IADR Abstract Archives
Low- Versus Conventional-speed Drilling in Maxillary Dental Implants: A RCT
Objectives: Currently, controversies exist regarding the ideal drilling protocol for maxillary dental implants placement. The present study investigated the effects of low speed drilling without irrigation versus conventional speed drilling with irrigation in dental implants’ placement on patient-reported pain, implants’ survival, crestal bone loss, bone density and implants’ stability over 6 months in a randomized controlled clinical setting.
Methods: Following sample size calculation, patients were recruited from the outpatient clinic of the Faculty of Dentistry, Cairo University and randomized into two treatment groups (n=10/group), receiving dental implants in the edentulous posterior maxillary region, via low speed (50-70 rpm) without irrigation (test-group) or conventional speed drilling (800-1200 rpm) with irrigation (control-group). Patient-reported VAS scores for pain were recorded after one week, while implants’ survival, crestal bone loss, bone density and implant stability were evaluated at 3 and 6 months follow ups.
Results: Following the first week, pain scores were significantly lower in the low (1.6±0.7) versus the conventional speed (4.3±0.7) drilling group (p<0.001). Two implants were lost early in the low speed drilling group, while one implant was lost post-loading in the conventional speed drilling group. Implant stability demonstrated no significant differences between the two groups (p>0.001). Bone density significantly increased over 6 months around the osseointegrated implants (p<0.001), with no differences observed between the groups. Crestal bone loss was significantly higher in the low versus the conventional speed drilling group at 3 months (1.27±0.78mm & 0.61±0.71mm respectively, p=0.01), as well at 6 months (1.79±0.97mm & 0.83±0.50mm respectively, p<0.001; repeated measure ANOVA, Bonferroni).
Conclusions: Within the limitation of the present randomized controlled clinical trial, low speed drilling appears to provide better initial pain scores and patients’ satisfaction. Both low as well as conventional speed drilling protocols do not appear to affect implants’ survival, peri-implant bone density as well as implants’ stability. Yet, crestal bone loss appears to be the main parameter negatively affected by the low in contrast to the conventional speed drilling protocol.
Methods: Following sample size calculation, patients were recruited from the outpatient clinic of the Faculty of Dentistry, Cairo University and randomized into two treatment groups (n=10/group), receiving dental implants in the edentulous posterior maxillary region, via low speed (50-70 rpm) without irrigation (test-group) or conventional speed drilling (800-1200 rpm) with irrigation (control-group). Patient-reported VAS scores for pain were recorded after one week, while implants’ survival, crestal bone loss, bone density and implant stability were evaluated at 3 and 6 months follow ups.
Results: Following the first week, pain scores were significantly lower in the low (1.6±0.7) versus the conventional speed (4.3±0.7) drilling group (p<0.001). Two implants were lost early in the low speed drilling group, while one implant was lost post-loading in the conventional speed drilling group. Implant stability demonstrated no significant differences between the two groups (p>0.001). Bone density significantly increased over 6 months around the osseointegrated implants (p<0.001), with no differences observed between the groups. Crestal bone loss was significantly higher in the low versus the conventional speed drilling group at 3 months (1.27±0.78mm & 0.61±0.71mm respectively, p=0.01), as well at 6 months (1.79±0.97mm & 0.83±0.50mm respectively, p<0.001; repeated measure ANOVA, Bonferroni).
Conclusions: Within the limitation of the present randomized controlled clinical trial, low speed drilling appears to provide better initial pain scores and patients’ satisfaction. Both low as well as conventional speed drilling protocols do not appear to affect implants’ survival, peri-implant bone density as well as implants’ stability. Yet, crestal bone loss appears to be the main parameter negatively affected by the low in contrast to the conventional speed drilling protocol.
