Surgical Drill Bit Design and Thermomechanical Damage in Bone Drilling: A Review
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Annals of Biomedical Engineering ( 2020) https://doi.org/10.1007/s10439-020-02600-2
Review
Surgical Drill Bit Design and Thermomechanical Damage in Bone Drilling: A Review MOHD FAIZAL ALI AKHBAR
1,2
and AKMAL WANI SULONG3
1
College of Engineering, Universiti Malaysia Pahang (UMP), 26300 Kuantan, Pahang, Malaysia; 2Faculty of Civil Engineering Technology (FTKA), Universiti Malaysia Pahang (UMP), 26300 Kuantan, Pahang, Malaysia; and 3Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Medical Campus, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Terengganu, Malaysia (Received 13 April 2020; accepted 17 August 2020) Associate Editor Daniel Elson oversaw the review of this article
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 onestop document for clinicians, engineers, and researchers who require information related to the tool design in bone drilling surgery. Keywords—Thermal osteonecrosis, Bone necrosis, Torque, Force, Bone drilling, Bone temperature, Drill bit geometry, Drill bit design, Osteonecrosis region.
INTRODUCTION Background Bone drilling is a common surgical operation used to create holes in the bone, which require further treatments: fracture fixation,7 dental implantation,179
Address correspondence to Mohd Faizal Ali Akhbar, College of Engineering, Universiti Malaysia Pahang (UMP), 26300 Kuantan, Pahang, Malaysia. Electronic mail: [email protected]; [email protected]
and cochlear implant installation.71 Customarily, surgeons drill the bone using a twist drill bit, driven by a hand drill machine.29 This operation varies from perforating blind-hole of one cortical layer to penetrating through-hole of two cortical layers, depending on the surgical requirements. Bone is anisotropic material47 with a low thermal conductivity.72 These characteristics prevent a quick heat dissipation during drilling5,8,89 and therefore, elevate the bone temperature. The drilling mechanism is generated from a complex combination of cutting and extrusion of bone at the drill point. These actions require precise cutting tools to ensure the safety of the surrounding tissues; the cutting force, torque, and temper
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