Definition of a drilling protocol for mini dental implants in different bone qualities

Mini dental implants (MDI) have proven to be a good alternative of the conventional implants to support lower overdentures in elderly edentulous patients with narrow residual ridge. The aim of the present study was to define drilling protocols for each diameter of the MDI in each bone quality. The number and the diameter of the drilling bur and the drilling depth was investigated. A total of 48 MDIs with a ball head and transgingival collar were used to the drilling protocol in four different bone qualities (Q1-Q4). All available four diameters of the implants were included: 1.8mm, 2.1mm, 2.4mm, and 2.9mm. The length of all implants was 15mm. Three different protocols were prepared for each of the four bone qualities and for each implant diameter. The insertion torques and the primary stability of the implants were measured in their final position. Regardless of implant diameter and bone quality, the insertion torque was significantly higher using drilling protocol 1 than 3 and using drilling protocol 2 than 3 as well. The insertion torque was significantly higher in bone quality Q1 than in Q2-Q4. The unscrewing resulted in considerably increase in the torque, which exceeded the insertion torques by up to two times. This repeatedly led to the bending and fractures of implants.

Evaluation of implant stability using different implant drilling sequences

Background/purpose

Simplifying the drilling sequence would be meaningful for implant surgery, if it does not exert a negative influence. This prospective clinical study was conducted to evaluate the stability of implant placements after simplifying the drilling sequence.

Materials and methods

Subjects were divided into a control group that underwent a normal drilling sequence or a test group that underwent only an initial and final drilling. To evaluate the stability of the placed implant, radiography and implant stability quotient (ISQ) measurements were recorded immediately and 5 months after placement.

Results

In all subjects, the prosthesis process was completed with no significant resorption of the marginal bones. In contrast, a statistically significant difference was observed between the control and test groups 5 months after the implants were placed in terms of the ISQ score (80.72 ± 6.76 and 71.83 ± 9.00, respectively); however, both scores were sufficient to proceed with the prosthesis process.

Conclusion

These attempts to simplify drilling protocols are expected to contribute the improvement of implant-related treatments in future.

Effect of low speed drilling on osseointegration using simplified drilling procedures

Our aim was to find out whether simplified drilling protocols would provide biological responses comparable to those of conventional drilling protocols at the low rotational speed of 400rpm. Seventy-eight root form endosseous implants with diameters of 3.75, 4.2, and 5mm were placed into canine tibias and allowed to heal for 3 and 5 weeks. After the dogs had been killed, the samples of implanted bone were retrieved and processed for non-decalcified histological sectioning. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) analyses were made on the histological sections. Implants treated by the simplified protocol resulted in BIC and BAFO values comparable to those obtained with the conventional drilling protocol, and there were no significant differences in the technique or diameter of the drilling. The results suggest that the simplified procedure gives biological outcomes comparable to those of the conventional procedure.