Bone Drilling Research Articles

Thermal model to investigate temperature distribution with a hollow notched K-wire for bone drilling

K-wire drilling is commonly used in orthopedic surgeries, generating significant heat that can lead to bone thermal osteonecrosis. To understand the heat propagation and thermal damage region, a mathematical model of the negative rake angle on the hollow notched K-wire was established. Subsequently, a theoretical model of the shear angle for this negative rake angle was proposed. Based on these models, a comprehensive theoretical model of the heat flux was derived. The accurate heat flux was determined using the theoretical values, and experimental temperature data through inverse heat transfer method (IHTM). This heat flux was then applied in a finite element analysis to simulate the heat transfer process and identify thermal damage regions under different drilling conditions. Results showed that the thermal damage region of bone with a solid K-wire, hollow notched K-wire without cooling, with air cooling, and with water cooling were approximately 6.4 mm, 3.2 mm, 2.6 mm, and 4.8 mm in width, respectively, and 6.79 mm, 6.45 mm, 6.39 mm, and 6.58 mm in depth, respectively. This study demonstrates that the hollow notched K-wire with air cooling is a potential solution to reduce the thermal damage region, thereby accelerating patient recovery.

Influence of the Vertek aiming device on the surgical accuracy of computer-assisted drilling of the equine distal sesamoid bone-An experimental cadaveric study.

To determine the effect of the Vertek aiming device (VAD) on the surgical accuracy of navigated drilling of the distal sesamoid bone (DSB). Experimental cadaveric study. A total of 30 paired equine cadaveric limbs from 15 horses. Each specimen was placed in a purpose-built frame (PBF). Preoperative cone beam computed tomography (CBCT) images were acquired with an imaging unit coupled with a surgical navigation system. In the DSB of each specimen, a 4.5 mm glide hole and a 3.2 mm thread hole were drilled under navigation guidance, to simulate drilling for the repair of a mid-sagittal DSB fracture. In the VAD group navigated drilling was assisted by using the VAD. In the free-hand drilling group navigated drilling was performed without the VAD. Pre-and postoperative CBCT scans were merged and surgical accuracy aberrations (SAA) between the planned drill corridor and the created bone tunnel were measured. Descriptive statistics and repeated-measures analyses of variance (rep.-meas. ANOVA) were performed to compare SAA measurements between the study groups. The SAA measurements ranged from 0 to 2.9 mm in the free-hand group and from 0 to 2.8 mm in the VAD group. The median overall SAA was lower in the VAD group than in the free-hand navigated group (0.6 mm ± [0.5-0.7] vs. 0.8 mm ± [0.7-1], rep.-meas. ANOVA p = .007). The additional use of the VAD in the described set-up for navigated drilling significantly improved surgical accuracy. The combined use of the VAD and PBF may help improve surgical accuracy in navigated lag screw repair of DSB fractures.

Optimization of Drill Bit Geometries for Minimum Thermal Damage in Bone Drilling

Thermal injury is a common post-operative effect in bone drilling surgeries. The extreme heat generated during the drilling process kills bone cells, which causes irreversible bone death. This bone death loosens medical fixations—screws, plates, and implants—and subsequently refractures the bone. Research on drill bit geometries in bone drilling has attracted interest from engineering and medical researchers. However, previous research has mainly focused on the simulation of bone drilling, which could generate an incorrect approximation of thermal bone damage if the simulation model is not validated. For this reason, this study focuses on the optimization and parametric analysis of the bone temperature elevations induced by customized drill bit features—point angle (60-180°), web thickness (25-50 %), and helix angle (10-55°)—in comprehensive ex-vivo bone (bovine) experimental drilling tests. The L9 Taguchi optimization method was then applied to determine the optimal design to minimize maximum bone temperature rise. Results from the parametric analysis revealed that the optimal setup for the drill point features can be obtained with the ranges of point angle of 160-180°, web thickness of 25-30 %, and helix angle of 30-40°. Based on the Taguchi optimization results, the minimum thermal damage is produced with the point angle of 180°, web thickness of 25 %, and helix angle of 35°. This work offers a promising solution for reducing thermal injury and preventing thermal osteonecrosis in bone drilling surgeries.

