Drill Stop Research Articles

Accuracy in osteotomy drilling using a new universal and disposable drill-stop device for dental implant drills: an in vitro study using a bovine rib model.

This study aimed to evaluate the surgical accuracy of a new universal disposable stop system for implant drills (FCA Universal Drill Stop). A total of 60 bovine ribs were included in this in vitro study. The ribs were randomized into three study groups (n=20 ribs per group). In each study group (Group1: drills without stop or control group, Group 2: prefabricated drills with stop or gold standard group, and Group 3: drills with FCA Universal Drill Stop) a total of 100 osteotomies were performed with implant drills in each group, following the drilling sequence for the placement of a dental implant of 10 mm length and 4 mm diameter. The accuracy of the depth of the osteotomies was quantified clinically (with periodontal probe) and radiologically, using ImageJ version 1.48v software. The order of highest to lowest accuracy (clinical and radiological) in the depth of osteotomies was: FCA Universal Drill Stop> prefabricated drills with a stop>drills without stop, with statistically significant differences being observed between both systems with stop with respect to the control group, although not between them. The new universal disposable stop system for implant drills, offers similar accuracy to prefabricated drills with stop, with both systems being much more accurate than implant drills without stop. Although this experimental evaluation showed favourable results, further clinical studies are necessary.

Comparison of Curved and Straight Anchor Insertion for SLAP Repair: A Cadaveric Study

To compare a curved drill guide with a straight guide for suture anchor placement into the posterosuperior glenoid from an anterolateral portal with respect to glenoid perforation, drill contact with the suprascapular nerve, and maximum load. Ten bilateral pairs of fresh human cadaveric shoulders were randomized to the curved technique on 1 side and the straight technique on the contralateral side. An anterolateral trans-rotator cuff portal was used for placement of anchors at the posterior (11 o'clock right shoulder) and far posterior (10 o'clock right shoulder) positions on the glenoid with a 24-mm drill stop, and the drill tip was marked with ink. Specimens were dissected for glenoid perforation and drill contact with the suprascapular nerve. The maximum load of each anchor was measured using a material testing system. Glenoid perforation occurred in 30% in the curved group and 60% in the straight group overall (P= .01). Ink markings demonstrated a direct hit on the suprascapular nerve in most of the penetrations (13 of 18) but was not significantly different between the curved and straight guides (P= .25). Maximum load of the posterior anchor was greater in the curved group than that in the straight group (199.5 vs 146.7N, respectively; P= .01). The curved technique has a lower rate of glenoid perforation and greater maximum load than the straight technique. However, the curved technique can result in glenoid perforation and injury to the suprascapular nerve, and we do not recommend it. Placing suture anchors through an anterolateral portal with a curved guide provides a more optimal trajectory with decreased risk of glenoid perforation and superior biomechanical strength than that with the straight guide, but it is not safe.

Drilling Repair Index (DRI) based on two-parameter fracture mechanics for crack arrest holes

The most common method of preventing cracks from growing is by making a “drill stop” or crack arrest hole (CAH) at the crack tip. The objective of drilling a hole is to “blunt” the crack tip and reduce the stress concentration at the crack tip. In this paper the following situations are studied: (i) a single hole drilled at a blunt crack tip, (ii) a single hole drilled at a distance r from the crack tip with an orientation angle θ relative to the crack direction and (iii) a second hole called the “stress concentrator reducer hole” drilled symmetrically to the first near to the crack hole. A Drilling Repair Index (DRI) is proposed for evaluation of the efficiency of the CAH method. It is based on two-parameter fracture mechanics.

Prise en charge de la rhinite allergique : une question d’actualité

The most common method of preventing cracks from growing is by making a “drill stop” or crack arrest hole (CAH) at the crack tip. The objective of drilling a hole is to “blunt” the crack tip and reduce the stress concentration at the crack tip. In this paper the following situations are studied: (i) a single hole drilled at a blunt crack tip, (ii) a single hole drilled at a distance r from the crack tip with an orientation angle θ relative to the crack direction and (iii) a second hole called the “stress concentrator reducer hole” drilled symmetrically to the first near to the crack hole. A Drilling Repair Index (DRI) is proposed for evaluation of the efficiency of the CAH method. It is based on two-parameter fracture mechanics.

Creating a Simple Drill Stop for Clavicle Plating

Creating a Simple Drill Stop for Clavicle Plating

Using drill stops on twist drills to promote safety and efficiency when creating osteotomies for dental implants

A growing number of dental implants are being placed each year in the United States. This upward trend is associated with an increased incidence of comorbidities. In this regard, use of a drill stop has the potential to decrease unintended consequences of overdrilling the depth of an osteotomy. The authors did not find any studies in the dental literature in which researchers assessed the safety and effectiveness of using drill stops on twist drills. Nevertheless, the advantages of utilizing drill stops and the undesired results due to excessive drilling can be reasonably deduced. The authors describe the following clinically relevant issues pertaining to overdrilling of osteotomies for dental implants: the anatomical effect of excessive drilling in different sections of the oral cavity, reasons for excessive drilling, methods to avoid overlengthening of implant sites and benefits of using drill stops on twist drills. Use of drill stops enhances safety, accuracy and efficiency when creating an osteotomy. Drill stops also reduce the clinicians and patients stress during operative procedures. Drills stops can be beneficial when utilized in situations in which there is reduced visibility, making it difficult to read the lines on a twist drill. They also are helpful when there is a dearth of bone over the mandibular or mental nerves, and precisely lengthened osteotomies are needed to avoid nerve injuries.

