Intraosseous temperature changes during the use of piezosurgical inserts in vitro

This study concerns intraosseous temperature changes during the use of piezosurgical inserts. On six fresh pig jaws heated to body temperature (36 °C), osteotomies and osteoplasties were performed in vitro with the Piezosurgery® 3 device (Mectron, Carasco, Italy) and various inserts. The intraosseous temperature increases were measured at a depth of 3 mm and at a distance of 1 mm from the working site using nickel–chromium/nickel temperature sensors. 20 °C Ringer's solution was used for cooling in an initial test series and 10 °C Ringer's in a second series. The processed bone was examined using digital volume tomography images to determine the ratio of cortical to cancellous bone thickness. Mean temperature increases of 4.4–10.9 °C were found; maximum temperature peaks were over 47 °C for an average of only 8.5 s. The type of piezosurgical insert had a marked influence on intraosseous temperature generation (p = 0.026); the thickness of the cortical bone and the temperature of the coolant did not. Coolant temperature had an influence on the bone cooling time (p = 0.013). The results show that correct use of the piezosurgery device does not give rise to prolonged temperature increases over 47 °C and hence does not cause any irreversible thermal damage in the bone.