Does the Drilling Technique for Implant Site Preparation Enhance Implant Success in Low-Density Bone? A Systematic Review.

PURPOSE: The objective of this systematic review was to investigate the possible association between the drilling technique and proper implant integration and survival in areas with low bone density. MATERIALS AND METHODS: An electronic search using the MEDLINE/PubMed database was performed including studies published up to April 2018. Animal and clinical studies that evaluated the association between the drilling technique and proper implant integration and survival in low-density bone were included. RESULTS: Fifteen studies met the inclusion criteria, including 7 experimental and 8 clinical. Undersized, osteotome, Piezosurgery, and osseodensification drilling were the 4 techniques found in the literature to enhance osseointegration of implants in low-density bone. Owing to the methodological variation, meta-analysis was not performed. The 4 drilling protocols were effective in increasing primary stability, but the long-term outcome is comparable with that of the conventional surgical drilling protocol. CONCLUSION: There is weak evidence suggesting that any of the previously mentioned surgical techniques could enhance successful osseointegration and survival of the implants placed in low-density bone.

Pattern of Antibiotic Prescription for Oral Implant Treatment Among Dentists in Saudi Arabia.

OBJECTIVE: To investigate antibiotic prophylaxis prescription behavior among dentists practicing dental implant surgery in Saudi Arabia. MATERIALS AND METHODS: An observational questionnaire study was conducted in the period between October 2016 and December 2016. A link to an online previously validated questionnaire was sent to a convenience sample of dentists practicing dental implant placement in the different areas of Saudi Arabia. Absolute frequencies were used to describe the data. RESULTS: One hundred nine completed questionnaires were received. A total of 59.63% (n = 65) of the respondents routinely prescribed prophylactic antibiotics when performing implant surgery. There was a wide variation in the preoperative and postoperative prescription regimens with the majority (67%) starting the antibiotic immediately postoperatively for 3 to 5 days, with no preoperative antibiotic use. Amoxicillin and clavulanic acid combination was the drug of choice for 50.3% of the respondents, whereas 26.6% prescribed amoxicillin as the drug of choice. CONCLUSION: Although a small study with a low response rate, a wide variation in antibiotic prescribing patterns with respect to the drugs chosen, timing, and duration was found in implant surgery in Saudi Arabia. Dentists should be aware of the risk of antibiotic overuse and start to share in the efforts that aim to reserve the antibiotics to combat life-threatening infections and to reduce development of bacterial resistance to the available antibiotics.

Effect of Simplifying Drilling Technique on Heat Generation During Osteotomy Preparation for Dental Implant.

OBJECTIVES: To test the hypothesis that there would be no difference in heat production by reducing the number of drills during the implant site preparation relative to conventional drilling sequence. METHODS: A total of 120 implant site preparations with 3 different diameters (3.6, 4.3, and 4.6 mm) were performed on bovine ribs. Within the same diameter group, half of the preparations were performed by a simplified drilling procedure (pilot drill + final diameter drill) and other half using the conventional drilling protocol (pilot drill followed by graduated series of drills to widen the site). Heat production by different drilling techniques was evaluated by measuring the bone temperature using k-type thermocouple and a sensitive thermometer before and after each drill. RESULTS: Mean for maximum temperature increase during site preparation of the 3.6, 4.3, and 4.6-mm implants was 2.45, 2.60, and 2.95° when the site was prepared by the simplified procedure, whereas it was 2.85, 3.10, and 3.60° for the sites prepared by the conventional technique, respectively. No significant difference in temperature increase was found when implants of the 3 different diameters were prepared either by the conventional or simplified drilling procedure. CONCLUSIONS: The simplified drilling technique produced similar amount of heat comparable to the conventional technique that proved the initial hypothesis.

Effect of the Drilling Technique on Heat Generation During Osteotomy Preparation for Wide-Diameter Implants.

OBJECTIVES: To test the hypothesis that there would be no difference in heat generation by reducing the number of drills during the implant site preparation relative to conventional drilling sequence. METHODS: A total of 80 implant site preparations with 2 different diameters (5.6 and 6.2 mm) were performed on bovine ribs. Within the same diameter group, half of the preparations were performed by a simplified drilling procedure (pilot drill + final diameter drill) and the other half using the conventional drilling protocol, where multiple drills of increasing diameter were utilized. Heat production by different drilling techniques was evaluated by measuring the bone temperature using K-type thermocouple and a sensitive thermometer before and after each drill. RESULTS: Mean for maximum temperature increase during site preparation of the 5.6- and 6.2-mm implants was 2.20°C, and it was 2.55°C when the site was prepared by the simplified procedure, whereas it was 2.80°C and 2.95°C for the sites prepared by the conventional technique, respectively. No significant difference in temperature increase was found when implants of the 2 chosen diameters were prepared either by the conventional or simplified drilling procedure. CONCLUSIONS: The simplified drilling protocol produces similar amount of heat comparable to the conventional technique, which proved the initial hypothesis.