Implant site preparation performed with piezoelectric drills does not have different outcomes than those performed with conventional drills

Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis—11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.

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Primary Stability of Short Implants Inserted Using Piezoelectric or Drilling Systems: An In Vitro Comparison

Journal of Oral Implantology ◽

10.1563/aaid-joi-18-00157 ◽

2019 ◽

Vol 45 (4) ◽

pp. 259-266

Author(s):

Claudio Stacchi ◽

Matteo De Biasi ◽

Lucio Torelli ◽

Massimo Robiony ◽

Roberto Di Lenarda ◽

...

Keyword(s):

Cancellous Bone ◽

Operative Time ◽

Primary Stability ◽

Site Preparation ◽

Preparation Technique ◽

Implant Stability ◽

Implant Stability Quotient ◽

Custom Made ◽

Implant Site Preparation

The primary objective of the present in vitro study was to evaluate the influence of implant site preparation technique (drills vs ultrasonic instrumentation) on the primary stability of short dental implants with two different designs inserted in simulated low-quality cancellous bone. Eighty implant sites were prepared in custom-made solid rigid polyurethane blocks with two different low cancellous bone densities (5 or 15 pounds per cubic foot [PCF]), equally distributed between piezoelectric (Surgysonic Moto, Esacrom, Italy) and conventional drilling techniques. Two short implant systems (Prama and Syra, Sweden & Martina) were tested by inserting 40 fixtures of each system (both 6.0 mm length and 5.0 mm diameter), divided in the four subgroups (drills/5 PCF density; drills/15 PCF density; piezo/5 PCF density; piezo/15 PCF density). Insertion torque (Ncm), implant stability quotient values, removal torque (Ncm), and surgical time were recorded. Data were analyzed by 3-way ANOVA and Scheffé's test (α = 0.05). With slight variations among the considered dependent variables, overall high primary implant stability was observed across all subgroups. Piezoelectric instrumentation allowed for comparable or slightly superior primary stability in comparison with the drilling procedures in both implant systems. The Prama implants group showed the highest mean reverse torque and Syra implants the highest implant stability quotient values. Piezoelectric implant site preparation took prolonged operative time compared to conventional preparation with drills; among the drilling procedures, Syra system required fewer surgical steps and shorter operative time.

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Effect of the Combination of Low-Speed Drilling and Cooled Irrigation Fluid on Intraosseous Heat Generation During Guided Surgical Implant Site Preparation

Implant Dentistry ◽

10.1097/id.0000000000000607 ◽

2017 ◽

Vol 26 (4) ◽

pp. 541-546 ◽

Cited By ~ 2

Author(s):

Ibrahim Barrak ◽

Arpad Joób-Fancsaly ◽

Endre Varga ◽

Kristof Boa ◽

Jozsef Piffko

Keyword(s):

Heat Generation ◽

Site Preparation ◽

Irrigation Fluid ◽

Low Speed ◽

Surgical Implant ◽

Implant Site Preparation

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Immediate Loading of Implant-Supported Single Crowns after Conventional and Ultrasonic Implant Site Preparation: A Multicenter Randomized Controlled Clinical Trial

BioMed Research International ◽

10.1155/2018/6817154 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 11

Author(s):

Claudio Stacchi ◽

Teresa Lombardi ◽

Domenico Baldi ◽

Calogero Bugea ◽

Antonio Rapani ◽

...

Keyword(s):

