Heat generated during bone drilling may be associated with thermal necrosis and direct damage, leading to complications after surgery.  Furthermore, we recommend that the use of dull drill bits or standard tip Kirschner wires be avoided.  Risk for early implant loosening and poor surgical outcome is influenced by thermal osteonecrosis of bone such that consistent use of saline irrigation, sharp drill bits, and optimized designs may have important clinical advantages. 
THERM