Objectives: To analyze the effects of three osteotomy drill designs (conventional, reverse helix, and densification) and running directions on heat generation, primary implant stability, block-to-implant contact, peri-implant block volume, and resistance to unscrewing forces in a low-density alveolar bone model.
Method and materials: Eighty-eight dental implants were placed in artificial bone blocks using manual and computer-controlled osteotomies. Temperature changes, insertion torque value, resonance frequency analyses (implant stability quotient [ISQ]), block-to-implant contact, and peri-implant block volume were measured. Statistical analyses used ANOVA and Kruskal-Wallis tests (P < .05).
Results: Densification drill designs produced the lowest temperature change (17.52 ± 2.57°C and 28.06 ± 4.35°C for the second and third drills), while conventional drills had the highest (27.53 ± 5.17°C and 38.03 ± 8.08°C). Counter-clockwise (CCW) conventional drilling significantly reduced the temperature change compared to clockwise (CW). Densification drill designs achieved the highest primary implant stability (38.01 ± 1.87 N/cm, 65.00 ± 4.69 ISQ) and removal torque (25.40 ± 5.08 N/cm), while conventional CW drills had the lowest (33.23 ± 2.91 N/cm, 61.83 ± 4.28 ISQ). Densification drill designs showed the highest peri-implant block volume (87.71 ± 4.23 mm3) but the lowest block-to-implant contact (49.12 ± 2.93%). CCW conventional drilling improved insertion torque value over CW (36.21 ± 3.63 vs 33.23 ± 2.91 N/cm).
Conclusion: Densification drill designs demonstrated better performance in heat reduction, primary implant stability, and peri-implant block volume, but had lower block-to-implant contact. CCW running of conventional drills showed improvements over CW in several parameters. While densification drilling excelled in most aspects, its lower block-to-implant contact and the positive outcomes of CCW conventional drilling warrant further investigation.
Keywords: bone density; dental implants; osseodensification; osteotomy; temperature; torque.