Thermal optimization of robotic piezoelectric osteotomy motion in porcine trabecular bone.

Background: Piezoelectric osteotomy represents a potentially viable alternative to conventional techniques for preparing pilot holes for bone screws. However, piezoelectric osteotomes have demonstrated the potential to heat bone beyond 47 °C, which induces necrosis that could contribute to screw loosening, resulting in osteosynthetic material failure and pseudarthrosis. Thus, we sought to determine the working movements of a piezoelectric drill that resulted in the lowest maximum bone temperatures while ensuring that this optimal drilling motion resulted in temperatures below 47 °C.