Increased Intraosseous Temperature Caused by Ultrasonic Devices During Bone Surgery and the Influences of Working Pressure and Cooling Irrigation

Purpose: The purpose of this study was to investigate the increases in intraosseous temperature generated by a modern ultrasonic device for bone surgery (UDBS) and the influences of working pressure and cooling irrigation on this temperature. Materials and Methods: Twenty human mandibular bone specimens (20 × 15 × 5 to 7 mm) were used; three vertical cuts were performed for a duration of 12 seconds per cut. Each bone specimen was machined with a different combination of working pressure (1.5, 2.0, 3.0, 4.0, or 6.0 N) and cooling irrigation (0, 30, 60, or 90 mL/min), and intraosseous temperatures were measured. Harmful temperature development was defined as an increase of more than 10°C for the 75th percentile and/or a maximum increase of more than 15°C. Cutting performance was also measured. Results: Harmless intraosseous temperature development was identified for working pressures of 1.5 N and 2.0 N with cooling irrigations of 30, 60, and 90 mL/min and for 3.0 N at 90 mL/min. The maximum temperature observed was 72°C (6.0 N with 60 mL/min). The mean cutting performance values were 0.21 ± 0.02 mm/s for 6.0 N, 0.21 ± 0.06 mm/s for 3.0 N, 0.20 ± 0.01 mm/s for 4.0 N, 0.11 ± 0.05 mm/s for 1.5 N, and 0.08 ± 0.03 mm/s for 2.0 N. Conclusions: To prevent tissue damage in dental bone surgery, a minimum coolant amount of 30 mL/min is recommended. The working pressure should be chosen with great care because of its significant influence on intraosseous temperature. Doubling of the working pressure from 1.5 to 3.0 N requires a tripling of the coolant (30 to 90 mL/min) to prevent tissue damage. A working pressure above 3.0 N did not result in improved cutting performance. Keywords: cutting performance, intraosseous temperature development, ultrasonic bone surgery