Survival Rate ◽

Test Group ◽

Site Preparation ◽

Control Group ◽

Controlled Clinical Trial ◽

Marginal Bone Loss ◽

One Year ◽

And Control ◽

Implant Site Preparation ◽

Single Crowns

Aim. To compare implant survival rate and marginal bone loss (MBL) of immediately loaded single implants inserted by using ultrasonic implant site preparation (UISP) (test) and conventional rotary instrumentation (control). Methods. Two single implants were inserted for each patient: after randomization, test site was prepared by using an ultrasonic device (Piezosurgery Touch, Mectron, Italy) and control site was prepared by using the drills of the selected implant system (Premium AZT, Sweden & Martina, Italy), until reaching a final diameter of 3 mm in both groups. Identical implants (3.8x11.5 mm) were inserted in all sites at crestal level. Impressions were taken and screwed resin single crowns with platform-switched provisional abutments were delivered with 48 hours. Periapical radiographs were taken at provisional crown insertion (T0), 6 months (T1) and one year (T2) after prosthetic loading to measure MBL. All data were tested for normality and subsequently analyzed by paired samples t-test and forward multiple linear regression. Results. Forty-eight patients were treated in six centers with the insertion of ninety-six implants (48 test; 48 control). Four implants in four patients failed within the first six months of healing (two in test group; two in control group; no difference between groups). Forty patients (age 60.1±10.7 years; 22 female, 18 male) were included in the final analysis. Mean MBL after six months of loading was 1.39±1.03 mm in the test group and 1.42±1.16 mm in the control group (p>0.05) and after one year was 1.92±1.14 mm and 2.14±1.55 mm in test and control, respectively (p>0.05). Conclusions. No differences in survival rate and MBL were demonstrated between UISP and conventional site preparation with rotary instruments in immediately loaded dental implants: UISP, with its characteristics of enhanced surgical control and safety in proximity of delicate structures, may be used as a reliable alternative to the traditional drilling systems.

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Successful stabilization of periodontal disease and preprosthetic implant site preparation using autogenous mandibular symphysis block bone grafting in aggressive periodontitis

Journal of Dental Implants ◽

10.4103/0974-6781.96579 ◽

2012 ◽

Vol 2 (1) ◽

pp. 59

Author(s):

NettemuSunil Kumar ◽

Nettem Sowmya

Keyword(s):

Periodontal Disease ◽

Bone Grafting ◽

Aggressive Periodontitis ◽

Site Preparation ◽

Mandibular Symphysis ◽

Implant Site Preparation

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Observational Study on the Preparation of the Implant Site with Piezosurgery vs. Drill: Comparison between the Two Methods in terms of Postoperative Pain, Surgical Times, and Operational Advantages

BioMed Research International ◽

10.1155/2019/8483658 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Michele Maglione ◽

Lorenzo Bevilacqua ◽

Federica Dotto ◽

Fulvia Costantinides ◽

Felice Lorusso ◽

...

Keyword(s):

Postoperative Pain ◽

Operative Time ◽

Oral Surgery ◽

Study Groups ◽

Site Preparation ◽

Medical Sciences ◽

Operative Duration ◽

Significant Difference ◽

Surgery Department ◽

Implant Site Preparation

Purpose. Recent advances show that ultrasonic implant site osteotomy is related to a decreased trauma and a better postoperative healing of the surgical site when compared to traditional drilling techniques. The micrometric bone cutting control and the operative advantages related to the piezoelectric approach are also characterized by a learning curve for the clinician in surgical practice and an increased operative duration of the procedure. The aim of this investigation is to compare the operative time, the postoperative pain, and the amount of painkillers taken by the patient during the healing period. Methods. A total of 65 patients were treated at the Unit of Oral Surgery (Department of Medical Sciences, Surgery and Health, University of Trieste, Italy) using a split mouth model: 75 drill-inserted implants (G1) and 75 piezoelectric device-inserted implants (G2) were placed. The Visual Analogue Scale (VAS) was performed to evaluate the postoperative pain at 15 days from surgery. The operative time and frequency of intake of painkillers were measured. Results. The G1 and G2 groups showed a significant difference with a higher use of painkillers observed for G1. The G2 patients showed a lower level of pain (VAS) at all experimental times between 8 hours to 7 days (p<0.01) postsurgery. At 15 days, the pain levels were similar for both groups. No differences were found in site preparation duration between the study groups. Conclusions. The evidence supports the application of the piezoelectric approach compared to the drill’s osteotomy as a useful technique for implant site preparation. This trial is registered with NCT03978923.

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