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Einafshar M(M, Rajaeirad M, Babazadeh Ghazijahani A, Skipper Andersen M. On the importance of precision in cortical bone drilling: Integrating experimental validation and computational modeling. J Orthop 2024; 56:70-76. [PMID: 38800589 PMCID: PMC11127272 DOI: 10.1016/j.jor.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024] Open
Abstract
Background Cortical bone drilling is integral to orthopedic and dental surgeries, yet challenges such as thermal necrosis persist. Previous finite element (FE) models may overlook critical parameters, impacting accuracy. This study aims to integrate experimental and computational approaches to predict essential parameters-initial temperature, point angle, and spindle speed-enhancing precision in cortical bone drilling. Methods Bovine cortical samples were utilized to systematically investigate the impact of four independent parameters on maximum temperature (MT) and maximum thrust force (MTF). Parameters included drill bit initial temperature (IT), diameter, point angle, and spindle speed (225-2700 rpm, feed rate 0.5-3 mm/s). Experimental procedures involved an orthopedic handpiece with titanium drill bits. DEFORM-3D V6.02 facilitated FE simulation, with the validated model developed for the second stage of the drilling process. Results The validated model highlighted the significant impact of drill bit IT on MT, predicting a 26.14 % decrease in final bone temperature as IT decreased from 25 to 5 °C. Increasing the point angle from 70 to 120° resulted in a 13.1 % MT increase and a 26.9 % decrease in MTF. Spindle speed variations exhibited a 48.3 % temperature increase and an 82.8 % MTF decrease. Conclusions Integrating experimental validation and computational modeling offers a comprehensive approach to predict drilling parameters. Precision in cortical bone drilling can be optimized by selecting specific parameters, including lower drill bit IT, smaller point angles, and controlled spindle speeds. This optimization reduces the risk of bone necrosis and thermal damage, thereby enhancing surgical outcomes.
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Affiliation(s)
| | - Mohadese Rajaeirad
- Department of Biomedical Engineering, University of Isfahan, Isfahan, Iran
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Zhao J, Wu D, Wu X, Zhang Z, Wen Z, Liu S. Design and performance analysis of low damage anti-skid crescent drills for bone drilling. J Orthop Surg Res 2024; 19:489. [PMID: 39153973 PMCID: PMC11330616 DOI: 10.1186/s13018-024-04983-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND With 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. METHODS Here, 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. RESULTS The 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. CONCLUSION The 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.
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Affiliation(s)
- Jing Zhao
- Department of Stomatology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
| | - Di Wu
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, 300384, China
| | - Xiaojie Wu
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, 300384, China
| | - Ziyang Zhang
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, 300384, China
| | - Zhiguo Wen
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, 300384, China
| | - Sinan Liu
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, 300384, China
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Chen YC, Tsai YJ, Hsiao HY, Chiu YW, Hong YY, Tu YK, Hsiao CK. Assessment of Thermal Osteonecrosis during Bone Drilling Using a Three-Dimensional Finite Element Model. Bioengineering (Basel) 2024; 11:592. [PMID: 38927828 PMCID: PMC11200731 DOI: 10.3390/bioengineering11060592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/19/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Bone drilling is a common procedure used to create pilot holes for inserting screws to secure implants for fracture fixation. However, this process can increase bone temperature and the excessive heat can lead to cell death and thermal osteonecrosis, potentially causing early fixation failure or complications. We applied a three-dimensional dynamic elastoplastic finite element model to evaluate the propagation and distribution of heat during bone drilling and assess the thermally affected zone (TAZ) that may lead to thermal necrosis. This model investigates the parameters influencing bone temperature during bone drilling, including drill diameter, rotational speed, feed force, and predrilled hole. The results indicate that our FE model is sufficiently accurate in predicting the temperature rise effect during bone drilling. The maximum temperature decreases exponentially with radial distance. When the feed forces are 40 and 60 N, the maximum temperature does not exceed 45 °C. However, with feed forces of 10 and 20 N, both the maximum temperatures exceed 45 °C within a radial distance of 0.2 mm, indicating a high-risk zone for potential thermal osteonecrosis. With the two-stage drilling procedure, where a 2.5 mm pilot hole is predrilled, the maximum temperature can be reduced by 14 °C. This suggests that higher feed force and rotational speed and/or using a two-stage drilling process could mitigate bone temperature elevation and reduce the risk of thermal osteonecrosis during bone drilling.
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Affiliation(s)
- Yung-Chuan Chen
- Department of Vehicle Engineering, National Pingtung University of Science and Technology, Pingtung 912301, Taiwan; (Y.-C.C.); (Y.-Y.H.)
| | - Yi-Jung Tsai
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (Y.-J.T.); (Y.-W.C.)
| | - Hao-Yuan Hsiao
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804201, Taiwan;
- Department of Orthopedics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Yen-Wei Chiu
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (Y.-J.T.); (Y.-W.C.)
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804201, Taiwan;
| | - You-Yao Hong
- Department of Vehicle Engineering, National Pingtung University of Science and Technology, Pingtung 912301, Taiwan; (Y.-C.C.); (Y.-Y.H.)
| | - Yuan-Kun Tu
- Department of Orthopedics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chih-Kun Hsiao
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (Y.-J.T.); (Y.-W.C.)
- Department of Orthopedics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Mechanical Engineering/Graduate Institute of Mechatronics Engineering, Cheng Shiu University, Kaohsiung 833301, Taiwan
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Pourgiv S, Mosavar A, Jamshidi N, Mohammadi A. Ultrasonic-assisted drilling of cortical and cancellous bone in a comparative point of view. Heliyon 2024; 10:e26248. [PMID: 38434327 PMCID: PMC10906326 DOI: 10.1016/j.heliyon.2024.e26248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/30/2023] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
Background During bone drilling, a common procedure in clinical surgeries, excessive heat generation and drilling force can cause damage to bone tissue, potentially leading to failure of implants and fixation screws or delayed healing. With this in mind, the aim of this study was to evaluate the efficiency of ultrasonic-assisted drilling compared to conventional drilling as a potential method for bone drilling. Methods This study examined optimal drilling parameters based on previous findings and investigated both cortical and cancellous bone. In addition to evaluating drilling force and temperature elevation, the effects of these factors on osteonecrosis and micro-crack formation were explored in ultrasonic-assisted and conventional drilling through histopathological assessment and microscopic imaging. To this end, three drilling speeds and two drilling feed-rates were considered as variables in the in vitro experiments. Furthermore, numerical modeling provided insight into temperature distribution during the drilling process in both methods and compared three different vibration amplitudes. Results Although temperature elevations were lower in the conventional drilling, ultrasonic-assisted drilling produced less drilling force. Additionally, the latter method resulted in smaller osteonecrosis regions and did not produce micro-cracks in cortical bone or structural damage in cancellous bone. Conclusions Ultrasonic-assisted drilling, which caused less damage to bone tissue in both cortical and cancellous bone, was comparatively more advantageous. Notably, this study demonstrated that to determine the superiority of one method over the other, we cannot rely solely on temperature variation results. Instead, we must consider the cumulative effect of both temperature elevation and drilling force.
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Affiliation(s)
- Sousan Pourgiv
- Department of Biomedical Engineering, University of Isfahan, 81746-73441, Iran
| | - Alireza Mosavar
- Department of Biomedical Engineering, University of Isfahan, 81746-73441, Iran
- Department of Biomechanics, School of Mechanical Engineering, College of Engineering, University of Tehran, 14174-66191, Tehran, Iran
| | - Nima Jamshidi
- Department of Biomedical Engineering, University of Isfahan, 81746-73441, Iran
| | - Aminollah Mohammadi
- Department of Mechanical Engineering, Isfahan University of Technology, Isfahan, 84156-83111, Iran
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Zhao R, Xie R, Ren N, Li Z, Zhang S, Liu Y, Dong Y, Yin AA, Zhao Y, Bai S. Correlation between intraosseous thermal change and drilling impulse data during osteotomy within autonomous dental implant robotic system: An in vitro study. Clin Oral Implants Res 2024; 35:258-267. [PMID: 38031528 DOI: 10.1111/clr.14222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 09/05/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES This study aims at examining the correlation of intraosseous temperature change with drilling impulse data during osteotomy and establishing real-time temperature prediction models. MATERIALS AND METHODS A combination of in vitro bovine rib model and Autonomous Dental Implant Robotic System (ADIR) was set up, in which intraosseous temperature and drilling impulse data were measured using an infrared camera and a six-axis force/torque sensor respectively. A total of 800 drills with different parameters (e.g., drill diameter, drill wear, drilling speed, and thickness of cortical bone) were experimented, along with an independent test set of 200 drills. Pearson correlation analysis was done for linear relationship. Four machining learning (ML) algorithms (e.g., support vector regression [SVR], ridge regression [RR], extreme gradient boosting [XGboost], and artificial neural network [ANN]) were run for building prediction models. RESULTS By incorporating different parameters, it was found that lower drilling speed, smaller drill diameter, more severe wear, and thicker cortical bone were associated with higher intraosseous temperature changes and longer time exposure and were accompanied with alterations in drilling impulse data. Pearson correlation analysis further identified highly linear correlation between drilling impulse data and thermal changes. Finally, four ML prediction models were established, among which XGboost model showed the best performance with the minimum error measurements in test set. CONCLUSION The proof-of-concept study highlighted close correlation of drilling impulse data with intraosseous temperature change during osteotomy. The ML prediction models may inspire future improvement on prevention of thermal bone injury and intelligent design of robot-assisted implant surgery.
