Purpose: To evaluate the effect of different drilling techniques on implant stability at different time intervals.
Keywords: drilling protocol, implant stability, reverse drilling, secondary stability, simplified drilling
Materials and Methods: Patients were randomly allotted into three groups based on drilling technique for osteotomy: conventional drilling technique; simplified drilling technique; or modified conventional drilling technique. In 30 patients (n = 10 each group), a total of 44 implants were placed. In the conventional drilling technique, drills with increasing diameters were used. In the simplified drilling technique, only pilot and final-diameter drills were used. In the modified conventional drilling technique, all the drills were used in sequential order in the clockwise direction except the last drill, which was used in the counterclockwise direction. Implant stability quotient was recorded immediately after placing implants and at 1 and 3 months. Statistical analysis was performed with two-way analysis of variance (ANOVA) and Student t test.
Results: Two-way ANOVA showed that drilling technique (P < .001) and time (P = .002) did have a statistically significant effect on implant stability quotient. The modified conventional drilling technique showed a drop in secondary implant stability at 1 month that was negligible compared to the other techniques. After 1 month, there was a significant increase in implant stability quotient with the modified conventional drilling technique compared to the conventional drilling technique (P = .001). The least crestal bone loss during 3 months of follow-up was with the modified conventional drilling technique (0.37 ± 0.06).
Conclusion: Secondary stability increased with the modified conventional drilling technique in 3 months and showed a negligible drop at 1 month. This novel drilling technique had an early shift from a decrease to an increase in stability pattern, along with the least crestal bone loss at 3 months.