Effect of low-speed drilling without irrigation on osseointegration: an experimental study in dogs

Primary stability evaluation of different morse cone implants in low-density artificial bone blocks: A comparison between high-and low-speed drilling

This study aimed to evaluate various biomechanical parameters associated with the primary stability of Maestro and Due Cone implants placed in low-density artificial bones, prepared using high-speed drilling with irrigation and low-speed drilling without irrigation. The insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ) values were recorded for Maestro and Due Cone implants placed in low-density polyurethane blocks (10 and 20 pounds per cubic foot (PCF) with and without a cortical layer) prepared using high-speed and low-speed with or without irrigation using a saline solution, respectively. A three-way ANOVA model and Tukey's post-hoc test were conducted, presenting data as means and standard deviations. P-values equal to or less than 0.05 were considered statistically significant. No statistically significant differences in IT, RT, and ISQ between drilling speeds were observed. However, Maestro implants exhibited lower IT and RT values after high- and low-speed drilling across almost all polyurethane blocks, significantly evident in the 20 PCF density block for IT and in the 20 PCF density block with the cortical layer for the RT with low-speed drilling (IT: 47.33 ± 10.02 Ncm and 16.00 ± 12.49 Ncm for Due Cone and Maestro implants, respectively, with p < 0.01; RT: 44.67 ± 22.81 Ncm and 20.01 ± 4.36 Ncm for Due Cone and Maestro implants, respectively, with p < 0.05) and among the same implant types inserted in different bone densities. Additionally, the study found that for all bone densities and drilling speeds, both implants registered ISQ values exceeding 60, except for the lowest-density polyurethane block. Overall, it can be inferred that low-speed drilling without irrigation achieved biomechanical parameters similar to conventional drilling with both implant types, even with lower IT values in the case of Maestro implants. These findings suggest a promising potential use of low-speed drilling without irrigation in specific clinical scenarios, particularly when focusing on preparation depth or when ensuring proper irrigation is challenging.

Osseointegration in relation to drilling speed in the preparation of dental implants sites: A systematic review

STATEMENT OF PROBLEM

The drilling speed used for preparing dental implants may affect bone-implant contact (BIC), implant stability quotient (ISQ), and bone area fraction occupancy (BAFO). Different rotational speeds and the presence or absence of irrigation during site preparation have been investigated, but an established protocol for achieving the best osseointegration results is lacking.

PURPOSE

The purpose of this systematic review was to investigate the influence of drill rotational speed on bone drilling for dental implant placement and its relationship with osseointegration.

MATERIAL AND METHODS

This review included the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and was registered in the international prospective register of systematic reviews (PROSPERO) database. Electronic searches were performed in the MEDLINE (PubMed), Scopus, Science Direct, and Embase databases. The risk of bias was analyzed by using the systematic review center for laboratory animal experimentation (SYRCLE).

RESULTS

A total of 1282 articles were found, and after removing duplicates and applying the eligibility criteria to in vivo articles on animals that addressed drilling speed and its relationship to osseointegration, 8 articles were selected for analysis. Of these, 5 articles showed no statistical differences, and 3 others showed significantly better osseointegration results by analyzing the parameters of BIC, BAFO, ISQs, and pull-out forces (PoFs). In all selected articles, high-speed drilling was performed with irrigation.

CONCLUSIONS

Although drilling speed seems to affect bone perforation, no definitive protocol was found in the literature consulted. The results vary depending on the combination of different factors, including bone type, irrigation, and drilling speed.

Application of reverse drilling technique in alveolar ridge expansion

Background/purpose

Recently, there is a new model adjustment in the osteotomy preparation named osseodensification. This study focused on the ridge expansion results based on reversed drilling technique regarding osseodensification technique and the modified method.

Materials and methods

Twenty-seven samples were fabricated from sawbones, tailored into three different widths: 6.75 mm, 7.25 mm, and 7.75 mm, and drilled by three different protocols: osseodensification bur with 1500 rpm reverse torque, triple-bladed drill with 200 rpm reverse torque, and triple-bladed drill with 1600 rpm standard forward turning; each group contained three samples. After implants were screwed into the sawbones over 5mm or till the bone fractured, the width change of the bone was measured, the insertion depth of the implant was calculated, and the fracture of the bone was also recorded for comparison.

Results

The result showed that in narrow bone width (6.75 mm) the enlargement of bone thickness showed significant difference among the groups (P < 0.05); both reverse torque group expressed a higher expansion result, but in the paired comparison, only osseodensification bur expanded the ridge significantly better than the standard drilling sequence. However, implant insertion depth of osseodensification group was significantly less than those of other two drilling protocols (P < 0.005). Even though the bone fracture happened least in the standard drilling sequence, there is no difference among the groups.

Conclusion

The counter-clockwise rotating method possesses the ability to expand bone ridge but lead to a higher stress in the bone structure, which may affect the insertion depth of the implants.