Bone Burring Research Articles

Surgical management of severe cherubism persisting into early adulthood: a case report and literature review.

Cherubism is a rare fibro-osseous condition characterized by bilateral expansion of the mandible and maxilla. Due to its rarity, treatment guidelines for cherubism have not been clearly established. Observation without surgical intervention is typically recommended, as cherubism often regresses spontaneously after puberty. However, a surgical intervention may be necessary if aggressive lesions lead to severe complications. In this report, we present a case involving surgical management of cherubism that did not spontaneously regress until early adulthood. An 18-year-old man was diagnosed with cherubism, presenting characteristic upward-looking eyes and a swollen face. He strongly desired surgical management. Gross contouring of the mandible was performed using an osteotome. Subsequently, delicate contouring was performed by bone burring and curettage. The remaining multiple locular bony defects were filled with demineralized bone matrix. No major complications, including infection and hematoma, occurred during the 8-month follow-up period. The facial contour remained stable without the aggravation of cherubism. The patient was satisfied with the cosmetic results. Considering that cherubism is a rare disease globally, with few reported cases in Korea, and that treatment guidelines are not clearly established, we anticipate that the results of this case will contribute to the development of future protocols for treating cherubism.

Craniofacial Fibrous Dysplasia: Surgical Management and Long-Term Outcomes at a Referral Center in Mexico City.

Background Craniofacial fibrous dysplasia (CFD) is an uncommon benign condition in which a bone is replaced by fibrous tissue. An adequate clinical characterization considering the number of affected bones and functional impairment is important to determine the most effective surgical intervention for its management. This study aims to present our institution's experience in the evaluation and management of CFD. Methods This was a retrospective study that included patients with CFD managed at our institution. Data included demographic characteristics, afflicted bones, surgical procedures performed, and recurrence. Results are presented as mean and percentages. Recurrence-free years and association between the type of surgery and recurrence was evaluated. Results Eighteen patients were included (11 females, 61%). The zygomatic, maxillary, and frontal bones were the most commonly affected with eight (18%) cases each. The most common procedure was bone burring, with 36 procedures. Recurrence was more prevalent after burring (58.3%) and occurred earlier than in the bone resection group (13 vs. 15 years, p > 0.05). Conclusion Surgery continues to be the cornerstone of CFD treatment. Bone burring is effective for debulking and contouring but increases the risk for recurrence. An individualized approach should be tailored according to the anatomical location of the disease, type of CFD, behavior of the lesion, and accompanying clinical complaints.

Coverage of Large Bone-Exposed Scalp Defect With Bone Burring Followed by Dermal Regeneration Template and Split-Thickness Grafting.

Coverage of Large Bone-Exposed Scalp Defect With Bone Burring Followed by Dermal Regeneration Template and Split-Thickness Grafting.

A mechanistic force model for simulating haptics of hand-held bone burring operations

This paper presents a mechanistic model to predict the forces experienced during bone burring with application to haptic feedback for virtual reality surgical simulations. Bone burring is a hand-held operation where the force perceived by the surgeon depends on the cutting tool orientation and motion. The model of this study adapted the concept of specific cutting energy and material removal rate based on machining theory to calculate force distribution on the spherical tool surface in a three-dimensional setting. A design of experiments with three tool cutting angles and three feed motions was performed to calibrate and validate the model. Despite some variance in the results, model predictions showed similar trends to experimental force patterns. While the actual force profile also exhibits significant oscillation, the dominant frequencies of this oscillating force component were found to be independent of cutting and non-cutting instances, and hence could be imposed as a uniform background signal. Though the presented model is primarily applicable to abrasive burrs, it has far-reaching applications within other types of surgical simulations as well.

