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Randomized Controlled Trial
. 2024 Dec 18;10(1):64.
doi: 10.1186/s40729-024-00582-7.

Dental implant site preparation with conventional rotary drill or piezosurgery: five-year after placement results from a within person randomised controlled trial

Adriano Azaripour  1   2 , Vittorio Siro Leone Farina  3 , Marco Esposito  4 , Jacopo Buti  5 , Bilal Al-Nawas  6 , Keyvan Sagheb  6
Affiliations
Randomized Controlled Trial

Dental implant site preparation with conventional rotary drill or piezosurgery: five-year after placement results from a within person randomised controlled trial

Adriano Azaripour et al. Int J Implant Dent. .

Abstract

Purpose: To evaluate whether there are clinical benefits by preparing dental implant sites using piezosurgery instead of conventional rotary drills in healed bone crests and if initial crestal soft tissue thickness could have an impact on marginal bone loss.

Methods: Twenty-five partially edentulous patients requiring two single implants in molar/premolar areas had each site randomly allocated to either piezosurgery or to conventional rotary drill preparation according to a split-mouth design. Definitive screw-retained metal-ceramic crowns were delivered after 6 months. All patients were followed to 5 years after placement. Outcome measures were: implant/crown failures, complications, peri-implant marginal bone level changes, resonance frequency analysis (RFA), and time required to complete site preparation, recorded, when possible, by blinded assessors.

Results: No patients dropped-out and no implant failed. Five years after placement, there were no statistically significant differences for complications (only one complication in the piezo group: difference = 0.04; P = 1), for peri-implant bone loss (difference = -0.11 mm; 95% CI -0.24 to 0.01; P = 0.083), and for RFA changes (6 months) (difference = -0.35; 95% CI -1.95 to 1.25; P = 0.672 between groups). Significantly more time was needed to prepare implant sites with piezosurgery (difference = 236.8 s; 95% CI -286.12 to -187.48; P < 0.0001). Initial soft tissue thickness had no effect on peri-implant bone loss (estimate = 0.05; 95% CI -0.03; 0.12; P = 0.239).

Conclusions: No clinically appreciable differences were noticed when placing implants using piezosurgery or conventional instrumentation with rotary drill, however, the preparation with rotary drills was on average 4 min faster. No effect of initial crestal soft tissue thickness was observed on peri-implant bone loss.

Keywords: Dental implants; Implant site preparation; Piezoelectric surgery; Rotary drills.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was approved by the University of Mainz Ethics Committee (Ethics Committee No.: 837.1 85.1 5 (9953)). All patients signed a specifically informed consent that was approved by the ethical committee in order to participate in the present trial. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Measurement of the mucosa height
Fig. 2
Fig. 2
Sequence of piezoelectric inserts used to prepare the test implant sites
Fig. 3
Fig. 3
Sequence of drills used to prepare the control implant sites
Fig. 4
Fig. 4
Illustration showing the implant design used in the study
Fig. 5
Fig. 5
a-c: a preoperative view of a representative patient; b site 15 was randomly allocated to piezosurgery and site 16 to conventional drilling; c flap closure; d postoperative baseline periapical radiograph
Fig. 6
Fig. 6
a-d: a clinical situation prior to delivery of definitive crowns; b occlusal and c vestibular view at delivery of definitive crowns; d periapical radiograph at initial loading (6 months after implant placement)
Fig. 7
Fig. 7
a-c: a and b clinical and c radiographic images at 5 years after placement
Fig. 8
Fig. 8
CONSORT 2010 Flow Diagram
See this image and copyright information in PMC

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