Thermal, mechanical, and densification analysis of osteotomy drill designs for implant placement: an analysis on foam blocks representing type IV bone.

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.