Biological drilling: Implant site preparation in a conservative manner and obtaining autogenous bone grafts

Abstract

Background/Aim: The drilling process for insertion of an implant should be as conservative as possible, as not to damage the future implant bed. If this drilling is conservative additional bone can be obtained to be used afterwards, during the same surgery, as bone graft particulate if needed. The objective of this study was to evaluate the efficiency of a biological low-speed drilling and to analyse the bone obtained in order to ascertain viability and vitality of the contained bone cells. Also, the bone obtained from the low-speed drilling was compared with bone obtained with high speed drilling and irrigation, collected through a filter in aspiration system. Material and Methods: In this pilot study, samples of biological drilling (low speed without irrigation) were collected in five patients undergoing implant surgery. In the same patients a high speed drilling with irrigation was also used. Bone of the drilling was collected through a filter in the aspiration system. Subsequently the samples were analysed by conventional histology and cultivated in order to observe cell growth. Results: The samples of bone obtained by biological drilling showed live cells in the conventional optical microscopy and cell growth after cultivation. The bone obtained with drilling at high revolutions showed no living cells and no cell growth after cultivation. Conclusions: The biological drilling at low speed offered two advantages compared to drilling at high speed with irrigation. The first of these is the perfect control of the drilling depth as the marks of the burs are visible during drilling; the second is possibility of collection of a large number of viable particulate bone grafts without increasing time and complexity of the surgery, which allows immediate augmentation of bone if needed.