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Materials and Methods: Osteotomies were performed on bovine ribs, with 2.0 mm diameter stainless steel drill bits of the SMART Guide System, under 3 sterilization protocols, at 800, 1200, 1500, and 2000 rpm. Sterilization was performed after every 3 drilling. Temperature was measured after every 30 drilling. Results: The studied contributing factors had a cumulative effect, and each contributed significantly to temperature elevation. Whether guide use led to a near-necrotic (47°C) temperature increment depended largely on the applied sterilization protocol. Conclusion: The metal sleeve is a significant contributing factor to heat generation during guided osteotomy, but its effect can be offset by keeping the other studied factors under control. Reprint requests and correspondence to: Gábor Braunitzer, DMD, PhD, Laboratory for Perception & Cognition and Clinical Neuroscience, Nyírő Gyula Hospital, Budapest, Hungary 1135, Phone: +36209297933, Fax: +3662341169, E-mail: braunitzer.gabor@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. 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