Implant Site Preparation: single versus multiple drilling?

What is the effect of bone density and drilling protocol on heat generation during implant bed preparation? A recent study 1 investigated ten single and ten gradual implant sites with diameters of 2.8, 3.5, and 4.2mm that were prepared in four artificial bone blocks (density types I-IV; D1-D4).

The conclusion:

Single drilling could generate more heat than traditional sequential drilling, and bone density, as well as drill diameter, influenced thermal increases. Particularly in lower-density bone, conventional sequential drilling seems to raise the temperature less.

What is your preferred drilling technique: single or sequential?

Read the Full Abstract Here

1. Int J Oral Maxillofac Surg. 2016 Nov;45(11):1478-1484. Thermal evaluation by infrared measurement of implant site preparation between single and gradual drilling in artificial bone blocks of different densities.
Möhlhenrich SC, et al.

4 thoughts on “Implant Site Preparation: single versus multiple drilling?

  1. Geoff says:

    We use both types of drilling due to sizes of implants and densities . The studies have shown as well that depth is a factor in heat . say 6mm verses 15.

  2. praveen m says:

    Hi we have conducted a similar study wherein sequential drilling was done on one side and simplified drilling using only the final drill in patients and found no difference in the osseointegration levels .

  3. Nicole Chambers says:

    In my opinion, both techniques are effective. What really concerns me is the effect of the procedure afterwards. Either way,I believe it would be less traumatic to a patient if we use simpler and less invasive procedures.

  4. Choukroun Joseph says:

    Preparation of an osteotomy results in a narrow zone of dead and dying osteocytes in peri-implant bone. The main issue is how do you place your implant after preparation:
    Placing implants with high Torque insertion:
    – More than 2x of dead and dying osteocytes
    – peri-implant bone develops micro-fractures
    – bone resorption is increased, and bone formation is decreased.
    – Using high Insertion torque to place an implant creates high interfacial stress and strain that are associated with damage to peri-implant bone
    – and therefore should be avoided to best preserve the viability of this tissue..
    The implant placement has to be adapted to the bone density..
    Multiscale Analyses of the Bone-implant Interface: J.Y. Cha, J.A. Helms Journal of Dental Research 2015, Vol. 94(3) 482–490


Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Research and News, Surgical.
Bookmark Implant Site Preparation: single versus multiple drilling?

Videos to Watch:

Ridge Splitting Cases in Narrow Alveolar ridge

This videos shows ridge splitting, which when combined with bone expansion, is an effective technique[...]

Watch Now!
Placement of 4 Implants and Cement-Retained Bridge

The treatment plan was to extract the lower incisors, canines, and lower premolar and place[...]

Watch Now!
Failing Bridge Replaced with Dental Implant Supported Bridge

Ahe patient presented with a failed dental bridge from the upper right canine to the[...]

Watch Now!
Lateral Sinus Augmentation with CGF

Following membrane elevation with the lateral approach, and confirmation of an intact sinus membrane, concentrated[...]

Watch Now!
Titanium Mesh for Ridge Augmentation

The use of titanium mesh is a reliable method for ridge augmentation to provide adequate[...]


Watch Now!
Implant Grafting Techniques: Demineralized Sponge Strip and Tunneling

This video reviews several unique grafting and surgical techniques, including the use of demineralized cancellous[...]

Watch Now!
Mandibular Fixed Screw Retained Restoration

This video shows the use of a surgical guide for a mandibular fixed screw retained[...]

1 Comment

Watch Now!
Clinical Tip for Fixation of a Collagen Membrane

This video provides a clinical tip with regards to the fixation of a collagen membrane.[...]

Watch Now!
Lower Molar Extraction with Graft

Video showing lower left first molar extraction, followed by a socket graft, and then immediate[...]


Watch Now!
Maxillary Bone Reconstruction

This video demonstrations Maxillary Bone Reconstruction using Subnasal Floor Elevation and an Osteotome Closed Approach[...]

Watch Now!
Infection of Lower Premolar: Extract and Place Implant

In this video, the lower left 2nd premolar was extracted due to infection, and implants[...]

Watch Now!
Flapless Immediate Implant and Provisional

This video shows a technique showing using the patient's own tooth as a provisional at[...]

Watch Now!