Response to the Letter to the editor. RE: Piezoelectric surgery versus conventional drilling for implant site preparation: a meta-analysis.

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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Piezoelectric vs. conventional drilling in implant site preparation: pilot controlled randomized clinical trial with crossover design

Clinical Oral Implants Research ◽

10.1111/clr.12278 ◽

2013 ◽

Vol 25 (12) ◽

pp. 1336-1343 ◽

Cited By ~ 22

Author(s):

Luigi Canullo ◽

David Peñarrocha ◽

Miguel Peñarrocha ◽

Alonso-Gonzalez Rocio ◽

Maria Penarrocha-Diago

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Site Preparation ◽

Crossover Design ◽

Implant Site Preparation ◽

Conventional Drilling

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In Vitro Comparison of Time and Accuracy of Implant Placement Using Trephine and Conventional Drilling Techniques Under Dynamic Navigation

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00125 ◽

2020 ◽

Author(s):

Janina Golob Deeb ◽

Anja Frantar ◽

George R. Deeb ◽

Caroline K. Carrico ◽

Ksenija Rener-Sitar

Keyword(s):

In Vitro Study ◽

Site Preparation ◽

Experimental Conditions ◽

Implant Placement ◽

Significant Difference ◽

Dynamic Navigation ◽

Drilling Technique ◽

Implant Site Preparation ◽

Conventional Drilling

The aim of this randomized in vitro study was to compare the time and accuracy of implant site preparation and implant placement using a trephine drill versus a conventional drilling technique under dynamic navigation. A total of 42 implants were placed in simulation jaw models with the two drilling techniques by two operators with previous experience with dynamic navigation. The timing of each implant placement was recorded, and horizontal, vertical, and angulation discrepancies between the planned and placed implants were compared. There was no significant difference in time or accuracy between the trephine and conventional drilling techniques. Implant site preparation with a single trephine drill using dynamic navigation was as accurate under in vitro experimental conditions as a conventional drilling sequence.

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Conventional Drilling Versus Piezosurgery for Implant Site Preparation: A Meta-Analysis

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-17-00091 ◽

2018 ◽

Vol 44 (5) ◽

pp. 400-405 ◽

Cited By ~ 2

Author(s):

Daniel Isaac Sendyk ◽

Natacha Kalline de Oliveira ◽

Claudio Mendes Pannuti ◽

Maria da Graça Naclério-Homem ◽

Ann Wennerberg ◽

...

Keyword(s):

Clinical Trials ◽

Dental Implants ◽

Site Preparation ◽

Implant Stability ◽

Controlled Clinical Trials ◽

Randomized Controlled Clinical Trials ◽

Randomized Controlled ◽

Significant Difference ◽

Implant Site Preparation ◽

Conventional Drilling

The aim of this study was to evaluate if the stability of dental implants varies between dental implants placed by piezosurgery compared with those placed by conventional drilling. An electronic search in MEDLINE, SCOPUS, and the Cochrane Library was undertaken until August 2016 and was supplemented by manual searches and by unpublished studies at OpenGray. Only randomized controlled clinical trials that reported implant site preparation with piezosurgery and with conventional drilling were considered eligible for inclusion in this review. Meta-analyses were performed to evaluate the impact of piezosurgery on implant stability. Of 456 references electronically retrieved, 3 were included in the qualitative analysis and quantitative synthesis. The pooled estimates suggest that there is no significant difference between piezosurgery and conventional drilling at baseline (weighted mean differences [WMD]: 2.20; 95% confidence interval [CI]: −5.09, 9.49; P = .55). At 90 days, the pooled estimates revealed a statistically significant difference (WMD: 3.63; 95% CI: 0.58, 6.67, P = .02) favoring piezosurgery. Implant stability may be slightly improved when osteotomy is performed by a piezoelectric device. More randomized controlled clinical trials are needed to confirm these findings.

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A Novel Osteotomy Preparation Technique to Preserve Implant Site Viability and Enhance Osteogenesis

Journal of Clinical Medicine ◽

10.3390/jcm8020170 ◽

2019 ◽

Vol 8 (2) ◽

pp. 170 ◽

Cited By ~ 5

Author(s):

Chih-Hao Chen ◽

Benjamin R. Coyac ◽

Masaki Arioka ◽

Brian Leahy ◽

U. Serdar Tulu ◽

...

Keyword(s):

Alveolar Bone ◽

Rotational Velocity ◽

Site Preparation ◽

Osteogenic Potential ◽

Osteotomy Site ◽

Preparation Technique ◽

Implant Site Preparation ◽

Conventional Drilling ◽

Drill Design ◽

Practical Implications

The preservation of bone viability at an osteotomy site is a critical variable for subsequent implant osseointegration. Recent biomechanical studies evaluating the consequences of site preparation led us to rethink the design of bone-cutting drills, especially those intended for implant site preparation. We present here a novel drill design that is designed to efficiently cut bone at a very low rotational velocity, obviating the need for irrigation as a coolant. The low-speed cutting produces little heat and, consequently, osteocyte viability is maintained. The lack of irrigation, coupled with the unique design of the cutting flutes, channels into the osteotomy autologous bone chips and osseous coagulum that have inherent osteogenic potential. Collectively, these features result in robust, new bone formation at rates significantly faster than those observed with conventional drilling protocols. These preclinical data have practical implications for the clinical preparation of osteotomies and alveolar bone reconstructive surgeries.

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