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Affiliation(s)
- Ruifeng Zhao
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
- Department of Stomatology, 960 Hospital of the Chinese People's Liberation Army, Jinan, Shandong, China
| | - Rui Xie
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
| | - Nan Ren
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
| | - Zhiwen Li
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
| | - Shengrui Zhang
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
| | - Yuchen Liu
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
| | - Yu Dong
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
- Department of Stomatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - An-An Yin
- Department of Plastic and Reconstructive Surgery, Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yimin Zhao
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
| | - Shizhu Bai
- Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, China
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Pazarcı Ö, Gündoğdu F. Temperature change during orthopedic drilling procedures: An experimental surgical internal fixation simulation study. J Orthop 2023; 46:58-63. [PMID: 37942216 PMCID: PMC10630755 DOI: 10.1016/j.jor.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023] Open
Abstract
Background The purpose of this experimental surgical internal fixation simulation study was to analyze four drilling parameters as a whole, use a thermal camera to observe the temperature, and then determine how these parameters were related to temperature. Methods Four separate experimental models were examined in terms of the impacts of four drilling parameters, defined as the drill, drill bit diameter, drill bit design, and the material drilled during drilling procedures, on temperature. Results The temperature was observed to be affected by the drill used, a change in the drill bit diameter, drill bit design, and the characteristics of the material drilled (p < 0.041, p < 0.001, p < 0.001, and p < 0.001, respectively). The speeds of the four drills used were measured as 558 rpm, 1385 rpm, 930 rpm, and 1490 rpm. Conclusion The findings of the present research demonstrated that the four parameters investigated were related to the temperature formed during drilling. Of the parameters examined, the parameter which increased the temperature the most was a change in the drill bit diameter.
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Affiliation(s)
- Özhan Pazarcı
- Department of Orthopaedics and Traumatology, Adana City Training and Research Hospital, Adana, Turkey
| | - Faruk Gündoğdu
- Department of Orthopaedics and Traumatology, Batman Training and Research Hospital, Batman, Turkey
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7
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Pye JL, Garcia TC, Kapatkin AS, Samol MA, Stover S. Biomechanical comparison of compact versus standard flute drill bits, and interlocking versus buttress thread self-tapping cortical bone screws in cadaveric equine third metacarpal condyle. Vet Surg 2023; 52:1128-1139. [PMID: 37302003 DOI: 10.1111/vsu.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/17/2023] [Accepted: 04/16/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To compare (1) performance of compact versus standard flute drill bits, (2) screw insertion properties and (3) pullout variables between interlocking thread (ITS) and buttress thread (BTS) self-tapping screws in third metacarpi. STUDY DESIGN In vitro experimental study. SAMPLE POPULATION Paired third metacarpi from 11 Thoroughbreds aged 2-4 years. METHODS Screws were inserted into the lateral condylar fossae following bone preparation using the respective drill bit for each screw type. Screw pullout was achieved using a mechanical testing system. Density and porosity of bone surrounding screw holes was measured with microcomputed tomography following each pullout test. Drilling, screw insertion and pullout variables were compared between drill bit and screw types using repeated measures ANOVA. Linear regression analyses were used to characterize relationships between bone tissue properties and drill bit and screw outcomes. RESULTS Maximum torque power spectral density (PSD) was lower for compact flute drill bits. Insertion torque was 50% higher for ITS. BTS had 33% greater preyield stiffness and 7% greater mean yield force. Bone tissue properties affected measured variables similarly for both screw and drill bit types. CONCLUSIONS Lower torque PSD may increase durability of the compact flute drill bit. ITS had greater insertional torque, which may reflect greater bone engagement. BTS had greater resistance to axial pullout forces. CLINICAL SIGNIFICANCE Metacarpal bone provides a simple model for comparison of drill bit and screw designs. Use of ITS to repair equine fractures subject to predominantly tensile forces is not justified based on the results of this study.
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Affiliation(s)
- Jannah L Pye
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Tanya C Garcia
- JD Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Amy S Kapatkin
- JD Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Monika A Samol
- California Animal Health and Food Safety System, San Bernadino Branch, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Susan Stover
- JD Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
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8
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Alam K, Qamar SZ, Iqbal M, Piya S, Al-Kindi M, Qureshi A, Al-Ghaithi A, Al-Sumri B, Silberschmidt VV. Effect of drill quality on biological damage in bone drilling. Sci Rep 2023; 13:6234. [PMID: 37069203 PMCID: PMC10110507 DOI: 10.1038/s41598-023-33381-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/12/2023] [Indexed: 04/19/2023] Open
Abstract
Bone drilling is a universal procedure in orthopaedics for fracture fixation, installing implants, or reconstructive surgery. Surgical drills are subjected to wear caused by their repeated use, thermal fatigue, irrigation with saline solution, and sterilization process. Wear of the cutting edges of a drill bit (worn drill) is detrimental for bone tissues and can seriously affect its performance. The aim of this study is to move closer to minimally invasive surgical procedures in bones by investigating the effect of wear of surgical drill bits on their performance. The surface quality of the drill was found to influence the bone temperature, the axial force, the torque and the extent of biological damage around the drilling region. Worn drill produced heat above the threshold level related to thermal necrosis at a depth equal to the wall thickness of an adult human bone. Statistical analysis showed that a sharp drill bit, in combination with a medium drilling speed and drilling at shallow depth, was favourable for safe drilling in bone. This study also suggests the further research on establishing a relationship between surface integrity of a surgical drill bit and irreversible damage that it can induce in delicate tissues of bone using different drill sizes as well as drilling parameters and conditions.
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Affiliation(s)
- Khurshid Alam
- Department of Mechanical and Industrial Engineering, College of Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud, 123, Sultanate of Oman.
| | - Sayyad Zahid Qamar
- Department of Mechanical and Industrial Engineering, College of Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud, 123, Sultanate of Oman
| | - Muhammad Iqbal
- Creative Engineering & Management Services, Saddar Road, Peshawar, Pakistan
| | - Sujan Piya
- Department of Industrial Engineering and Engineering Management, College of Engineering, University of Sharjah, Sharjah, UAE
| | - Mahmood Al-Kindi
- Department of Mechanical and Industrial Engineering, College of Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud, 123, Sultanate of Oman
| | - Asim Qureshi
- Department of Pathology, Sultan Qaboos University, Al-Khoud, 123, Sultanate of Oman
| | - Ahmed Al-Ghaithi
- Department of Surgery, Sultan Qaboos University Hospital, Al-Khoud, 123, Sultanate of Oman
| | - Badar Al-Sumri
- Histopathology Laboratory, Sultan Qaboos University Hospital, Al-Khoud, 123, Sultanate of Oman
| | - Vadim V Silberschmidt
- School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, UK
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Bai X, Qiao G, Liu Z, Zhu W. Investigation of transient machining in the cortical bone drilling process by conventional and axial vibration-assisted drilling methods. Proc Inst Mech Eng H 2023; 237:489-501. [PMID: 36927106 DOI: 10.1177/09544119231157448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
A temperature exceeding the safety threshold and excessive drilling force occurring during bone drilling may lead to irreversible damage to bone tissue and postoperative complications. Previous studies have shown that vibration-assisted drilling methods could have lower temperatures and drilling forces than those of the conventional drilling method; we hypothesized that the main reason for these reductions stems from the differences in the transient machining processes between conventional and vibration-assisted drilling methods. To investigate these differences, comparative experiments and two-dimensional finite element models were performed and developed. The differences in the transient machining processes were verified by experimentation and clearly exhibited by the finite element models. Compared with the steady cutting process that produced continuous-spiral chips in the conventional drilling method, transient machining in the low-frequency vibration-assisted drilling method was a periodically dynamic cutting-separation process that produced uniform petal chips with specific settings of drilling and vibration parameters. Moreover, the transient machining process in the ultrasonic vibration-assisted drilling method was transformed into a combined action with high-speed impact and negative rake angle cutting processes; this action produced a large proportion of powdery chips. Therefore, it could be concluded that the superposed axial vibration significantly changed the transient machining process and radically changed the mechanical state and thermal environment; these changes were the main reason for the apparent differences in the drilling performance levels.