Thermal Evaluation of Bone Drilling with a One-Drill Protocol.

This study evaluates the thermal impact of a one-drill protocol for osteotomy preparation in dental implant surgery. Our findings demonstrate a significant reduction in heat generation compared to traditional sequential drilling, suggesting potential benefits for implant osseointegration and patient comfort. Specifically, the one-drill protocol was associated with lower peak temperatures and a reduced duration of elevated temperatures. These findings suggest that the one-drill protocol may contribute to improved implant stability and reduce the risk of thermal-induced bone damage. While further research is needed to confirm these findings in clinical settings, the results of this study provide promising evidence for the potential advantages of the one-drill protocol in dental implant surgery. Additionally, the one-drill protocol may offer simplified surgical workflows and reduced instrument management, potentially leading to improved efficiency and cost-effectiveness in dental implant procedures.

Reducing aerosolization during bone drilling

The viscoelasticity of poly(ethylene oxide) allows for reduced aerosolization while maintaining coolant performance, reducing disease transmission via the dispersion of aerosols

Analysis of osseointegration of implants with macrogeometries with healing chambers: a randomized clinical trial

BackgroundTo verify the influence of macrogeometry with healing chambers on the osseointegration of dental implants by analyzing implant stability quotient (ISQ) and evaluate the correlation between insertion torque and ISQ insertion with different macrogeometries.MethodsIn total, 26 implants were installed in the posterior mandible of eight patients with sufficient bone height for the installation of implants measuring 3.5 mm in diameter and 9.0 mm in length. The implants were categorized according to two types of macrogeometry: a test group (GT) with 13 conical implants with healing chambers and a control group (GC) with 13 conical implants with conventional threads. To insert the implants, a bone drilling protocol was used up to a diameter of 3 mm with the last helical bur. The insertion torque of the implants was evaluated, followed by the measurement of ISQ at 0 (T-0), 7 (T-7), 14 (T-14), 21 (T-21), 28 (T-28), and 42 (T-42) days.ResultsThe mean insertion torque was 43 Ncm in both groups, without a significant difference. Moreover, no significant difference in the ISQ values was found between the groups at different time points (p > 0.05), except at T-7 (GT = 69.87±1.89 and GC = 66.48±4.49; p = 0.01). Although there was no significant difference, ISQ median values were higher in the GT group than GC group at 28 days (GT = 67.98 and GC = 63.46; p = 0.05) and 42 days (GT = 66.12 and GC = 60.33; p = 0.09). No correlation was found between the insertion torque and ISQ insertion (p > 0.05).ConclusionFurthermore, implants with a 3.5 mm diameter macrogeometry, with or without healing chambers, inserted with a drilling protocol up to 3 mm in diameter of the last helical bur, led to a similar secondary stability, with no difference in ISQ values. Although, implants with healing chamber demonstrates ascending values in the graph of ISQ, having a trend of faster osseointegration than implants without healing chambers. Both macrogeometries provide a similar primary stability to implants.Trial registrationThis study was registered retrospectively in ReBec (brazilian registry of clinical trials) under the number RBR-96n5×69, on the date of 19/06/2023.

Sheep Head Cadaveric Model for the Transmeatal Extensions of the Retrosigmoid Approach

AbstractThe transmeatal extension of the retrosigmoid approach is an important procedure used in the treatment of various pathologies affecting the posterior fossa, petroclival region, and jugular foramen. Mastering this technique requires a high level of manual skill, particularly in temporal bone drilling. The objective of this study was to describe an easily accessible and cost-effective model of the transmeatal extension of the retrosigmoid approach using cadaveric sheep heads. Five cadaveric sheep heads, fixed in alcohol and formalin with intravascular-colored silicone injection, were prepared for this study. Two heads (four sides) were designated for illustrative anatomical specimens, while three heads (six sides) were used for surgical simulation. Additionally, one head was used to prepare and dissect a dry skull. All critical steps of the transmeatal approach, including both supra- and inframeatal extensions, were successfully replicated on the model. A comparative anatomical analysis was conducted, focusing on the technical nuances of the model. The cadaveric sheep head serves as an effective model for the retrosigmoid approach with transmeatal extensions, primarily for training manual haptic skills. While the sheep model cannot precisely replicate human anatomy, it still offers valuable training opportunities for neurosurgeons, particularly when human cadaveric specimens are unavailable.

