Title: 0592 - A Smart Surgical Tool for Optimal Dental Implant Fixation
Polly Blaikie (Presenter)
Wayne Nishio Ayre, Cardiff University
David Thomas, Cardiff University
Taslima Begum, Cardiff Metropolitan University
Mark Eaton, Cardiff University
Carly Harwood, OsteoCare Implant System Limited
Davide Crivelli, Cardiff University
Objectives: This project aims to develop a smart surgical tool for placing dental implants to reduce failure rates. The device detects the optimal tightening of dental implants based on bone integrity rather than torque alone. This technique is based on non-destructive Acoustic Emission (AE) monitoring, which utilizes sensors to record ultrasonic shock waves released by materials as they develop cracks. This can address human error and ensure optimal conditions for both bone repair and implant stability, while being insensitive to variability in bone quality.
Methods: AE sensors are attached onto the surgical tool and dental implants from Osteocare are placed into Sawbone blocks of 3 porosities using 3 torque values: a clinically recommended torque value (0.3Nm), an undertightened (<0.2Nm) and an overtightened torque (>0.7Nm). Each combination is repeated 3 times (n=27). MicroCT scans are taken to quantify bone-implant contact and to assess cracking and crushing due to the screw insertion process. Pullout tests are performed on each implant to measure the fixation strength.
Results: Analysis of AE data will highlight the relationship between the AE and the fixation torque, correlated with different levels of damage in the Sawbone. Increased damage as indicated by AE levels (rather than torque) is expected to reflect in a lower pull-out strength and to be dependant on Sawbone porosity. Micro-CT scans will assess the damage caused by under-tightened, nominal and over-tightened screws. Correlation analysis between AE, torque, bone-implant contact and fixation strength are ongoing.
Conclusions: Initial evidence suggests a “stop twisting” criterion can be created using AE energy for achieving maximum pull-out strength. This can be established for different bone porosities to create a smart surgical tool to guide surgeons regarding optimum implant placement. Future work will focus on the biological response of bone to these AE signals and potential methods of ergonomically optimising the device.
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: Osteocare Ltd has provided in-kind contributions in the form of implants and tools for implant fixation.