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Affiliation(s)
- Xiaofan Bai
- School of Mechanical and Equipment Engineering, Hebei University of Engineering, Handan, China
| | - Guochao Qiao
- School of Mechanical Engineering, Hebei University of Technology, Tianjin, China
| | - Zhiqiang Liu
- School of Mechanical and Equipment Engineering, Hebei University of Engineering, Handan, China
| | - Weidong Zhu
- Department of Mechanical Engineering, University of Maryland, Baltimore County, MD, USA
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10
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Tool parameters to minimize temperature changes in bone drilling. Injury 2023; 54:904-909. [PMID: 36621360 DOI: 10.1016/j.injury.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/28/2022] [Accepted: 01/02/2023] [Indexed: 01/04/2023]
Abstract
BACKGROUND Drilling is a common technique used in orthopedic surgery procedures but causes increases in temperature that can lead to cell damage and death. The extent of this depends largely on the magnitude of the increase in temperature. The commonly accepted limit to prevent osteonecrosis is less than 47 °C for 60 s. There is controversy when it comes to the optimal drilling parameters that limit temperature increases and cell death. In addition to this, less research has been done on the drilling effects in the osteochondral area of joints. Osteochondral tissue damage can interfere with the daily lives of patients and if severe enough will need to be treated. We hypothesize that increasing tool speed and drill bit size will increase temperature that could be above the osteonecrosis limit. METHODS Ex-vivo experiments were conducted on porcine shoulder joints that tested the thermal effects of different tool speeds and drill bit sizes. A thermal camera was used to record and measure real time temperature changes while drilling. Three drill bit sizes and five tool speeds were used. Statistical analyses includes Welch's ANOVA with Games-Howell Post Hoc analyses, multivariate linear regression, and surface response regression were used to explore the association of tool speeds and drill bit size on temperature. RESULTS AND CONCLUSIONS All the tool speed and drill bit size combinations lead to an increase in temperature that were under the commonly accepted limit. The highest temperature reached was 44 °C with a tool speed of 1150 RPM and 3070 RPM and drill bit size 5.159 mm. It was found that increasing the tool speed increased the temperature change and increasing the drill bit size increased the temperature change.
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11
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Bone cutting efficiency and heat generation using a traditional fluted Burr and a novel fluteless resurfacing tool. Clin Biomech (Bristol, Avon) 2023; 102:105898. [PMID: 36764102 DOI: 10.1016/j.clinbiomech.2023.105898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Powered instrumentation is often used for bone preparation and/or removal in many orthopaedic procedures but does risk thermogenesis. This study compares biomechanical properties of a fluted burr and a novel fluteless resurfacing tool. METHODS Twenty cadaveric metatarsals were tested with four predetermined cutting forces to evaluate heat generation and cutting rate for the fluted burr and fluteless resurfacing tool over 40 s or until a depth of 4 mm was reached. Cutting rate was calculated from displacement transducer data. Heat generation was measured by thermocouples placed in the bone adjacent to the burring site. Assuming a body temperature of 37 °C, a 10 °C increase in heat was used as the threshold of inducing osteonecrosis. FINDINGS At 1.0 N and 1.7 N, the thermal osteonecrosis threshold was reached at comparable times between burrs, while the bone removed by the resurfacing tool was on average five times greater than fluted burr at 1.0 N and over twice as great at 1.7 N. Statistical analysis of these common cutting forces showed the resurfacing tool had significantly higher cutting rates (P < 0.01). As a result, the fluted burr produced higher temperatures for the same amount of bone removal (P < 0.01). INTERPRETATION In a cadaveric study, the fluteless resurfacing tool demonstrated higher bone cutting rates and lower heat generation for the same amount of bone removed than a traditional fluted burr.
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12
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Li S, Tanner A, Romanos G, Delgado-Ruiz R. Heat Accumulation in Implant Inter-Osteotomy Areas-An Experimental In Vitro Study. Biomedicines 2022; 11:biomedicines11010009. [PMID: 36672516 PMCID: PMC9855973 DOI: 10.3390/biomedicines11010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/26/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
To examine the influence of the distance between adjacent implant osteotomies on heat accumulation in the inter-osteotomy area, two experimental groups with 15 pairs of osteotomies in Type II polyurethane blocks were compared: 7 mm inter-osteotomy separations (Group A, n = 15) and 14 mm inter-osteotomy separations (Group B, n = 15). An infrared thermographic analysis of thermal changes in the inter-osteotomy area was completed. A one-way analysis of variance (ANOVA) and Fisher post-test were used to determine group differences. Higher temperatures were recorded in Group A at the coronal and middle levels compared to the apical level in both groups. The temperature reached max temperatures at T80s and T100s. In Group A, the threshold for thermal necrosis was exceeded. Meanwhile, Group B did not reach the threshold for thermal necrosis. Preparing adjacent implant osteotomies in dense bone with a 7 mm separation between their centers increases the temperature in the inter-osteotomy area, exceeding the threshold for bone thermal necrosis; meanwhile, increasing the distance between osteotomies reduces the thermal accumulation and the risk for thermal necrosis.
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Affiliation(s)
- Shanlin Li
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Adam Tanner
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
- Correspondence:
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Cardoso DV, Veljkovic A. General Considerations About Foot and Ankle Arthrodesis. Any Way to Improve Our Results? Foot Ankle Clin 2022; 27:701-722. [PMID: 36368793 DOI: 10.1016/j.fcl.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Nonunion and adjacent joint osteoarthritis (OA) are known complications after a fusion procedure, and foot and ankle surgeons are commonly exposed to such disabling complications. Determining who is at risk of developing nonunion is essential to reducing nonunion rates and improving patient outcomes. Several evidenced-based modifiable risk factors related to adverse outcomes after foot and ankle arthrodesis have been identified. Patient-related risk factors that can be improved before surgery include smoking cessation, good diabetic control (HbAc1 <7%) and vitamin D supplementation. Intraoperatively, using less invasive techniques, avoiding joint preparation with power tools, using bone grafts or orthobiologics in more complex cases, high-risk patients, nonunion revision surgeries, and filling in bone voids at the arthrodesis site should be considered. Postoperatively, pain management with NSAIDs should be limited to a short period (<2 weeks) and avoided in high-risk patients. Furthermore, early postoperative weight-bearing has shown to be beneficial, and it does not seem to increase postoperative complications. The incidence of surrounding joint OA after foot and ankle fusion seems to increase progressively with time. Owing to its progression and high probability of being symptomatic, patients must be informed consequently, as they may require additional joint fusions, resulting in further loss of ankle/foot motion. In patients with symptomatic adjacent joint OA and unsatisfactory results after an ankle arthrodesis, conversion to total ankle arthroplasty (TAA) has become a potential option in managing these complex and challenging situations.
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Affiliation(s)
- Diogo Vieira Cardoso
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 1205, Switzerland.
| | - Andrea Veljkovic
- Division of Orthopaedics and Trauma Surgery, British Columbia University, Vancouver, Canada
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Zhao J, Liu S, Zhang Z, Gong K, Zhao J. Understanding the thrust force evolution and primary stability for dental implantation – An in-vitro experimental investigation. Proc Inst Mech Eng H 2022; 236:1732-1743. [DOI: 10.1177/09544119221131880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The dental implant is challenging due to the unstable quality of the surrounding bone. This study aimed to explore the feasibility of using thrust force characteristics to identify different bone types and the influencing mechanisms of spindle speed and feed rate on primary stability of dental implants through in-vitro experiments. 13 groups of osteotomy experiments were performed on mandibles and maxillae of pigs with different bone types (I, II, and III) under different spindle speeds (600 and 800 rpm) and feed rates (20 and 60 mm/min). The thrust force evolution under different conditions was extracted and analysed to elaborate the distribution and thickness of the cortical and trabecular bone layers on different bone types. Dental implant placements were performed, and corresponding primary stabilities were obtained. Furthermore, histologic observation was conducted to reveal the bone/implant contact morphology. From the results, the amplitude and trend of thrust force show a regular variation during drilling different bone types. The highly dynamic information of thrust force can be analysed to characterise the distribution and thickness of the cortical and trabecular bone layers, hence effectively detecting different bone types. Since a lower feed rate and resulting bone temperature elevation lead to more thermal damages, primary stability decreases with the decrease of feed rate. Spindle speed has no significant effect. This study establishes a more in-depth understanding into the thrust force evolution and also provide a clinical option for reducing the complexity of bone type and drilling parameters determination in osteotomy.
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Affiliation(s)
- Jing Zhao
- Department of Stomatology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, China
| | - Sinan Liu
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, China
| | - Zhijun Zhang
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, China
| | - Kun Gong
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, China
| | - Jian Zhao
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, China
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15
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Prediction of temperature elevation in rotary ultrasonic bone drilling using machine learning models: An in-vitro experimental study. Med Eng Phys 2022; 110:103869. [PMID: 35963828 DOI: 10.1016/j.medengphy.2022.103869] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 01/18/2023]
Abstract
Bone drilling is frequently used during orthopaedic surgeries to treat the fractured part of the bone. A major concern for surgeons is the increase in temperature during real-time orthopaedic bone drilling. The temperature elevation at the bone-tool interface may cause permanent death of regenerative soft tissues and cause thermal osteonecrosis. A robust predictive machine-learning model is suggested in this in-vitro research for monitoring temperature rise during surgery. The objective of the present work is to introduce different machine learning algorithms for predicting temperature elevations in rotary ultrasonic bone drilling. Different machine-learning models were compared with the standard response surface methodology. The performance and accuracy of different predictive models were compared at different error metrics. It was witnessed that support vector machines performed the best for predicting the change in temperature in comparison to other predictive models. Moreover, the error metrics for statistical response surface methodology analysis were comparatively higher than the machine learning algorithms. By using machine learning models, it is possible to predict temperature rise during bone drilling.