Thermal Evaluation of Bone Drilling: Assessing Drill Bits and Sequential Drilling.

Sequential drilling is a common practice in dental implant surgery aimed at minimizing thermal damage to bone. This study evaluates the thermal effects of sequential drilling and assesses modifications to drilling protocols to manage heat generation. We utilized a custom drill press and artificial bone models to test five drill bits under various protocols, including sequential drilling with different loads, spindle speeds, and peck drilling. Infrared thermography recorded temperature changes during the drilling process, with temperatures monitored at various depths around the osteotomy. The results reveal sequential drilling does not eliminate the thermal damage zone it creates (well over 70 °C). It creates harmful heat to surrounding bone that can spread up to 10 mm from the osteotomy. The first drill used in sequential drilling produces the highest temperatures (over 100 °C), and subsequent drill bits cannot remove the thermal trauma incurred; rather, they add to it. Modifying drill bit design and employing proper drilling techniques, such as reducing drilling RPM and load, can reduce thermal trauma by reducing friction. Inadequate management of heat can lead to prolonged recovery, increased patient discomfort, and potential long-term complications such as impaired bone-to-implant integration and chronic conditions like peri-implantitis. Ensuring healthy bone conditions is critical for successful implant outcomes.

Deep learning-based temperature prediction during rotary ultrasonic bone drilling

Bone drilling is a common but critical medical procedure in orthopedic surgeries used to treat fractured bones. During this procedure, the temperature of the bone increases due to generation of frictional energy. Temperature control has been a major challenge in bone drilling since its foundation. If this temperature increases over 47°C for 1 min, then it can result in permanent bone damage. To control the temperature elevation this study proposes a deep learning-based robust predictive model which has been trained and tested on data from pig bones. Excessive in-house testing has been done on pig femur bones to gather data and verify the results. Rotary ultrasonic bone drilling was the machining process used for drilling. Four independent variables which were rotational speed, feed rate, abrasive grit size, and vibrational ultrasonic power were varied and the temperature for each set of values was recorded. Multiple deep learning models were made and were compared on different error metrics. It was found that convolutional neural network 1D gave the least error over other models. The error generated by deep learning models was less than mathematical and experimental models.

Supervised Machine Learning to Predict Drilling Temperature of Bone

Surgeons face a significant challenge due to the heat generated during drilling, as excessive temperatures at the bone–tool interface can lead to irreversible damage to the regenerative soft tissue and result in thermal osteonecrosis. While previous studies have explored the use of machine learning to predict the temperature rise during bone drilling, this in vitro study introduces a comprehensive approach by combining the Response Surface Methodology (RSM) with advanced machine learning techniques. The main objective lies in the comprehensive evaluation and comparison of support vector machine (SVM) and random forest (RF) models specifically for the optimization of the bone drilling parameters to prevent thermal bone necrosis. A total of 27 experiments were conducted using a multi-level factorial method, with analysis performed via the Minitab software version 19.1. Performance metrics such as the mean squared error (MSE), mean absolute percentage error (MAPE), and coefficient of determination (R2) were used to assess model accuracy. The RF model emerged as the most effective, with R2 values of 94.2% for testing and 97.3% for training data, significantly outperforming other models in predicting temperature fluctuations. This study demonstrates the superior predictive capabilities of the RF model and offers a robust framework for the optimization of surgical procedures to mitigate the risk of thermal damage.

