Overheating the bone and exerting too much pressure
Minimal temperature elevation during surgical drilling of the bone is a key factor in atraumatic surgical technique. Bone cell death occurs at a temperature of 47 degrees Celsius and higher when drilling is performed for one minute. Because of bone cell damage, a connective tissue interface is formed between the implant and the viable bone thus leading to loss of integration. It is recommended therefore, that a speed of no more than 2000 rpm with a copious irrigation, graded drilling (with graded series of drill sizes) with minimal application of pressure be used