Analysing Osteotomy Drilling Speed on Cortical Bone on Implant Stability and Bone Healing
Keywords:
Osteotomy drilling speed, cortical bone, implant stability, bone healing, osseointegration, thermal damage, Implant Stability Quotient (ISQ)Abstract
Background:
Osteotomy drilling speed plays a critical role in dental implantology, influencing both primary implant stability and subsequent bone healing. Excessive drilling speeds may generate thermal damage, compromising osseointegration, whereas lower speeds may enhance bone preservation. This study aims to evaluate the impact of different drilling speeds on cortical bone during implant site preparation and assess their effects on implant stability and bone healing outcomes.
Materials and Methods:
A total of 30 implant sites were prepared in bovine cortical bone samples, divided equally into three groups based on drilling speeds: Group A (800 rpm), Group B (1200 rpm), and Group C (1600 rpm). Standardized saline irrigation was applied across all groups. Primary implant stability was measured using the Implant Stability Quotient (ISQ) immediately after placement. Histological analysis was conducted after 6 weeks to assess bone healing and new bone formation around the implants.
Results:
Group A (800 rpm) demonstrated the highest mean ISQ value of 75 ± 2, followed by Group B (1200 rpm) with 70 ± 3, and Group C (1600 rpm) with 65 ± 4. Histological evaluation revealed greater new bone formation in Group A (68% bone-to-implant contact) compared to Group B (60%) and Group C (52%). Higher drilling speeds correlated with increased signs of thermal osteonecrosis and delayed bone remodeling.
Conclusion:
Lower osteotomy drilling speeds significantly enhance primary implant stability and promote superior bone healing by minimizing thermal damage to cortical bone. Optimal drilling protocols emphasizing reduced speeds with adequate irrigation may improve clinical outcomes in dental implant procedures.
Downloads
Metrics
References
Ozcan M, Salimov F, Temmerman A, Turer OU, Alkaya B, Haytac MC. The Evaluation of Different Osteotomy Drilling Speed Protocols on Cortical Bone Temperature, Implant Stability and Bone Healing: An Experimental Study in an Animal Model. J Oral Implantol. 2022;48(1):3-8. doi:10.1563/aaid-joi-D-20-00228. PMID: 33270867.
Salimov F, Ozcan M, Ucak Turer O, Haytac CM. The effects of repeated usage of implant drills on cortical bone temperature, primary/secondary stability and bone healing: A preclinical in vivo micro-CT study. Clin Oral Implants Res. 2020;31(8):687-693. doi:10.1111/clr.13603. PMID: 32302433.
Bernabeu-Mira JC, Soto-Peñaloza D, Peñarrocha-Diago M, Camacho-Alonso F, Rivas-Ballester R, Peñarrocha-Oltra D. Low-speed drilling without irrigation versus conventional drilling for dental implant osteotomy preparation: a systematic review. Clin Oral Investig. 2021;25(7):4251-4267. doi:10.1007/s00784-021-03939-z. PMID: 33893557.
Salomó-Coll O, Auriol-Muerza B, Lozano-Carrascal N, Hernández-Alfaro F, Wang HL, Gargallo-Albiol J. Influence of bone density, drill diameter, drilling speed, and irrigation on temperature changes during implant osteotomies: an in vitro study. Clin Oral Investig. 2021;25(3):1047-1053. doi:10.1007/s00784-020-03398-y. PMID: 32533265.
Gil LF, Sarendranath A, Neiva R, Marão HF, Tovar N, Bonfante EA, et al. Bone Healing Around Dental Implants: Simplified vs Conventional Drilling Protocols at Speed of 400 rpm. Int J Oral Maxillofac Implants. 2017;32(2):329-336. doi:10.11607/jomi.4802. PMID: 28291851.
Brisman DL. The effect of speed, pressure, and time on bone temperature during the drilling of implant sites. Int J Oral Maxillofac Implants. 1996;11(1):35-7. PMID: 8820120.
Giro G, Marin C, Granato R, Bonfante EA, Suzuki M, Janal MN, et al. Effect of drilling technique on the early integration of plateau root form endosteal implants: an experimental study in dogs. J Oral Maxillofac Surg. 2011;69(8):2158-63. doi:10.1016/j.joms.2011.01.029. PMID: 21530048.
Romanos GE, Bastardi DJ, Kakar A, Moore R, Delgado-Ruiz RA, Javed F. In vitro comparison of resonance frequency analysis devices to evaluate implant stability of narrow diameter implants at varying drilling speeds in dense artificial bone blocks. Clin Implant Dent Relat Res. 2019;21(5):1023-1027. doi:10.1111/cid.12842. PMID: 31464362.
Limmeechokchai S, Kan JY, Rungcharassaeng K, Goodacre CJ, Lozada J, Oyoyo U. Heat and Sound Generation During Implant Osteotomy When Using Different Types of Drills in Artificial and Bovine Bone Blocks. J Oral Implantol. 2022;48(3):187-193. doi:10.1563/aaid-joi-D-20-00361. PMID: 34091687.
Hong HH, Hong A, Yang LY, Chang WY, Huang YF, Lin YT. Implant Stability Quotients of Osteotome Bone Expansion and Conventional Drilling Technique for 4.1 mm Diameter Implant at Posterior Mandible. Clin Implant Dent Relat Res. 2017;19(2):253-260. doi:10.1111/cid.12451. PMID: 27665748.
Liu YF, Wu JL, Zhang JX, Peng W, Liao WQ. Numerical and Experimental Analyses on the Temperature Distribution in the Dental Implant Preparation Area when Using a Surgical Guide. J Prosthodont. 2018;27(1):42-51. doi:10.1111/jopr.12488. PMID: 27078175.
Kim SJ, Yoo J, Kim YS, Shin SW. Temperature change in pig rib bone during implant site preparation by low-speed drilling. J Appl Oral Sci. 2010;18(5):522-7. doi:10.1590/s1678-77572010000500016. PMID: 21085811.
Marković A, Lazić Z, Mišić T, Šćepanović M, Todorović A, Thakare K, et al. Effect of surgical drill guide and irrigans temperature on thermal bone changes during drilling implant sites - thermographic analysis on bovine ribs. Vojnosanit Pregl. 2016;73(8):744-50. doi:10.2298/VSP141208041M. PMID: 29328609.
Sagheb K, Kumar VV, Azaripour A, Walter C, Al-Nawas B, Kämmerer PW. Comparison of conventional twist drill protocol and piezosurgery for implant insertion: an ex vivo study on different bone types. Clin Oral Implants Res. 2017;28(2):207-213. doi:10.1111/clr.12783. PMID: 26799448.
Seo DU, Kim SG, Oh JS, Lim SC. Comparative Study on Early Osseointegration of Implants According to Various Drilling Speeds in the Mandible of Dogs. Implant Dent. 2017;26(6):841-847. doi:10.1097/ID.0000000000000673. PMID: 29068799.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