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Tamiti L, Braymand S, Bahlouli N, Facca S, Sapa MC, Liverneaux P. K-wire pullout strength in hand surgery: Impact of diameter, threading length and drilling speed. Orthop Traumatol Surg Res 2022; 108:103248. [PMID: 35181514 DOI: 10.1016/j.otsr.2022.103248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/23/2021] [Accepted: 09/03/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The aim of the present study was to assess the impact, combined and in interaction, of diameter, threading length and drilling speed on K-wire pullout strength in a synthetic model of a hand bone. MATERIAL AND METHODS The material comprised Sawbones® (20 ×20×50mm), K-wires (diameter 1.2mm, 1.5mm, 1.8mm; threading 0mm, 5mm, 10mm, 15mm), a universal chuck with T handle and a drill (speed 0, 320, 500, 830, 1,290rpm), and tensile testing machine and a digital decision aid. The Sawbones® were drilled, varying diameter, threading and speed. The Statistical Design of Experiments (SDOE) methodology enabled the number of trials to be reduced from 300 to 70. Tensile tests at 1mm/s was imposed on the K-wire up to pullout (pullout strength). RESULTS There was no interaction between threading length and diameter effects or between drilling speed and diameter effects, but a strong interaction between drilling speed and threading length effects. CONCLUSION Before using K-wires for internal fixation in wrist or hand fracture, the surgeon has to select their characteristics, optimal holding power being theoretically ensured by large diameter wires with long threading inserted by a high-speed drill. LEVEL OF EVIDENCE I, experimental study.
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Affiliation(s)
- Louisa Tamiti
- ICube CNRS UMR7357, Strasbourg University, 2-4, rue Boussingault, 67000 Strasbourg, France
| | - Sandrine Braymand
- ICube CNRS UMR7357, Strasbourg University, 2-4, rue Boussingault, 67000 Strasbourg, France
| | - Nadia Bahlouli
- ICube CNRS UMR7357, Strasbourg University, 2-4, rue Boussingault, 67000 Strasbourg, France
| | - Sybille Facca
- ICube CNRS UMR7357, Strasbourg University, 2-4, rue Boussingault, 67000 Strasbourg, France; Department of Hand Surgery, Strasbourg University Hospitals, FMTS, 1, avenue Molière, 67200 Strasbourg, France
| | - Marie Cécile Sapa
- Department of Hand Surgery, Strasbourg University Hospitals, FMTS, 1, avenue Molière, 67200 Strasbourg, France
| | - Philippe Liverneaux
- ICube CNRS UMR7357, Strasbourg University, 2-4, rue Boussingault, 67000 Strasbourg, France; Department of Hand Surgery, Strasbourg University Hospitals, FMTS, 1, avenue Molière, 67200 Strasbourg, France.
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Aydın K, Ökten K, Uğur L. An analytical and numerical approach to the determination of thermal necrosis in cortical bone drilling. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3640. [PMID: 35899364 DOI: 10.1002/cnm.3640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/08/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
In the process of repairing fractures in the bone region with orthopedic injuries, the application of supporting and strengthening the bone tissue with screws, wires, rods, and plates is a widely preferred internal fixation method. In this treatment process, it is necessary to drill the bone tissue to fix the screws. Due to the heat generated in the drilling process, mechanical and thermal damage occurs in the bone tissue. In this study, it is focused that the effect of different cutting conditions on the temperature distribution and necrosis zones in the drilling of human cortical bone. In this context, by selecting variable drill geometry (diameter, point angle, and helix angle) and variable cutting parameters (cutting speed and feed rate), temperature distribution and necrosis zones were investigated with finite element analyses and analytical calculations. When the findings were evaluated, it was understood that drill diameter and cutting speed did not have a significant effect on temperatures and necrosis zone at low cutting speeds. At high cutting speeds, it was observed that the feed rate and drill point angle had an indeterminate effect on the temperatures. The lowest temperature values were obtained at cutting speed of 750 rpm and a feed rate of 0.1 mm/rev for low cutting speeds, and cutting speed of 1500 rpm, helix angle of 10° and drill bit diameter of 2 mm for high cutting speeds. The narrowest necrosis zones were obtained at cutting speed of 250 rpm and feed rate of 0.1 mm/rev for both drill diameters. As a result, the effects of different drill geometry and cutting parameters were determined in order to obtain low temperature distribution and narrow necrosis zone in cortical bone drilling.
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Affiliation(s)
- Kutay Aydın
- Faculty of Engineering, Department of Mechanical Engineering, Amasya University, Amasya, Turkey
| | - Korhan Ökten
- Faculty of Engineering, Department of Mechanical Engineering, Amasya University, Amasya, Turkey
| | - Levent Uğur
- Faculty of Engineering, Department of Mechanical Engineering, Amasya University, Amasya, Turkey
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18
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Vittrup S, Stilling M, Hanberg P, Tøstesen SK, Knudsen MB, Kipp JO, Bue M. Concentrations of co-administered vancomycin and meropenem in the internal dead space of a cannulated screw and in cancellous bone adjacent to the screw - Evaluated by microdialysis in a porcine model. Injury 2022; 53:2734-2740. [PMID: 35710595 DOI: 10.1016/j.injury.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/22/2022] [Accepted: 06/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Cannulated screws are often used in the management of open lower extremity fractures. These fractures exhibit broad contamination profiles, necessitating empirical Gram-positive and Gram-negative antibiotic coverage. To ensure full antibiotic protection of the cannulated screw and the bone tissue, it is generally accepted that target tissue antibiotic concentrations, as a minimum, reach and remain above relevant epidemiological cut-off minimal inhibitory concentrations (T>MIC) for a sufficient amount of time. METHODS 8 female pigs were included. Microdialysis catheters were placed in the internal dead space of a cannulated screw placed in tibial cancellous bone, in tibial cancellous bone adjacent to the screw (mean distance to the screw: 3 mm), and in cancellous bone on the contralateral tibia. Following single-dose simultaneous intravenous administrations of vancomycin (1000 mg) and meropenem (1000 mg), microdialysates and plasma were dynamically sampled over 8 h. The applied MIC targets ranged from 1 to 4 µg/mL for vancomycin and 0.125-2 µg/mL for meropenem RESULTS: For both drugs, and for all MIC targets investigated (except for the high vancomycin target: 4 µg/mL), the internal dead space of the cannulated screw had the shortest T>MIC. At the low MIC targets T>MIC ranged between 88 and 449 min across sampling sites for vancomycin (1 µg/mL), and 148-406 min for meropenem (0.125 µg/mL). For the high MIC targets, T>MIC ranged between 3 and 446 min for vancomycin (4 μg/mL) and 17-181 min for meropenem (2 μg/mL). Vancomycin displayed longer T>MIC (2 and 4 μg/mL), higher area under the concentration time curve (AUC0-last) and peak drug concentration in the proximal tibial cancellous bone without a screw nearby. For meropenem, only the cancellous bone AUC0-last was significantly higher on the side with no screw. CONCLUSION We found short T>MIC, particularly for the high MIC targets for vancomycin and meropenem, both inside the cannulated screw and in cancellous bone adjacent to the screw. The presence of a cannulated screw impaired the penetration of especially vancomycin into cancellous bone adjacent to the screw. More aggressive or different vancomycin and meropenem approaches may be considered to encompass contaminating differences and to ensure a theoretically more sufficient antibiotic protection of cannulated screws when used in the management of open lower extremity fractures.