Suppression of aerosol dispersion by highly viscoelastic poly(acrylic acid)- and poly(ethylene oxide)-based coolants during bone drilling

Bone drilling in neurosurgical, dental, and orthopedic procedures, combined with the use of coolants, generates a dispersion of bone particles, coolants, and blood aerosols in the air. This poses the threat of airborne transmission of infectious diseases between patients and medical practitioners. Highly viscoelastic polymeric poly(acrylic acid) (PAA) and poly(ethylene oxide) (PEO) solutions of various concentrations were used as coolants during bone drilling at different mass flow rates to suppress aerosol generation, thereby mitigating the threat of cross-infection. The results revealed that the PAA and PEO solutions provide less advection than water and a comparable cooling performance. However, excessive viscoelasticity of PEO causes the fluid to rise along the cutting burr (the Weissenberg effect), thereby reducing the cooling coverage area. In contrast, slightly lower viscoelasticity of PEO results in a high cooling coverage area. The cooling coverage area is smaller for the PAA at 20 ml/min because the corresponding PAA solution easily swirls or splashes away from the drilling location. However, at 80 ml/min, the supplied PAA solution sufficiently cools the drilling area, despite the loss through splashing. The numbers of atomized droplets of water and the PAA and PEO solutions were quantified and compared to investigate the degree of aerosol formation and dispersion. The solution with the strongest viscoelasticity most significantly suppressed aerosolization and produced the fewest dispersed aerosol droplets during bone drilling.

Modified colored three-dimensional posterior and temporal cranial fossa model with mobility of the joint between C1 and occipital condyle

BackgroundSkull base surgery requires anatomical knowledge and appropriate surgical technique in bone drilling. We developed a newly modified three-dimensional (3D) model of the posterior cranial fossa as a learning tool that improves knowledge of skull base anatomy and surgical approaches, including skull base drilling techniques. MethodsThis bone model of the posterior cranial fossa was created based on computed tomography data using a 3D printer, and incorporates artificial cranial nerves, cerebral vessels, bony structures, dura mater, and cerebellar tentorial dura. These anatomical components are differentiated with various colors. In addition, the atlanto-occipital junction can be mobilized to fully expose the surface of the cartilage between the C1 condyle and occipital condyle to allow drilling to open the hypoglossal canal under a wide surgical field. The usefulness of the model for practicing skull base surgical approaches was evaluated. ResultsExperience of bone drilling, dural dissection, and 3D positioning of important structures, including cranial nerves and blood vessels, was identical to that in actual surgery. ConclusionsThis model is designed to facilitate teaching anatomical knowledge and essential epidural procedure-related skills, and is useful for teaching the essential elements of posterior skull base surgery.

Impact of Hydroxyapatite Nanoparticles, Demineralized and Decellularized Bone Matrix on Tibia Fracture Healing: A Biochemical and Histological Study in Goats

At present, using bone grafts is the most successful surgical approach for repairing deficits in the bone structure. This study investigated into how goat tibial defect fracture healing was impacted by using hydroxyapatite (HA) or demineralized and decellularized bone matrix (dDBM) xenograft. Methodology: In this study, fifteen young goats were employed. Three groups (n=5) consisting of the control group, nano-group, and xeno-group were created from the animals. Bone drill was used to remove 2 mm from the tibia of the right hind limp in all animals. The hydroxyapatite nanoparticles (HA) in the Nano-group and the xenograft demineralized and decellularized bone matrix (dDBM) (obtained from sheep tibia) in the Xeno-group were used to fill the bone defect respectively, while the bone defect in the control group remained without treatment, and the surgical site was regularly closed. Blood serum was collected at the following intervals: postoperative, 14, 42, and 64 days for detection of alkaline phosphatase (ALP) and osteocalcin (OC) levels. At 64 days after surgery, all goats were euthanized and the healing was evaluated by specimen histological observation. Results: Biochemical examination in treated groups (Nano and Xeno groups) showed a statistically significant (P < 0.05) increase in the level of ALP and OC. histopathological examination at 64 day post-operation, treated groups shows Completely grown woven bone and the fracture callus composed of mature fibro-osteoid mixture. In conclusion, We demonstrate that the healing process accelerated and the bone defect can be filled by using hydroxyapatite (HA), or dDBM, as a scaffold for the damaged tibia bone.

