Temperature Changes (Δ) in Correlation with Number of Implant Osteotomy Preparations in Human Cadaver Tibiae, Comparing Osseodensification (OD) Burs in Clockwise (CW) versus Counterclockwise (CCW) Mode.

(1) Background: OD burs are used in two different modes: (i) CW and (ii) CCW. The purpose of the study was to evaluate the Δ during the preparation of implant osteotomies in a four-way interaction. (2) Methods: Three hundred and sixty osteotomies were prepared at 12 mm depth in human cadaver tibiae. The Δ values were calculated similarly to the method used in two previous studies carried out by our group. Four different variables were evaluated for their effect on Δ. (3) Results: A four-way interaction was observed in the CCW mode, allowing for 1000 RPM to have the least effect in both modes. However, in the CCW mode the use of 3.0 and 4.0 burs after 23 osteotomies showed a statistically significant increase in Δ and significant chatter, compared to the CW mode. In the CCW mode, the Δ was increased significantly as the diameter of the burs increased in 800 and 1200 RPM. (4) Conclusions: The synergistic effect of drills' diameter, CCW mode, 800 and 1200 RPM, and bur usage (over 23 times) had a significant effect on Δ, which exceeded 47 °C. One thousand (1000) RPM had the least effect in both modes. The 3.0 and 4.0 burs in the CCW mode drastically increased the temperature and produced significant chatter.