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Affiliation(s)
- Sofus Vittrup
- Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, J112, Aarhus N 8200, Denmark.
| | - Maiken Stilling
- Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, J112, Aarhus N 8200, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, IN CUBA, Aarhus N 8200, Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N 8200, Denmark
| | - Pelle Hanberg
- Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, J112, Aarhus N 8200, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, IN CUBA, Aarhus N 8200, Denmark
| | - Sara Kousgaard Tøstesen
- Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, J112, Aarhus N 8200, Denmark
| | - Martin Bruun Knudsen
- Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, J112, Aarhus N 8200, Denmark
| | - Josephine Olsen Kipp
- Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, J112, Aarhus N 8200, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, IN CUBA, Aarhus N 8200, Denmark
| | - Mats Bue
- Aarhus Denmark Microdialysis Research (ADMIRE), Orthopaedic Research Laboratory, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, J112, Aarhus N 8200, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, IN CUBA, Aarhus N 8200, Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N 8200, Denmark
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19
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Song S, Cheng X, Li T, Shi M, Zheng G, Liu H. Experimental study of bone drilling by Kirschner wire. Med Eng Phys 2022; 106:103835. [DOI: 10.1016/j.medengphy.2022.103835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/21/2022] [Accepted: 06/12/2022] [Indexed: 10/18/2022]
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20
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Tsiagadigui JG, Ndiwe B, Ngo Yamben MA, Fotio N, Belinga FE, Njeugna E. The effects of multiple drilling of a bone with the same drill bit: thermal and force analysis. Heliyon 2022; 8:e08927. [PMID: 35243056 PMCID: PMC8861400 DOI: 10.1016/j.heliyon.2022.e08927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/21/2021] [Accepted: 02/07/2022] [Indexed: 11/17/2022] Open
Abstract
Repeated use of the same drill bit during drilling wears off the cutting edges, which can lead to a significant increase in heat as a result of friction, which is harmful to a bone above 55 °C. Few previous studies have examined the effects of using the same drill bit several times, on temperature. The objective of this study was to determine the effect of each drilling on temperature and force. 72 trials were performed. A total of 24 stainless steel drill bits of ∅3.2 mm were used to drill bovine bone samples. Each drill bit was used at least 3 times. T thermocouples were used to measure temperatures during each drilling test. Possible correlations of cutting parameters were studied. Tests were performed on a test rig measuring forces and temperatures during drilling. Effects of spindle speed (N), feed rate (Vf), and several trials (E) on temperature and forces were measured. Images of the drill bits were analyzed by digital microscopy before and after the drilling series for signs of wear. Temperatures increased significantly from E1 to E3. They decreased moderately with Vf. The best cutting conditions were at N = 200 rpm for Vf = 60 mm/min and N = 100 rpm for Vf = 30 mm/min drilling. At N > 200 rpm, they were very high. Temperature rise is significantly related to number of drilling (E), spindle speed (N), and inversely to feed rate (Vf). Analysis of images by digital microscopy confirmed drill bits wearing off, following the number of trials.
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Affiliation(s)
- Jean Gustave Tsiagadigui
- Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, B.P: 1364, Yaoundé, Cameroon
- Department of Mechanical Engineering, ENSET, University of Douala, P.O. Box 1872, Douala, Cameroon
- Corresponding author.
| | - Benoit Ndiwe
- Department of Mechanical Engineering, ENSET, University of Douala, P.O. Box 1872, Douala, Cameroon
| | - Marie-Ange Ngo Yamben
- Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, B.P: 1364, Yaoundé, Cameroon
| | - Nzogning Fotio
- Department of Mechanical Engineering, ENSET, University of Douala, P.O. Box 1872, Douala, Cameroon
- Laboratory of Materials Mechanics, Structures and Integrated Manufacturing, National Advanced School of Engineering, Yaoundé 1 University, BP 8390, Yaoundé, Cameroon
| | - Fabrice Ella Belinga
- Department of Mechanical Engineering, ENSET, University of Douala, P.O. Box 1872, Douala, Cameroon
| | - Ebenezer Njeugna
- Department of Mechanical Engineering, ENSET, University of Douala, P.O. Box 1872, Douala, Cameroon
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21
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Song S, Cheng X, Li T, Shi M, Zheng G, Liu H. Parametric study of bone drilling by the Kirschner wire. Med Eng Phys 2021; 98:115-124. [PMID: 34848030 DOI: 10.1016/j.medengphy.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/28/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
In order to improve the quality and reduce mechanical damage during bone drilling in surgeries, the three key parameters in drilling by the Kirschner wire are experimentally studied based on the response surface method (RSM). And through response surface analysis, a predictive model of each factor and response value is established. The experimental results found that when the beveled plane angle Φ = 10°, the rotational speed n = 1200 rpm, and the feed speed vf = 20 mm/min. Not only the drilling force is minimized, the delamination coefficient and the height of the hole exit burr are also the minimum. Therefore, the smaller bevel angle, the feed speed and the higher rotation speed can effectively reduce the drilling force, the delamination factor and the height of the hole exit burr, and significantly improve the drilling quality.
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Affiliation(s)
- Shaokang Song
- School of Mechanical Engineering, Shandong University of Technology, Zibo, 255000, China
| | - Xiang Cheng
- School of Mechanical Engineering, Shandong University of Technology, Zibo, 255000, China.
| | - Tao Li
- Zibo Central Hospital, Zibo 255000, China
| | - Ming Shi
- Zibo Central Hospital, Zibo 255000, China
| | - Guangming Zheng
- School of Mechanical Engineering, Shandong University of Technology, Zibo, 255000, China
| | - Huanbao Liu
- School of Mechanical Engineering, Shandong University of Technology, Zibo, 255000, China
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22
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Safari M, Tahmasbi V, Rabiee AH. Investigation into the automatic drilling of cortical bones using ANFIS-PSO and sensitivity analysis. Neural Comput Appl 2021. [DOI: 10.1007/s00521-021-06248-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bai W, Pan P, Shu L, Yang Y, Zhang J, Xu J, Sugita N. Design of a self-centring drill bit for orthopaedic surgery: A systematic comparison of the drilling performance. J Mech Behav Biomed Mater 2021; 123:104727. [PMID: 34492615 DOI: 10.1016/j.jmbbm.2021.104727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/12/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
Bone drilling is an indispensable and demanding operation among many orthopaedic operations. A dedicated drill bit that can achieve low-trauma and self-centring drilling is in urgent need. In this study, a three-step orthopaedic low-traumatic drill bit design was proposed. In order to evaluate the drilling performance of the proposed drill, comprehensive comparison tests were carried out with various commercial medical drills in terms of skiving force, thrust force, temperature rise, and surface quality. The experimental results show that the proposed three-step drill design with the optimal point angle, a small chisel edge, transition arc and web thinning can obtain lower and more stable thrust force, slighter bending force, smaller temperature rise, and higher hole quality compared with the commercial drill bits. The proposed drill shows satisfactory drilling performance and has great application potential in clinical surgery.
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Affiliation(s)
- Wei Bai
- State Key Lab of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China; Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen, 518000, China
| | - Pengfei Pan
- State Key Lab of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Liming Shu
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1138656, Japan.
| | - Yuhang Yang
- Department of Mechanical and Aerospace Engineering, University of Miami, Coral Gables, FL, 33124, United States
| | - Jianguo Zhang
- State Key Lab of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China; Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen, 518000, China
| | - Jianfeng Xu
- State Key Lab of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China.
| | - Naohiko Sugita
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1138656, Japan
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Son K, Son YT, Kim JY, Lee JM, Yu WJ, Kim JW, Lee KB. Effect of repeated use of an implant handpiece on an output torque: An in-vitro study. J Adv Prosthodont 2021; 13:136-143. [PMID: 34234923 PMCID: PMC8250193 DOI: 10.4047/jap.2021.13.3.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/13/2021] [Accepted: 05/27/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This study aimed to evaluate the effect of repeated use of an implant handpiece under an implant placement torque (35 Ncm) and overloading torque condition (50 Ncm) on an output torque. MATERIALS AND METHODS Two types of implant handpiece systems (Surgicpro/X-DSG20L [NSK, Kanuma, Japan] and SIP20/CRB46LN [SAESHIN, Daegu, South Korea]) were used. The output torque was measured using a digital torque gauge. The height and angle (x, y, and z axes) of the digital torque gauge and implant handpiece were adjusted through a jig for passive connection. The experiment was conducted under the setting torque value of 35 Ncm (implant placement torque) and 50 Ncm (overloading torque condition) and 30 times per set; a total of 5 sets were performed (N = 150). For statistical analysis, the difference between the groups was analyzed using the Mann-Whitney U test and the Friedman test was used to confirm the change in output torque (α=.05). RESULTS NSK and SAESHIN implant handpieces showed significant differences in output torque results at the setting torques of 35 Ncm and 50 Ncm (P<.001). The type of implant handpiece and repeated use influenced the output torque (P<.001). CONCLUSION There may be a difference between the setting torque and actual output torque due to repeated use, and the implant handpiece should be managed and repaired during long-term use. In addition, for successful implant results in dental clinics, the output torque of the implant handpiece system should be checked before implant placement.
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Affiliation(s)
- KeunBaDa Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea
| | - Young-Tak Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea
| | - Ji-Young Kim
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea
| | - Jae-Mok Lee
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Won-Jae Yu
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Jin-Wook Kim
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Kyu-Bok Lee
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu, Republic of Korea.,Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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25
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Lotz M, Schumacher C, Stadlinger B, Ikenberg K, Rücker M, Valdec S. Accuracy of guided biopsy of the jawbone in a clinical setting: A retrospective analysis. J Craniomaxillofac Surg 2021; 49:556-561. [PMID: 33726950 DOI: 10.1016/j.jcms.2021.02.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/18/2021] [Accepted: 02/20/2021] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to investigate the accuracy of a previously described technique for guided biopsy of osseous pathologies of the jawbone in a clinical setting. The data sets of patients who had undergone guided biopsy procedures were retrospectively examined for accuracy. Digital planning of the biopsies and manufacturing of the tooth-supported drilling template were performed with superimposed cone beam computed tomography and intraoral scans using implant planning software. After a trephine biopsy was taken using the template, the postoperative low-dose cone beam computed tomography was analyzed for accuracy using the planning software with the corresponding (digitally-planned) biopsy cylinder. The mean angular deviation was 4.35 ± 2.5°. The mean depth deviation was -1.40 ± 1.41 mm. Guided biopsy seems to be an alternative to a conventional approach for minimally invasive and highly accurate jawbone biopsy.