Navigating Challenges: Case Series of Congenital Nasal Pyriform Aperture Stenosis

Congenital nasal pyriform aperture stenosis (CNPAS) is characterized by a narrowing of the pyriform orifice attributed to excessive growth of the nasal process of the maxilla, resulting in blockage of the nasal passage. Early intervention is crucial as newborns are obligate nasal breathers during the first few months, which may result in respiratory distress in patients with CNPAS. This report reviewed the presentation and management of the CNPAS in a single tertiary paediatric otorhinolaryngology centre. We reported a case series with three term neonates that presented with respiratory distress and noisy breathing at birth. All of them required intubation and were unable to introduce suction catheter size 6Fr via the nostrils. Conservative management, including the use of nasal decongestants and humidification, was tried but failed. The sublabial approach was used for surgical correction in all patients. The pyriform aperture is enlarged with a bone drill and the placement of a nasopharyngeal airway (NPA) into both nostrils, which acts as a stent. The stent is left in place for a total of two to three weeks for all three patients to ensure the patency of the surgical area. All the patients were able to be extubated following surgery and discharged home without oxygen support.

Modeling and verification of cortical bone drilling forces based on tissue structure heterogeneity

Bone drilling mechanism study is the basis for the optimization of cortical bone drilling process and drill geometry. In this paper, a drilling force model for modified drills with thinned chisel edge is established considering the heterogeneous structure of cortical bone. The bone mineral density is embedded into the established model, the model can predict the axial thrust force change along the drilling depth direction, and the model is verified through cortical bone drilling experiments. The thrust force and torque predicted by the model are in good agreement with the drilling experimental results of cortical bone drilling. Then, the drilling performance of the modified drill and the common drill is compared through cortical bone drilling experiments. Compared with common drill bits, the maximum reduction in average thrust force of the modified drill bit during stable drilling is 21.21 % (n = 2500 rpm, Vf=60 mm/min). The maximum reduction in average roughness of the hole wall is 21.87 % (n = 500 rpm, Vf=10 mm/min). The drill chisel edge thinning design reduces the negative impact of the negative normal rake angle on the cutting lip of common drill on drilling force and stability. Therefore, the drill bit chisel edge thinning design can effectively improve the drilling performance.

Experimental Analysis of Robotic Cortical Bone Specimen Drilling Performance: Effect of Cryogen.

In orthopedic surgery, precise bone screw insertion is crucial for stabilizing fractures, necessitating a preliminary cortical bone drilling procedure. However, this process can induce temperatures exceeding 70 °C due to the low thermal conductivity of cortical bone, potentially leading to thermal osteonecrosis. Furthermore, significant cutting forces and torque pose risks of tool breakage and bone damage, underlining the need for high precision and optimal processing parameters. Traditionally, drilling relies on the surgeon's experience and often results in imprecise outcomes due to inconsistent feed rates. Therefore, this study proposes the use of a 6-axis robot for controlled drilling, offering precise control over angular velocities and consistent feed rates. Additionally, explore the use of cryogenic liquid nitrogen (LN2) as a novel cooling method compared to conventional saline solutions, examining its efficacy under various cutting conditions. The results demonstrate that LN2 cooling conditions lead to a reduction in thrust and torque under specific processing conditions, and facilitate smoother chip evacuation. Additionally, LN2 significantly lowers the peak temperature around the drilling site, thus minimizing the risk of thermal osteonecrosis. Consequently, the use of a 6-axis robot provides consistent feed rates, and LN2 cooling achieves optimal processing conditions, enabling a more controlled and effective drilling process.

