The effects of operator technique and bur design on temperature during osseous preparation for osteosynthesis self-tapping screws

Objective. Although the importance of atraumatic preparation of bone before the placement of osseointegrated implants has long been emphasized, the si tuation during placement of self-tapping screws has received little attenti on. Because the production of excessively high temperatures during osseous drilling is known to impair bony regeneration, the strict thermal criteria that are set for implant placement should theoretically be extended to trau ma and orthognathic internal fixation. Study design. Temperatures achieved during the drilling of thawed human cad averic bone before the insertion of osteosynthesis self-tapping screws were measured in vivo with thermocouples. Combinations of 2 drilling systems an d 2 bur designs were studied. Variations in surgical technique were incorpo rated by altering both the force applied by the operator and the applicatio n of irrigant. Statistical significance was examined through use of a Stude nt t test. Results. One of the 2 bur designs and careful operator technique were assoc iated with significantly smaller increases in temperature. Irrigation had t he greatest effect on temperature recorded, the absence of irrigant resulti ng in temperatures in excess of 70 degrees C. Conclusions, These findings emphasize the importance of careful surgical te chnique and constant irrigation during osseous preparation ii the potential for bone regeneration around osteosynthesis self-tapping screws is to be m aximized.