# Heat Generated during Dental Implant Placement: A Scoping Review
## 2 Materials and Methods
### Osteotomy Depth  
As demonstrated by [PERSON] et al. in 1983 [6], the duration of exposure to heat is as important as the temperature itself in causing bone damage. Prolonged exposure to traumatic stimuli at the same temperature has been reported to lead to more significant damage. Consequently, factors like the depth of osteotomy, increasing working time, and exposure time to heat could pose potential risks to the bone.  
The correlation between timing, osteotomy depth, and heat generation was demonstrated in the studies by [PERSON] et al. in 1997 [48] and [PERSON] et al. in 2012 [59].  
In 2004, [PERSON] et al. [60] concluded that a greater depth of instrumentation results in a longer time to process the bone and therefore a greater amount of heat developed during osteotomy. The same conclusion was reached by [PERSON] et al. in 2012 [61]. In their study, temperature increases between 3 mm and 7 mm osteectomies were evident. Again, increasing the friction time increased the overall heat in the bone.  
[PERSON] et al. [41] demonstrated the same in an in vitro study, working at milling depths of 8 mm and 10 mm, indicating the increased difficulty of irrigation reaching the active part of the drill as a possible cause. This difference remained unchanged even when varying the materials that made up the drills (metal versus ceramic).  
[PERSON] et al. [62] were able to demonstrate a significant temperature increase in the case of 16 mm and 10 mm osteotomies. An innovative finding reported in the study was the temperature during the drill withdraw phase. Depth had a negative influence on heat generation even during the drill shrinkage phase. This new indication could have a clinical relevance regarding depth.  
In a study by [PERSON] et al. [38], different implant preparation lengths were compared. In the two reference groups, two preparations were performed, at 10 and 16 mm, using titanium and zirconium drills with different diameters. Standardized bovine bone samples and infrared thermography were used for the measurements. This study demonstrated how greater depths (16 mm vs. 10 mm) and longer working times (23 s vs. 43 s) lead to greater heat development during the osteotomy phase.  
Again, in their 2022 study, [PERSON] et al. [39] showed that performing a 10 mm osteotomy takes less time than performing a 16 mm osteotomy. Similarly, they demonstrated a strong correlation between osteotomy depth and increased intraosseous temperature. This finding complements another conclusion given in the study, namely, that the passive shrinkage time of the drill is also an important parameter in the development of heat. Thus, it appears that a longer passive shrinkage time causes more heating in the bone. Great importance is given to the passive withdrawal phase of the cutter.  
Similar results were found by [PERSON] et al. in a 2018 study [63].  
In conclusion, the literature agrees that the depth of the osteotomy is an important factor in the generation of intraosseous heat, and as the depth of the osteotomy increases, so does the heat generated [64; 65; 66; 67]. Considering data on the survival rate of implants with a length of 10/12 mm [68], it does not seem reasonable, even if there is bone available vertically, to opt for much longer implants, especially in type 1 bone.