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.

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

  1. 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. 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. 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. 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

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