Emera, A., Aly, T., Elsheikh, S. (2018). PIEZOELECTRIC VERSUS CONVENTIONAL SURGICAL DRILLING FOR IMPLANT PLACEMENT IN ANTERIOR MAXILLA. Alexandria Dental Journal, 43(1), 111-117. doi: 10.21608/adjalexu.2018.57608
Amr M. Emera; Tarek M. Aly; Samraa A. Elsheikh. "PIEZOELECTRIC VERSUS CONVENTIONAL SURGICAL DRILLING FOR IMPLANT PLACEMENT IN ANTERIOR MAXILLA". Alexandria Dental Journal, 43, 1, 2018, 111-117. doi: 10.21608/adjalexu.2018.57608
Emera, A., Aly, T., Elsheikh, S. (2018). 'PIEZOELECTRIC VERSUS CONVENTIONAL SURGICAL DRILLING FOR IMPLANT PLACEMENT IN ANTERIOR MAXILLA', Alexandria Dental Journal, 43(1), pp. 111-117. doi: 10.21608/adjalexu.2018.57608
Emera, A., Aly, T., Elsheikh, S. PIEZOELECTRIC VERSUS CONVENTIONAL SURGICAL DRILLING FOR IMPLANT PLACEMENT IN ANTERIOR MAXILLA. Alexandria Dental Journal, 2018; 43(1): 111-117. doi: 10.21608/adjalexu.2018.57608
PIEZOELECTRIC VERSUS CONVENTIONAL SURGICAL DRILLING FOR IMPLANT PLACEMENT IN ANTERIOR MAXILLA
1-B.D.S. Faculty of Dentistry Alexandria University, Oral and Maxillofacial Surgery.
2-Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University
Abstract
INTRODUCTION: Osteotomies done for implant placement has been classically performed using drills of various shapes to conform the site to the implant’s geometry. Drilling procedures may cause not only mechanical trauma to the bone but also heat-induced bone necrosis, representing a significant risk for failed osseointegration. As an alternative, ultrasonic drilling for implant placement allows precise and effective bone cutting without damaging adjacent soft tissues. OBJECTIVES: This study evaluated the effect of Piezoelectric drilling in decreasing the peri-implant marginal bone loss as well as increasing the implant stability values throughout a 6 months healing period. MATERIALS AND METHODS: A clinical and radiographic study with a split-mouth design was carried out on 10 patients. Each patient received two implants in both sides of anterior maxilla, one implant was placed with piezoelectric drilling (study group) and the other was placed with conventional drilling (control group). Assessments included measurements of implant stability using Osstell and measurements of the linear changes in the peri-implant marginal bone using cone beam computed tomography images. Measurements were done immediately post-operative, at 3 months and 6 months. RESULTS: The clinical and radiographical results of the Piezoelectric study sides were better than the conventional control sides. Marginal bone loss was significantly lower in the study group. Implant Stability Quotient (ISQ) values were significantly higher in the study group at the immediate time of placement and at 6 months. CONCLUSIONS:Within the limitations of this clinical trial, it can be concluded that the piezoelectric drilling for implant placement in the anterior maxilla is a successful option for reducing marginal bone loss and increasing implant stability throughout the healing period.
1. McDermott NE, Chuang SK, Woo VV, Dodson TB. Maxillary sinus augmentation as a risk factor for implant failure. Int J Oral Maxillofac Implants. 2006;21:366-74.
2. Stein AE, McGlmphy EA, Johnston WM, Larsen PE. Effects of implant design and surface roughness on crestal bone and soft tissue levels in the esthetic zone. Int J Oral Maxillofac Implants. 2009;24:910-9.
3. Yoo RH, Chuang SK, Erakat MS, Weed M, Dodson TB. Changes in crestal bone levels for immediately loaded implants. Int J Oral Maxillofac Implants. 2006;21:253-61.
4. Valderrama P, Bornstein MM, Jones AA, Wilson TG, Higginbottom F, Cochran DL. Effects of implant design on marginal bone changes around early loaded chemicallymodified sand blasted, acid etched surfaced implants: A histological analysis in dogs. J Periodontol. 2010;25:548- 57.
5. Vehemente VA, Chuang SK, Daher S, Muftu A, Dodson TB. Risk factors affecting dental implant survival. J Oral Implantol. 2002;28:74-81.
6. Chuang SK, Wei LJ, Douglass CW, Dodson TB. Risk factors for dental implant failure: a strategy for the analysis of clustered failure-time observations. J Dent Res. 2002;81:572-7.