The Efficacy of Local Autologous Bone Dust: A Systematic Review

Study DesignA systematic review of bone dust as an autologous bone graft to encourage osseous fusion. ObjectiveTo identify and review studies that report on the therapeutic potential of bone dust. The research question was structured as follows: populations—animal and human sources of bone dust harvested using burrs; interventions—autologous bone dust compared with other clinically utilized bone graft options; outcomes assessed—(1) in vitro cell viability, cell differentiation, and osteogenic potential and (2) clinical efficacy in the form of fusion rates as assessed using plain radiographs; study designs—in vitro, preclinical in vivo and clinical studies investigating the therapeutic potential of bone dust, harvested by burring, are included in this systematic review. Summary of Background DataLittle is known about the efficacy of bone dust, generated during burring of local bone in spine surgery, as a bone graft to encourage osseous union. MethodsA systematic search was conducted in Medline, PubMed, OVID, Scopus, and Cochrane library. The following key words were used: bone dust, bone burring, bone paste, bone pate. ResultsA total of 285 studies were reviewed. Fourteen articles were identified as relevant for inclusion in this systematic review. Current evidence suggests that bone dust retains osteogenic properties, but limited information is available regarding the osteoinductive potential of bone dust. ConclusionBone dust represents a free source of autologous bone, which can be easily collected during the time of surgery and used as an augment to aid osseous fusion. Further research is required to evaluate the osteoinductive potential of bone dust. The retained growth factors in bone dust may potentially induce local osteoprogenitor cells to proliferate and mineralize to form new bone.

How Safe Is High-Speed Burring in Spine Surgery? An In Vitro Study on the Effect of Rotational Speed and Heat Generation in the Bovine Spine.

In vitro animal cadaveric study. To identify the appropriate rotational speed and safe bone distance from neural tissue during bone burring in spinal surgery. Bone burring is a common step in spinal surgery. Unwanted frictional heat produced during bone burring may result in thermal injury to the bone and adjacent neural structure. One of the important parameters influencing the bone temperature rise during bone burring is rotational speed. This laboratory-based animal study used bovine spine bones, and the tests were conducted using a steel round burr. The bone temperature was measured simultaneously with thermocouple at the distances of 1 mm, 3 mm, and 5 mm from the burring site during the burring process. The bone burring was done with 4 different rotational speeds of 35,000 revolutions per minute (rpm), 45,000 rpm, 65,000 rpm, and 75,000 rpm. This study showed that increasing the rotational speed significantly elevated bone temperature. The threshold temperature of 47°C was reached when bone was burred for 10 seconds, with a rotational speed of 45,000 rpm. The mean bone temperature measured at a distance 1 mm from the burring site for all 4 rotational speeds was always higher than that measured at a distance of 3 mm and 5 mm and this difference was statistically significant (P < 0.001). There was no significant difference between the mean bone temperature measured at a distance of 3 mm and 5 mm (P > 0.05). Taking 47°C as the threshold temperature for causing significant impairment to the regenerative capacity of bone, a rotational speed of lower than 45,000 rpm is preferable so as to minimize thermal injury to bone tissue. We also concluded that a 3-mm distance between the site of burring and the neural tissue is a safe distance. N/A.

Arthroscopic mgmt of thumb CMCJ and STTJ arthritis

Arthroscopic mgmt of thumb CMCJ and STTJ arthritis

VOLUME MANIPULATION FOR SIMULATING FACIAL CONTOURING SURGERY

In facial contouring surgery, surgeons operate the facial bone to correct bone morphology and thus achieve esthetic feminine face. To evaluate the face appearance after surgery and rehearse every surgical procedure in facial contouring surgery, simulations for tissue peeling, incising and suturing on the face together with bone burring and grafting on the facial bone are required. This paper presents a method that transforms respective tissue vertices to simulate tissue peeling. The transformation is based on specified incisions and clamps as in real facial contouring surgery. This paper also uses an auxiliary structure to represent and record tissue boundary changes inside the face. The elastic, partially plastic and plastic tissue deformation and wound formation during an incision can be simulated by manipulating these boundary changes. The incised wound recorded in the auxiliary structure is also manipulated to simulate tissue generation in wound healing during a suture. This volume manipulation method is combined with the reported method for bone burring and grafting simulations so that high-quality 3D images for illustrating surgical procedures both on the face and facial bone can be achieved. Simulations of two case examples including tissue peeling, incising and suturing procedures, and three modalities of facial contouring surgery demonstrate the effectiveness of the proposed method and system.