Requirements and infection prophylaxis for internally cooled implant drills.
2006
Implant site preparation is crucially important to long-term success. Heat generation
during drilling is unfavourable, since bone is relatively susceptible to heat,
depending on its vascularisation and microstructure. Numerous factors such as
drilling pressure, number of revolutions, drill design, wear and material, drilling
depth and cooling influence heat generation. Internally cooled drills are, therefore,
increasingly used, even though the improved cooling effect compared to
conventional externally cooled drills is controversial. Internally cooled drills may
have the disadvantage of a germ reservoir developing in the cooling channel.
This study aimed to examine the effects of disinfection and sterilisation of internally
cooled drills. After contamination of the cooling channel with suitable bioindicators
( Enterococcus faecium , ATCC 6057 and spores of Bacillus stearothermophilus ,
ATCC 7953), the drills were disinfected (disinfection solution ID 220,
Durr Dental) and autoclaved (Webeco, E5S90, 134°C, 2.6 bar, 5 min). Disinfection
was not completely effective except after pre-cleaning. By means of sterilisation
all spores of Bacillus stearothermophilus were completely killed. Internally
cooled drills can be successfully disinfected by means of this hygienic procedure
routinely used in dental practice and no source of infection is created.
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