Single-drill implant induces bone corticalization during submerged healing: an in vivo pilot study

Paolo Trisi,Antonello Falco,Marco Berardini

doi:10.1186/s40729-019-0198-y

Abstract

PurposeThe aim of the present paper is to evaluate a simplified implant site preparation technique to preserve bone bulk and enhance osseointegration using a new conical self-tapping implant in cancellous bone.Materials and methodsTen Expander® 3.8 × 10 mm implants (NoDrill®, Milano, Italy) were inserted in the right side (test group) of sheep’s iliac crest using only the pilot drill 1.8 mm in diameter. Ten 3.8 × 10 mm Dynamix® implants (Cortex, Shlomi, Israel) were inserted in the right side (control group) of the same animals following the drilling protocol provided by the manufacturer. Histological, histomorphometric, and biomechanical analyses were performed after 2 months.ResultsImplants that belonged to the test group showed a %BIC of 70.91 ± 7.95 while the control group implants had a %BIC value of 49.33 ± 10.73. The %BV was 41.83 ± 6.30 in the test group and 29.61 ± 5.05 in the control group. These differences were statistically significant. A phenomenon of osseocorticalization, characterized by more bone volume percentage around implant area than in the neighboring areas, caused by implant threads geometry, was evident in the test group.ConclusionThis surgical protocol allows to insert an innovative fixture geometry in low-density bone using only a pilot drill. This technique demonstrated many clinical and histological advantages with respect to standard implant drilling procedures and classical implant geometry.

Highlights

It is well documented that implant initial bone fixation, known as primary implant stability, represents the prerequisite to achieve a successful long-term osseointegration [1].Many studies demonstrated that the implant primary stability is strictly influenced by host bone density [2], fixture geometry [3, 4], and surgical technique used for preparing bone implant bed [5]
Other studies [6, 7] highlighted that host bone quality and fixture macro geometry as main factors able to influence the primary implant stability
The aim of the present paper is to evaluate a reduced implant site preparation technique to preserve bone bulk and enhance primary stability using a new conical self-tapping implant in cancellous type IV bone

Summary

Introduction

Many studies demonstrated that the implant primary stability is strictly influenced by host bone density [2], fixture geometry [3, 4], and surgical technique used for preparing bone implant bed [5]. A minimally traumatic bone drilling is strongly recommended to preserve much bone tissue as possible without impairing its healing potential [9]. To this end, several surgical techniques [10] have been proposed to avoid or reduce bone sacrifice during implant placement procedures to enhance primary implant stability and bone quality The excessive surgical trauma prior to implant insertion and the bone temperature rise during standard drilling procedures [8] are other crucial factors modifiable by the surgeon, whose importance is often underestimated.

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Conclusion