Evaluation of implant site preparation with piezosurgery versus conventional drills in terms of operation time, implant stability and bone density (randomized controlled clinical trial- split mouth design)

Abstract

Background: The preparation of the implant bed has a major influence on the success rate and long-term survival of dental implants. Piezoelectric devices and special implant drilling inserts are now emerging to replace conventional drills showing improved bone response and healing around implants. The purpose of this study is to compare the piezoelectric inserts versus the traditional drills for implant site preparation.

Methods: Twelve male patients who received a total of twenty-four dental implants have been selected to participate in this split-mouth clinical trial. Each patient received two implants; one installed after piezosurgery assisted osteotomy, while the contralateral side received the implant with the original drilling protocol. The timing of surgery, implant stability, and bone density around the installed dental implants have been evaluated during a follow-up period extended to 4 months.

Results: a significant difference in terms of time of surgery (p < 0.005) and in implant stability at 4 months (p = 0.024) on the study side, while a non-statistical significance in terms of bone density was detected (p = 0.468).

Conclusion: The piezoelectric implant site drilling protocol seemed to be a reliable and repeatable technique. Despite the limited sample size and lengthier operative time, the piezoelectric inserts enhanced bone quality and implant stability. Clinical trial registration Current Controlled Trials (ClinicalTrials.gov) https://clinicaltrials.gov/ct2/show/NCT05512273 ; the date of registration: 23/08/2022. Retrospectively registered.

Keywords: Bone density; Implant osteotomy; Implant stability; Piezosurgery.

Fig. 1

a Mectron piezosurgery white device, b implant osteotomy inserts

Fig. 2

a OT4 insert correcting osteotomy axis, b P3-4 insert optimizing the concentricity of the osteotomy, c Bego RSX dental implant inserted, d Transducer probe directed towards the smartpeg to record ISQ

Fig. 3

CBCT Para-axial view showing preoperative bone density measurements

Fig. 4

Participant flow diagram

Fig. 5

Bar chart graph comparing time in minutes

Fig. 6

Grey value measured, apical (1), middle (2), and cervical (3). Para-axial view of the buccal measurements. The arrow indicates the region of the reference value at the lip/cheek area

Fig. 7

Line chart graph representing the bone density grey value at different follow up period