Study on the influence of cortical bone heterogeneity on the spatio-temporal distribution of drilling temperature

The degree of thermal damage during cortical bone drilling is an important factor in determining the success rate of surgery and postoperative recovery time. In this study, high and low feed rate drilling experiments are carried out on bovine femoral cortical bone by chisel edge thinning drill. Combined with the characterization of cortical bone tissue structure and the measurement results of important thermal property parameters, the potential impact mechanisms of cortical bone heterogeneity on the spatio-temporal distribution of drilling temperature and thermal damage are analyzed. The temperature rise rate and overheating duration at different distances from the hole wall in cortical bone drilling under different feed rates are also compared. The experimental results show that the specific heat gradually increases and the thermal conductivity gradually decreases from the periosteum to the endosteum. The hole wall temperature and thermal diffusion of cortical bone with different tissue structures are different under high and low feed rates. The closer to the cortical bone endosteum, the lower the drilling temperature, thermal diffusion and thermal damage area. This is not only related to the contact time between the drill bit and the hole wall of cortical bone with different tissue structures, but also closely related to the heterogeneous structure of cortical bone. In addition, it is found that in high feed rate cortical bone drilling, the temperature rise rate at different positions from the hole wall is higher and the overheating duration is shorter.

Design and performance analysis of low damage anti-skid crescent drills for bone drilling

BackgroundWith orthopedic surgery increasing year on year, the main challenges in bone drilling are thermal damage, mechanical damage, and drill skid. The need for new orthopedic drills that improve the quality of surgery is becoming more and more urgent.MethodsHere, we report the skidding mechanism of drills at a wide range of inclination angle and propose two crescent drills (CDTI and CDTII). The anti-skid performance and drilling damage of the crescent drills were analyzed for the first time. Inclined bone drilling experiments were carried out with crescent drills and twist drills and real-time drilling forces and temperatures were collected.ResultsThe crescent drills are significantly better than the twist drill in terms of anti-skid, reducing skidding forces, thrust forces and temperature. The highest temperature is generated close to the upper surface of the workpiece rather than at the hole exit. Finally, the longer crescent edge with a small and negative polar angle increases the rake angle of the cutting edge and reduces thrust forces but increases skidding force and temperature. This study can promote the development of high-quality orthopedic surgery and the development of new bone drilling tools.ConclusionThe crescent drills did not skid and caused little drilling damage. In comparison, the CDTI performs better in reducing the skidding force, while the CDTII performs better in reducing the thrust force.

Gca-pvt-net: group convolutional attention and PVT dual-branch network for oracle bone drill chisel segmentation

Oracle bones (Obs) are a significant carrier of the shang dynasty civilization, primarily consisting of tortoise shells and animal bones, through the study of which we can gain a deeper understanding of the political, economic, religious, and cultural aspects of the shang dynasty. The oracle bone drill chisel (Obdc) is considered an essential non-textual material. The segmentation of Obdc assists archaeologists determine the approximate age of the Obs, which possesses considerable research value. However, the breakage of thousands of years of underground buried Obs, the blurring of the edges of the area burned by the Obdc, the different shapes, and the inconsistent number have brought challenges to the accurate segmentation of the Obdc. In this article, we propose a group convolutional attention and pvt dual-branch network (GCA-PVT-Net) for Obdc segmentation. To our knowledge, this paper is the first to research the automatic segmentation of Obdc. It is a hybrid Convolutional neural network (CNN) and Transformer framework. The work offers the following contributions: (1) The Obdc images are labeled based on the delineation criteria of different drill chisel (DC) shapes to create the Obdc dataset. (2) A convolutional attention module (CAM) is proposed as both an encoder and decoder. The feature extraction process, which effectively integrates global and local information, ensures better modeling of long-term correlations in images while preserving details. (3) A channel feature aggregation module (CFAM) is designed to enhance the effective integration of channel features, enabling feature fusion across various branches and at different levels. (4) The edge deep supervision strategy is applied to smooth the jagged edge of the predicted images at the decoder’s end. Extensive experiments on the Obdc dataset show that GCA-PVT-Net outperforms other state-of-the-art (SOTA) methods. The comparative experimental results show that the edge accuracy and segmentation accuracy of the model reach the top 1.

Bone Drilling: Review with Lab Case Study of Bone Layer Classification Using Vibration Signal and Deep Learning Methods

Bone Drilling: Review with Lab Case Study of Bone Layer Classification Using Vibration Signal and Deep Learning Methods