“…Different factors affect the heat generated during drilling at the implant site, including the operator (pressure, status, movement, speed and duration of drilling), manufacturer (design and sharpness of the drill, irrigation system and implant system), site (cortical thickness, condition of the site and depth drilled) and patient (age and bone density) ( 22 ). In an animal study, Trisi et al ( 23 ) analyzed histomorphometric parameters in implants that had been placed with different irrigation systems (without irrigation, with internal irrigation, with external irrigation, and a combination of both). The results of the study suggest that due to insufficient irrigation, hard bone caused massive resorption of the cortical bone and implant failure.…”