Multistepped Drill Design for Single-Stage Implant Site Preparation: Experimental Study in Type 2 Bone

Clin Implant Dent Relat Res. 2015 Oct:17 Suppl 2:e472-85. doi: 10.1111/cid.12273. Epub 2014 Sep 29.

Abstract

Purpose: To evaluate an experimental multistepped drill for single-stage implant site preparation by means of real-time analysis of thermal variations during and postdrilling, and by implant stability evaluation.

Materials and methods: Temperature and time were recorded in real time by paired microprobe thermocouples during simulated osteotomy in type 2 bone similes at the cortical and cancellous zones. Three different drilling groups with a new multistepped drill design were compared: Control (2-mm diameter pilot drill + 3.3-mm three-stepped drill + 4.1-mm three-stepped drill); Test A (3.3-mm three-stepped drill); and Test B (4.1-mm three-stepped drill). Implants were inserted, and implant stability was evaluated with the Perio Test Value (PTV). Two-way anova was used to test the independent effects of osteotomy and implant diameter on temperature and stability.

Results: All the drills induced thermal changes without significant differences between groups (p > .05). Drilling in cortical bone produced significant increase of the temperatures in a range of 1.8 ± 0.9°C compared with drilling in cancellous bone (p < .05). ΔT temperatures were significantly higher for test groups in cortical and cancellous bone (p < .05); ΔT10 for all groups showed a reduction of the temperature in a range of 1.7 ± 0.3°C without significant differences between groups (p > .05); the mean time to accomplish drilling was significantly longer in the control group (p < .05); test groups took 10 ± 0.3 seconds less to reach the required drilling depth. PTV values were higher in test groups compared with controls (p < .05).

Conclusions: The multistepped drills used for single-stage implant site preparation Increase temperature as in comparison with a conventional incremental protocol; Induce the temperature increment in cortical bone compared with the cancellous bone; Reduce drilling time when a multistepped drill is used alone; and Increase implant stability twofold compared with a conventional incremental protocol.

Keywords: dental implants; implant stability; single-stage implant site preparation; surgical drills design.

MeSH terms

  • Dental Implantation, Endosseous / methods*
  • Dental Instruments*
  • Humans
  • Temperature