical implant removal tools.