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Affiliation(s)
- Martin Lotz
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Caterina Schumacher
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Kristian Ikenberg
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Martin Rücker
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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26
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Ein-Afshar MJ, Shahrezaee M, Shahrezaee MH, Sharifzadeh SR. Biomechanical Evaluation of Temperature Rising and Applied Force in Controlled Cortical Bone Drilling: an Animal in Vitro Study. THE ARCHIVES OF BONE AND JOINT SURGERY 2020; 8:605-612. [PMID: 33088862 DOI: 10.22038/abjs.2020.45014.2233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The present study was conducted to quantify the relationships between bone drilling process parameters (i.e., feed rate, resting time, exit rate, and drill bit diameter) and drilling outcome parameters (i.e., thrust force and maximum temperature). Methods This study utilized 10-cm cortical bovine samples to evaluate the effects of four independent parameters, including drill bit diameters, six different feed rates, three various resting times, and three different exit rates on thrust force and maximum temperature (MT). A total of 28 stainless steel orthopedic drill bits with a diameter of 2.5 and 3.2 mm, as well as an orthopedic handpiece were attached to the 500N load cell and an accurate linear variable differential transformer to obtain forces. Moreover, two k-type thermocouples were utilized to record the temperature-time curve near the drilling site. The data were analyzed using the two-way analysis of variance and post hoc Tukey-Kramer Honest test. Results Maximum thrust force (MTF) decreased by almost 230% as the drill bit diameter increased from 2.5 to 3.2 mm in the lowest feed rate. The MTF showed a 335% increase, whereas a decrease of 69% was observed as the feed rates rose from 0.5 to 3 mm/sec. Moreover, the MT decreased to 67% with an increasing exit rate from 1 to 3 mm/sec. Furthermore, a slight increase was observed in MT when the resting time increased from 0 to 2 seconds (P>0.05). Conclusion The desired drilling is drilling with lower thrust force and lower final temperature of bone. Increasing feed rate can cause an increase and decline in thrust force and final temperature, respectively. The highest rates of MT were 0.5 and 1 mm/min, and the optimum feed rate would be 1.5 mm/min due to the averaged thrust force. Moreover, the resting time had no significant effects on the final temperature. Attentions to resting time would be useful to provide a more accurate, efficient, and uniform drill hole.
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Affiliation(s)
- Mohammad Javad Ein-Afshar
- Department of Orthopedic Surgery, School of Medicine, AJA University of Medical Science, Tehran, Iran
| | - Mostafa Shahrezaee
- Department of Orthopedic Surgery, School of Medicine, AJA University of Medical Science, Tehran, Iran
| | | | - Seyed Reza Sharifzadeh
- Department of Orthopedic Surgery, School of Medicine, AJA University of Medical Science, Tehran, Iran
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Surgical Drill Bit Design and Thermomechanical Damage in Bone Drilling: A Review. Ann Biomed Eng 2020; 49:29-56. [PMID: 32860111 DOI: 10.1007/s10439-020-02600-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/17/2020] [Indexed: 11/27/2022]
Abstract
As drilling generates substantial bone thermomechanical damage due to inappropriate cutting tool selection, researchers have proposed various approaches to mitigate this problem. Among these, improving the drill bit design is one of the most feasible and economical solutions. The theory and applications in drill design have been progressing, and research has been published in various fields. However, pieces of information on drill design are dispersed, and no comprehensive review paper focusing on this topic. Systemizing this information is crucial and, therefore, the impetus of this review. Here, we review not only the state-of-the-art in drill bit designs-advances in surgical drill bit design-but also the influences of each drill bit geometries on bone damage. Also, this work provides future directions for this topic and guidelines for designing an improved surgical drill bit. The information in this paper would be useful as a one-stop document for clinicians, engineers, and researchers who require information related to the tool design in bone drilling surgery.
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28
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Bai X, Hou S, Li K, Qu Y, Zhu W. Analysis of machining process and thermal conditions during vibration-assisted cortical bone drilling based on generated bone chip morphologies. Med Eng Phys 2020; 83:73-81. [PMID: 32807351 DOI: 10.1016/j.medengphy.2020.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 06/26/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022]
Abstract
When the temperature during bone drilling exceeds the safety threshold, the bone tissue surrounding the drilling site can be irreversibly damaged. To investigate the influence of vibration-assisted drilling (VAD) methods on the temperature increase during bone drilling and the causes for temperature increase, drilling experiments were performed on fresh bovine femur samples. The morphology and granularity distribution of the generated bone chips were innovatively used to directly compare the machining processes and thermal conditions of conventional drilling (CD), low-frequency vibration-assisted drilling (LFVAD), and ultrasonic vibration-assisted drilling (UVAD). The experimental results indicated that LFVAD produced the lowest temperature increase of 31.4°C, whereas UVAD produced the highest temperature increase of 44.1°C with the same drilling parameters. Additionally, the morphologies and granularity distributions of the bone chips significantly differed among these methods. We concluded that the smaller temperature increase in LFVAD was mainly attributed to the improved thermal conditions resulting from the periodic cutting/separation motion and the reliable geometric chip-breaking mechanism. In contrast, the unfavourable thermal conditions of UVAD were caused by the higher applied frequency, which created a significantly larger amount of friction heat. This was the main cause for the highest observed temperature increase, resulting in bone crushing processes that generated additional heat.
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Affiliation(s)
- Xiaofan Bai
- School of Mechanical Engineering, Hebei University of Technology, Tianjin 300130, China
| | - Shujun Hou
- School of Mechanical Engineering, Hebei University of Technology, Tianjin 300130, China.
| | - Kai Li
- School of Mechanical Engineering, Hebei University of Technology, Tianjin 300130, China
| | - Yunxia Qu
- School of Mechanical Engineering, Hebei University of Technology, Tianjin 300130, China
| | - Weidong Zhu
- Department of Mechanical Engineering, University of Maryland, Baltimore, United States
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29
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Shu L, Bai W, Shimada T, Ying Z, Li S, Sugita N. Thermographic assessment of heat-induced cellular damage during orthopedic surgery. Med Eng Phys 2020; 83:100-105. [PMID: 32505661 DOI: 10.1016/j.medengphy.2020.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/19/2020] [Accepted: 05/13/2020] [Indexed: 11/18/2022]
Abstract
The heat generated during orthopedic surgery can cause thermal damage to bone cells, leading to cell necrosis, death, and bone resorption. In this study, the drill-exit surface in cortical bone drilling was firstly investigated by infrared thermography to understand the thermal characteristics of bone cutting. In order to mimic the short-term thermal condition of high temperature during surgical cutting, the osteoblasts were exposed to heat shock for short periods of time to investigate the effect of cutting heat on the bone. Necrosis and apoptosis were investigated immediately after heat shock for 2 s, 5 s, and 15 s at 50 °C, 60 °C, 70 °C, and 80 °C, respectively. The cells were then incubated for 4 days at 37 °C and analyzed by fluorescein annexin V-FITC/PI double staining. The temperature and heat-duration were precisely controlled by a novel heating approach. In comparison to the control group (37 °C), immediate necrotic and apoptotic response to heat shock was found in cells exposed to 50 °C for 5 s (11.8%, p<0.05); however, the response was negligible in cells exposed to 50 °C for 2 s. In addition, recovery was found in the group exposed to 50 °C and 60 °C for 2 s (p ≤ 0.05) after incubation for 4 days. Cell damage depends on the magnitude and duration of heat exposure. These findings provide fundamental knowledge for future developments of surgical tool design and cutting methods.
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Affiliation(s)
- Liming Shu
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan.
| | - Wei Bai
- State Key Lab of Digital Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Takehiro Shimada
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Zhenzhi Ying
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Shihao Li
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Naohiko Sugita
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
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30
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Babbar A, Jain V, Gupta D. In vivo evaluation of machining forces, torque, and bone quality during skull bone grinding. Proc Inst Mech Eng H 2020; 234:626-638. [DOI: 10.1177/0954411920911499] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study investigates neurosurgical bone grinding with varying parameters on skull bone using a miniature grinding burr. Three process parameters, namely, rotational speed, feed rate, and depth of cut, have been investigated at three different levels in the terms of tangential force, thrust force, and torque generated during grinding. The results revealed that as the rotational speed is increased, the cutting forces and torque showed a decreasing trend. Nevertheless, the increase in feed rate and depth of cut leads to the escalation in response characteristics. The best parametric combination for minimum cutting forces and torque is as follows: rotational speed = 55,000 r/min, feed rate = 20 mm/min, and depth of cut = 0.50 mm. Morphological analysis reveals cracks in the bone’s surface at a higher feed rate. Furthermore, delamination and cutting streaks are also visible on the surface of the bone after grinding. Energy-dispersive spectroscopy and elemental mapping of the tool after bone grinding indicate the accumulation of the bone chips in the successive diamond abrasives. The outcomes of the study will be beneficial for the neurosurgeons in understanding the effect of various process parameters on cutting force, toque, microcracks, and bone’s regeneration ability during surgical bone grinding.
