Abstract
Objectives. To test the hypothesis that there would be no differences in osseointegration by reducing the number of drills for site preparation relative to conventional drilling sequence. Methods. Seventy-two implants were bilaterally placed in the tibia of 18 beagle dogs and remained for 1, 3, and 5 weeks. Thirty-six implants were 3.75 mm in diameter and the other 36 were 4.2 mm. Half of the implants of each diameter were placed under a simplified technique (pilot drill + final diameter drill) and the other half were placed under conventional drilling where multiple drills of increasing diameter were utilized. After euthanisation, the bone-implant samples were processed and referred to histological analysis. Bone-to-implant contact (BIC) and bone-area-fraction occupancy (BAFO) were assessed. Statistical analyses were performed by GLM ANOVA at 95% level of significance considering implant diameter, time in vivo, and drilling procedure as independent variables and BIC and BAFO as the dependent variables. Results. Both techniques led to implant integration. No differences in BIC and BAFO were observed between drilling procedures as time elapsed in vivo. Conclusions. The simplified drilling protocol presented comparable osseointegration outcomes to the conventional protocol, which proved the initial hypothesis.
Highlights
Osseointegration has been defined as the intimate contact between bone tissue and implanted biomaterial in the optical microscopy level, and such phenomenon has rendered dental implantology as one of the most successful treatment modalities in both dentistry and medicine [1, 2]
Half of the implants of each diameter were placed under a simplified technique and the other half were placed under the conventional drilling technique where multiple drills of increasing diameter were utilized
The present study design allowed the evaluation of osseointegration measurable parameters in implants placed in sites that were prepared in an incremental diameter fashion or in a two-step fashion to final diameters of 3.6 mm and 4.0 mm at 900 rpm under abundant irrigation
Summary
Osseointegration has been defined as the intimate contact between bone tissue and implanted biomaterial in the optical microscopy level, and such phenomenon has rendered dental implantology as one of the most successful treatment modalities in both dentistry and medicine [1, 2]. Especially in cases where endogenous factors are not present, failure of dental implants has been attributed to exogenous factors such as implant design (including macroand microgeometry), surgical technique (excessive surgical trauma), overload, misfit of suprastructures, or surgical site infection [3, 4]. Albrektsson et al (1981) suggested that there are 6 factors that determine the success of osseointegration, that is, biocompatibility, design, surface, state of the host bed, surgical technique, and loading conditions [5]. Compared to the plethora of studies concerning the implant biocompatibility, design, surface, and loading conditions, the number of studies focusing on the host bed and surgical technique is limited. The effect of surgical procedures such as the drilling protocol has been sparsely explored, and clinicians basically follow the given instructions from the manufacturers
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