A Novel Dental Implant Guided Surgery Based on Integration of Surgical Template and Augmented Reality

Stereoscopic visualization concept combined with head-mounted displays may increase the accuracy of computer-aided implant surgery. The aim of this study was to develop an augmented reality-based dental implant placement system and evaluate the accuracy of the virtually planned versus the actual prepared implant site created in vitro. Four fully edentulous mandibular and four partially edentulous maxillary duplicated casts were used. Six implants were planned in the mandibular and four in the maxillary casts. A total of 40 osteotomy sites were prepared in the casts using stereolithographic template integrated with augmented reality-based surgical simulation. During the surgery, the dentist could be guided accurately through a head-mounted display by superimposing the virtual auxiliary line and the drill stop. The deviation between planned and prepared positions of the implants was measured via postoperative computer tomography generated scan images. Mean and standard deviation of the discrepancy between planned and prepared sites at the entry point, apex, angle, depth, and lateral locations were 0.50 ± 0.33 mm, 0.96 ± 0.36 mm, 2.70 ± 1.55°, 0.33 ± 0.27 mm, and 0.86 ± 0.34 mm, respectively, for the fully edentulous mandible, and 0.46 ± 0.20 mm, 1.23 ± 0.42 mm, 3.33 ± 1.42°, 0.48 ± 0.37 mm, and 1.1 ± 0.39 mm, respectively, for the partially edentulous maxilla. There was a statistically significant difference in the apical deviation between maxilla and mandible in this surgical simulation (p < .05). Deviation of implant placement from planned position was significantly reduced by integrating surgical template and augmented reality technology.

Injury of the suprascapular nerve during arthroscopic repair of superior labral tears: An anatomic study

The purpose of this cadaveric anatomic study was to investigate the risk of iatrogenic suprascapular nerve injury during the standard drilling techniques in arthroscopic superior labrum anterior-posterior (SLAP) repairs. Cadaveric shoulder girdles were isolated and drilled at the glenoid peripheral rim by use of standard arthroscopic equipment reproducing common drill locations and portal orientations for SLAP repairs. Drill hole depth was determined by the manufacturer's drill stop (20 mm), and any subsequent drill perforations through the medial bony surface of the glenoid were directly confirmed by dissection. The suprascapular nerve was then isolated to note the presence of any observable direct nerve injury from the drilling. The bone tunnel depth, subsequent distance to the suprascapular nerve, scapular height and width, and humeral length were also recorded. Eighteen drill perforations through the medial glenoid wall occurred in 8 of 21 cadavers (38%). Twelve perforations occurred through anterosuperior drill holes with only one associated nerve injury. Six perforations occurred through low posterosuperior drill holes with four associated nerve injuries. Five of the six shoulders with low posterosuperior perforation also had an associated anterior perforation. No perforations occurred through high posterosuperior drill holes. Of the specimens, 5 had bilateral involvement (4 female and 1 male). Specimens with a perforation had a significantly shorter scapular height (P = .007) and humeral length (P = .01). The suprascapular nerve is at risk for direct injury during arthroscopic SLAP repairs from penetration of the medial glenoid with arthroscopic drill equipment in cadavers.

Use of a Yankauer Sucker as a Temporary Soft Tissue Protector and Drill Stop in Surgical Procedures

Use of a Yankauer Sucker as a Temporary Soft Tissue Protector and Drill Stop in Surgical Procedures

Arthrodesis for osteoarthritis of the manubriosternal joint

Osteoarthritis of the manubriosternal joint is rare. The diagnosis is not easy to make, and more serious causes of chest pain have to be ruled out first. We report one case that was treated with arthrodesis of the manubriosternal joint using double locking screw compression plating (LCP) with excellent results. Pre-operative CT-scan images with 3D reconstruction were used to measure the screw length and the drill stop depth. In this case report, we have shown that arthrodesis can be an effective way of treating osteoarthritis of the manubriosternal joint, when other measures fail. Furthermore, the use of a locking compression plate with appropriate and careful pre-operative planning affords a safe surgical technique, rapid pain relief and ultimately sound and asymptomatic union of the joint.

Drill stop for twist drill. Technical note.

✓ An inexpensive, readily available drill stop is described that can be applied to the twist drill bit to reduce the risk of “plunge.”