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Affiliation(s)
- Atul Babbar
- Department of Mechanical Engineering, Thapar Institute of Engineering and Technology (TIET), Patiala, India
| | - Vivek Jain
- Department of Mechanical Engineering, Thapar Institute of Engineering and Technology (TIET), Patiala, India
| | - Dheeraj Gupta
- Department of Mechanical Engineering, Thapar Institute of Engineering and Technology (TIET), Patiala, India
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Velikov S, Susin C, Heuberger P, Irastorza-Landa A. A New Site Preparation Protocol That Supports Bone Quality Evaluation and Provides Predictable Implant Insertion Torque. J Clin Med 2020; 9:jcm9020494. [PMID: 32054122 PMCID: PMC7074433 DOI: 10.3390/jcm9020494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 02/06/2023] Open
Abstract
When preparing an implant site, clinicians often base their assessment of the bone on subjective tactile and visual cues. This assessment is used to plan the surgical procedure for site preparation, including how many drilling steps will be used. The subjective nature of bone evaluation, consequently, results in poor reproducibility and may lead to under or over preparation of the site. Recently, an unconventional site preparation protocol was developed in which the decision of which instruments to use is dictated by insertion torque of the novel site preparation instrument (OsseoShaper™, Nobel Biocare AB, Gothenburg, Sweden). The aim of this study was to quantify the correlation of the site preparation torques of the new instrument with bone density and maximum implant insertion torques. In vitro and in vivo data showed strong linear correlation between site preparation torque and density and resulted in reliable implant insertion torques, respectively. From our analysis, we conclude that this new instrument and protocol has the potential to eliminate the need for additional intraoperative bone evaluation and may reduce the risk of inadequate preparation of the site due to the ability to serve as a predictor of the final implant insertion torque.
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Affiliation(s)
- Stefan Velikov
- Nobel Biocare Services AG P.O. Box, CH-8058 Zürich-Flughafen, Switzerland; (S.V.); (P.H.)
| | - Cristiano Susin
- Department of Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Peter Heuberger
- Nobel Biocare Services AG P.O. Box, CH-8058 Zürich-Flughafen, Switzerland; (S.V.); (P.H.)
| | - Ainara Irastorza-Landa
- Nobel Biocare Services AG P.O. Box, CH-8058 Zürich-Flughafen, Switzerland; (S.V.); (P.H.)
- Correspondence:
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32
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Experimental study of temperature rise during bone drilling process. Med Eng Phys 2020; 78:64-73. [PMID: 32044224 DOI: 10.1016/j.medengphy.2020.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 12/24/2019] [Accepted: 01/19/2020] [Indexed: 11/24/2022]
Abstract
An excessive temperature rise during bone drilling processes can result in osteonecrosis or impairment of the osteogenic potential. However, the effect of geometric parameters of the surgical drill bit, drilling process parameters, and the bone type on the temperature rise have not been fully investigated. In this study, thermocouples are introduced to measure the temperature rise, and three experimental designs are utilized separately to investigate the temperature rise with respect to each parameter, identify the effect of important drill geometric parameters and their interaction on the temperature rise, and develop a quadratic model of the temperature rise with respect to process parameters. The results show that the temperature rise can be significantly affected by geometric parameters of the surgical drill bit, drilling process parameters, and the bone type. The effects of the point angle and the interaction between the web thickness and the helix angle on the temperature rise are very significant. The quadratic regression equation obtained using response surface methodology can provide accurate predictions under a wide range of drilling process conditions, and the optimized drilling process parameters are in good agreement with the experimental results.
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Yu D, Liu C, Wu Y, An Q. Measurement and prediction of drilling force in fresh human cadaver mandibles: A pilot study. Clin Implant Dent Relat Res 2019; 22:4-12. [PMID: 31797556 DOI: 10.1111/cid.12841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/29/2019] [Accepted: 08/09/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bone drilling is a vital procedure in implant surgery and dental implant training systems based on virtual reality technology. PURPOSE Predict and update drilling force in real time based on a virtual dental implant training system and lay the foundation for realizing force feedback in dental implant training instruments. MATERIALS AND METHODS An experimental platform was established to measure the drilling force for human mandibles from donors of different ages. Response surface methodology was applied to analyze the drilling force. RESULTS Force regression equations for different age groups were acquired. The order of the effects (from greatest to least) of the drilling parameters on the drilling force was the drill bit diameter, feed rate, and rotational speed. To obtain the minimum force, higher rotational speeds, lower feed rates, and smaller diameters were preferred within the range of commonly used medical reference parameters of bone drilling. CONCLUSION The experimental data were confirmed to be scientific for the predicted models of drilling force.
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Affiliation(s)
- Dedong Yu
- Department of 2nd Dental Center, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chang Liu
- Institute of Manufacturing Technology and Equipment Automation, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yiqun Wu
- Department of 2nd Dental Center, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Qinglong An
- Institute of Manufacturing Technology and Equipment Automation, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
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Abstract
The field of robotic surgery has progressed from small teams of researchers repurposing industrial robots, to a competitive and highly innovative subsection of the medical device industry. Surgical robots allow surgeons to perform tasks with greater ease, accuracy, or safety, and fall under one of four levels of autonomy; active, semi-active, passive, and remote manipulator. The increased accuracy afforded by surgical robots has allowed for cementless hip arthroplasty, improved postoperative alignment following knee arthroplasty, and reduced duration of intraoperative fluoroscopy among other benefits. Cutting of bone has historically used tools such as hand saws and drills, with other elaborate cutting tools now used routinely to remodel bone. Improvements in cutting accuracy and additional options for safety and monitoring during surgery give robotic surgeries some advantages over conventional techniques. This article aims to provide an overview of current robots and tools with a common target tissue of bone, proposes a new process for defining the level of autonomy for a surgical robot, and examines future directions in robotic surgery.
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35
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Akhbar MFA, Yusoff AR. Drilling of bone: thermal osteonecrosis regions induced by drilling parameters. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab42f2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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36
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Mediouni M, Kucklick T, Poncet S, Madiouni R, Abouaomar A, Madry H, Cucchiarini M, Chopko B, Vaughan N, Arora M, Gökkuş K, Lozoya Lara M, Paiva Cedeño L, Volosnikov A, Hesmati M, Ho K. An overview of thermal necrosis: present and future. Curr Med Res Opin 2019; 35:1555-1562. [PMID: 30943796 DOI: 10.1080/03007995.2019.1603671] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Introduction: Many orthopaedic procedures require drilling of bone, especially fracture repair cases. Bone drilling results in heat generation due to the friction between the bone and the drill bit. A high-level of heat generation kills bone cells. Bone cell death results in resorption of bone around bone screws.Methods: We searched in the literature for data on parameters that influence drilling bone and could lead to thermal necrosis. The points of view of many orthopaedists and neurosurgeons based upon on previous practices and clinical experience are presented.Results: Several potential complications that lead to thermal necrosis are discussed and highlighted.Discussion: Even in the face of growing evidence as to the negative effects of heat induction during drilling, simple and effective methods for monitoring and cooling in real-time are not in widespread usage today. For that purpose, we propose some suggestions for the future of bone drilling, taking note of recent advances in autonomous robotics, intelligent systems and computer simulation techniques.Conclusions: These advances in prevention of thermal necrosis during bone drilling surgery are expected to reduce the risk of patient injury and costs for the health service.
