Comparison of heat generation between internally guided (cannulated) single drill and traditional sequential drilling with and without a drill guide for dental implants.

PURPOSE: To determine whether a wire-guided single drill protocol could be utilized without causing an increase in bone temperature beyond those seen with the traditional techniques of sequential drilling with and without a drill guide. MATERIALS AND METHODS: A bovine femoral bone model was used with thermocouples and infrared temperature measurements to record thermal increase of the bone and drills during implant site preparation. Two thermocouples, one on each side of the osteotomy, were placed 1 mm from the outer diameter of the final drill. Drilling was performed at a constant speed (2,100 rpm) and pressure (2 kg) under continuous room temperature irrigation. Infrared temperature measurements of each drill were taken immediately before and after drilling. The six study groups included standard sequential drilling protocols for 3.5-mm and 4.2-mm final drills with and without the use of a surgical guide, and cannulated single drill technique for 3.5-mm and 4.2-mm drills. Statistical analysis was performed using a Tukey post hoc one-way ANOVA test. P<.05 was determined to be significant. RESULTS: No significant difference in thermal increase was found between single drill cannulated implant site preparation and sequential drilling with or without the use of a drill guide for the 3.5-mm or 4.2-mm drilling sequences, respectively. The thermal increase was found to be significantly less for the 4.2-mm single drill compared with the 3.5-mm sequential drill with surgical guide (P=.046). Infrared temperature measurement revealed no significant difference in drill temperatures throughout the study. CONCLUSIONS: Cannulated single drill technique does not cause an increase in bone temperature greater than that seen with standard sequential drilling with or without a surgical guide.

Randomized, double-blind, placebo-controlled comparison of the analgesic efficacy of oxycodone 10 mg/acetaminophen 325 mg versus controlled-release oxycodone 20 mg in postsurgical pain.

This randomized, controlled trial compared the analgesic efficacy and safety of the new oxycodone 10-mg/acetaminophen 325-mg formulation (Percocet) for the treatment of acute pain following oral surgery with double the dose of oxycodone alone (controlled-release [CR] oxycodone 20 mg [OxyContin]). A total of 150 male and female patients with > or = 2 full or partial bone-impacted mandibular molars, at least moderate persistent pain, and moderate trauma received a single dose of combination agent, CR oxycodone, or placebo following oral surgery and rated pain intensity and pain relief over the next 6 hours. The intent-to-treat population comprised 141 patients (55 on combination agent, 56 on oxycodone, and 30 on placebo). Combination agent and CR oxycodone were significantly superior to placebo for all efficacy measures. Combination agent was statistically superior to CR oxycodone in four of five outcome measures of pain intensity and pain relief (PPID, PPAR, SPID, and SPRID). It also provided a faster onset and 24% reduction in the number of patients reporting treatment-related adverse events compared with twice the dose of opioid alone. This new formulation offers the combination of two analgesic drugs with complementary mechanisms of action, which results in enhanced analgesia, an "opioid-sparing" effect, and an improved side effect and safety profile.