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Affiliation(s)
| | | | - Sébastien Poncet
- Mechanical Engineering Department, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Riadh Madiouni
- University of Paris-Est Créteil, Vitry sur Seine, France
| | | | - Henning Madry
- Saarland University Medical Center, Homburg, Germany
| | | | | | - Neil Vaughan
- Department of Computer Science, University of Chester, Chester, UK
| | - Manit Arora
- Department of Orthopaedics and Sports Medicine, Fortis Hospital, Chandigarh, India
| | - Kemal Gökkuş
- Department of orthopaedics, Memorial Antalya, Antalya, Turkey
| | | | - Lorenlay Paiva Cedeño
- Departement of orthopaedics, Francisco de Miranda Experimental University, Falcón, Venezuela
| | - Alexander Volosnikov
- Restorative Traumatology and Orthopaedics of Ministry of Healthcare Kurgan, Federal State Budgetary Institution Russian Ilizarov Scientific Center, Kurgan, Russia Region
| | - Mohamed Hesmati
- Departement of orthopaedics, Tehran University Medical of Sciences, Tehran, Iran
| | - Kevin Ho
- University of Western Australia, Perth, Australia
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Bai X, Hou S, Li K, Qu Y, Zhang T. Experimental investigation of the temperature elevation in bone drilling using conventional and vibration-assisted methods. Med Eng Phys 2019; 69:1-7. [PMID: 31229386 DOI: 10.1016/j.medengphy.2019.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 06/05/2019] [Accepted: 06/10/2019] [Indexed: 11/26/2022]
Abstract
Bone drilling is widely used in orthopaedics for inserting screws and fixing prostheses. Thermal necrosis is one of the major problems that may seriously affect post-operative recovery. Accordingly, this paper mainly focuses on comparing the influences of conventional drilling (CD), ultrasonic vibration-assisted drilling (UVAD) and low-frequency vibration-assisted drilling (LFVAD) methods, and drilling parameters on the temperature elevation in bone drilling process. A full factorial experiment was performed, and the temperatures were measured using an infrared camera. The lowest temperature elevation was obtained by LFVAD compared with CD and UVAD at the same drilling conditions. Setting CD as a reference, the maximum difference between LFVAD and CD was approximately -4 °C, whereas that between UVAD and CD was approximately 16 °C. The temperature elevation increases linearly with the spindle speed and follows an inverted U-shaped curve, with the feed rate having a peak at 40 min/mm in each drilling method. The results were discussed with regard to the features of LFVAD and UVAD. It was expected that the LFVAD could achieve minimal thermal damage and attain better results in the medical bone drilling process.
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Affiliation(s)
- Xiaofan Bai
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu 1(#) Street, Hongqiao District, Tianjin 300130, China
| | - Shujun Hou
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu 1(#) Street, Hongqiao District, Tianjin 300130, China.
| | - Kai Li
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu 1(#) Street, Hongqiao District, Tianjin 300130, China
| | - Yunxia Qu
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu 1(#) Street, Hongqiao District, Tianjin 300130, China
| | - Tao Zhang
- Department of Orthopedics, Tianjin Hospital, Tianjin 300210, China
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Al‐Abdullah KI, Lim CP, Najdovski Z, Yassin W. A model‐based bone milling state identification method via force sensing for a robotic surgical system. Int J Med Robot 2019; 15:e1989. [DOI: 10.1002/rcs.1989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/12/2019] [Accepted: 01/28/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Kais I. Al‐Abdullah
- Institute for Intelligent Systems Research and Innovation (IISRI)Deakin University Geelong Australia
| | - Chee Peng Lim
- Institute for Intelligent Systems Research and Innovation (IISRI)Deakin University Geelong Australia
| | - Zoran Najdovski
- Institute for Intelligent Systems Research and Innovation (IISRI)Deakin University Geelong Australia
| | - Wisam Yassin
- Department of SurgeryFMHS. Universiti Tunku Abdul Rahman Ampang‐Selangor Malaysia
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39
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Experimental Study of Thrust Force and Torque for Drilling Cortical Bone. Ann Biomed Eng 2019; 47:802-812. [PMID: 30627838 DOI: 10.1007/s10439-018-02196-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/29/2018] [Indexed: 12/24/2022]
Abstract
Excessive drilling forces can result in drill breakage, bone breakthrough, and thermal necrosis during bone drilling process. However, the effect of drilling process parameters, drill geometry parameters, and bone material type on drilling forces have not been fully investigated. Three designs of experiments are introduced separately to study single factor's effect on drilling forces, identify significant geometry parameters and possible interactions for drilling forces, and formulate direct relationship between drilling forces and process parameters. The results show that thrust force and torque are increased with feed rate, drill diameter or web thickness. The effect of spindle speed, point angle, helix angle, and chisel edge angle on drilling forces is complex. The results also show that the drilling forces are affected by bone type significantly, which are highest for bovine cortical bone, and lowest for Sawbones 3401. The levels of significance of geometry parameters are identified and different for thrust force and torque, which can assist new surgical drill development. Quadratic regression equations obtained by response surface methodology can predict thrust force and torque accurately in a wide range of process parameters, which can be used to control drilling conditions for robot assisted surgeries to realize safe drilling.
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40
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Ali Akhbar MF, Yusoff AR. Drilling of bone: Effect of drill bit geometries on thermal osteonecrosis risk regions. Proc Inst Mech Eng H 2018; 233:207-218. [PMID: 30572787 DOI: 10.1177/0954411918819113] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bone-drilling operation necessitates an accurate and efficient surgical drill bit to minimize thermal damage to the bone. This article provides a methodology for predicting the bone temperature elevation during surgical bone drilling and to gain a better understanding on the influences of the point angle, helix angle and web thickness of the drill bit. The proposed approach utilized the normalized Cockroft-Latham damage criterion to predict material cracking in the drilling process. Drilling simulation software DEFORM-3D is used to approximate the bone temperature elevation corresponding to different drill bit geometries. To validate the simulation results, bone temperature elevations were evaluated by comparison with ex vivo bone-drilling process using bovine femurs. The computational results fit well with the ex vivo experiments with respect to different drill geometries. All the investigated drill bit geometries significantly affect bone temperature rise. It is discovered that the thermal osteonecrosis risk regions could be reduced with a point angle of 110° to 140°, a helix angle of 5° to 30° and a web thickness of 5% to 40%. The drilling simulation could accurately estimate the maximum bone temperature elevation for various surgical drill bit point angles, web thickness and helix angles. Looking into the future, this work will lead to the research and redesign of the optimum surgical drill bit to minimize thermal insult during bone-drilling surgeries.
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Affiliation(s)
| | - Ahmad Razlan Yusoff
- Faculty of Manufacturing Engineering, Universiti Malaysia Pahang, Pekan, Malaysia
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41
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Recommended Drilling Parameters of Tungsten Carbide Round Drills for the Most Optimal Bone Removals in Oral Surgery. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3108581. [PMID: 30581849 PMCID: PMC6276513 DOI: 10.1155/2018/3108581] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/06/2018] [Accepted: 10/25/2018] [Indexed: 11/18/2022]
Abstract
Background High temperatures during drilling can cause thermal osteonecrosis and abnormal wound healing. According to our best knowledge, a widely accepted recommendation for optimal drilling parameters in routine oral surgery bone removals does not exist. Purpose Our aim was to investigate the correlations of different drilling parameters, including axial load and revolution speed on drilling temperatures and preparation times. Materials and Methods Standard, 5 mm deep cavities were drilled in 20 PCF (lb/ft3) dens polyurethane blocks with 3 mm (50PCF) cortical layer using new and worn, 3.1mm in diameter tungsten carbide round drills. Worn drills were used in 50 impacted third molar operations before. Axial loads of 3N, 10N, and 25N and speeds of 4.000-8.000-16.000-40.000 revolutions per minute (rpm) were tested. Temperature differences of drilling parameters were calculated by 1-way ANOVA, followed by Tukey's HSD post hoc tests. Time differences and differences among “optimal” and “suboptimal” groups (with the cut-off value of 3°C and 3s) were estimated by Kruskal-Wallis test with pairwise comparisons. P<0.05 was considered significant. Results The highest mean temperatures with new and worn drills were 4.64±0.53°C and 6.89±1.16°C, while drilling times varied between 0.16±0.02s and 22.77±5.45s. A 3°C and 3s cut-off value classified drillings significantly to (1) optimal [3N and 8000-16000-40000 rpm or 10N and 4000-8000-16000-40000 rpm] or suboptimal due to (2) high temperatures or (3) long preparation times. Using worn drills, the following parameters should be avoided: 3N with 4.000-8.000 rpm, 10N with 40000 rpm, and 25N at any revolutions. Discussion The study extensively mapped the drilling temperatures and preparation times of tungsten carbide round drills. Temperatures did not exceed 10°C during drillings with maximal amount of cooling, as well as the drilling parameters, which kept temperatures and preparation times in the most optimal range which were clearly established.
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Akhbar MFA, Yusoff AR. Optimization of drilling parameters for thermal bone necrosis prevention. Technol Health Care 2018; 26:621-635. [PMID: 29966212 DOI: 10.3233/thc-181221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Bone drilling is a mandatory process in orthopedic surgery to fix the fractured bones. Excessive heat is generated due to the shear deformation of bone and friction energy during the drilling process. OBJECTIVE This paper is carried out to optimize the bone drilling parameters to prevent thermal bone necrosis. The main contribution of this work is instead of only consider the influence of rotational speed and feed rate, the effect of tool diameter and drilling hole depth are also incorporated for optimization study. METHODS Response surface methodology (RSM) was used to develop a temperature prediction model. Drilling experiments were performed using finite element software DEFORM-3D. Analysis of variance (ANOVA) was conducted to investigate the drilling parameters' effect. Desirability function in RSM was used to determine the optimum combination of drilling parameters. RESULTS Results indicated that one applicable combination of drilling parameters could increase the bone temperature by less than 0.03%. To avoid thermal bone necrosis, eight reasonable combinations of drilling parameters were proposed. 3.3∘C residuals between in-vitro experiments and predicted values were demonstrated. CONCLUSIONS It is envisaged that finite element simulation with RSM can simplify tedious experimental works and useful in the clinical application to avoid bone necrosis.
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