7. Pae A, Kim JW, Kwon KR. Immediate loading of two implants supporting a magnet attachment-retained overdenture: one-year clinical study. Implant Dent. 2010;19:428-36.
8. Eriksson RA, Albrektsson T. The effect of heat on bone regeneration: an experimental study in the rabbit using the bone growth chamber. J Oral Maxillofac Surg. 1984;42:705-11.
9. Brisman DL. The effect of speed, pressure, and time on bone temperature during the drilling of implant sites. Int J Oral Maxillofac Implants. 1996;11:35-7.
10.Lundskog J. Heat and bone tissue. An experimental investigation of the thermal properties of bone and threshold levels for thermal injury. Scand J Plast Reconstr Surg. 1972;9:1-80.
11. Ercoli C, Funkenbusch PD, Lee HJ, Moss ME, Graser GN. The influence of drill wear on cutting efficiency and heat production during osteotomy preparation for dental implants: a study of drill durability. Int J Oral Maxillofac Implants. 2004;19:335-49.
12.Eriksson A, Albrektsson T, Grane B, McQueen D. Thermal injury to bone. Avital-microscopic description of heat effects. Int J Oral Surg. 1982;11:115-21.
13.Dergeliyurt K, Akar V, Denizci S, Yucel E. Bone lid technique with piezosurgery to preserve inferior alveolar nerve. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:1-5.
14.Spiegelberg F, Claar M. Piezo: a minimally traumatic alternative in implantology. Aust Dent Pract. 2009;144-8.
15.Eggers G, Klein J, Blank J, Hassfeld S. Piezosurgery: an ultrasound device for cutting bone and its use and limitations in maxillofacial surgery. Br J Oral Maxillofac Surg. 2004;42:451-3.
16.Schaller BJ, Gruber R, Merten HA, Kruschat T, Schliephake H, Buchfelder M, et al. Piezoelectric bone surgery: a revolutionary technique for minimally invasive surgery in cranial base and spinal surgery? Technical note. Neurosurgery. 2005;57:E410.
17.Berengo M, Bacci C, Sartori M, Perini A, Della Barbera M, Valente M. Histomorphometric evaluation of bone grafts harvested by different methods. Minerva Stomatol. 2006;55:189-98.
18.Cordaro L, Amade DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. Clin Oral Implants Res. 2002;13:103-11.
19.González-García A, Diniz-Freitas M, Somoza-Martín M, García-García A. Ultrasonic osteotomy in oral surgery and implantology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:360-7.
20.Vercellotti T, Nevins ML, Kim DM, Nevins M, Wada K, Schenk RK, et al. Osseous response following resective therapy with Piezosurgery. Int J Periodontics Restor Dent. 2005;25:543-9.
21.Preti G, Martinasso G, Peirone B, Navone R, Manzella C, Muzio G, et al. Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus a drill technique: a pilot study in minipigs. J Periodontol. 2007;78:716-22.
22.Di Alberti L, Donnini F, Di Alberti C, Camerino M. A comparative study of bone densitometry during osseointegration: piezoelectric surgery versus rotary protocols. Quintessence Int 2010; 41: 639-44.
23. Blus C, Szmukler-Moncler S. Atraumatic tooth extraction and immediate implant placement with piezosurgery: evaluation of 40 sites after at least 1 year of loading. Int J Periodontics Restorative Dent. 2010;30:355-63.
24. Padmanabhan, TV , Gupta, R. Comparison of crestal bone loss and implant stability among implants placed with conventional procedure and using osteotome technique: clinical study. Journal of Oral Implantology 2010;36: 475– 483.
25. Canullo L, Peñarrocha D, Peñarrocha M, Rocio AG, Diago MP. Piezoelectric vs. conventional drilling in implant site preparation: pilot controlled randomized clinical trial with crossover design. Clin Oral Implants Res. 2014;25:1336-43.
26. Schlee M, Steigmann M, Bratu E, Garg AK. Piezosurgery: basics and possibilities. Implant Dent 2006; 12: 334-40.
27. Albrektsson, T, Zarb, GA. Current interpretations of the osseointegrated response: clinical significance. Int J Prosthodont. 1993;6:95–105.
28. Stelzle F, Neukam FW, Nkenke E. Load dependent heat development, thermal effects, duration and soft tissue preservation in piezosurgical implant site preparation: an experimental ex vivo study. Int J Oral Maxillofac Implants. 2012;27:513-22.
29. Vercellotti, T., Stacchi, C., Russo, C., Rebaudi, A., Vincenzi, G., Pratella, U., Baldi, D., Mozzati, M., Monagheddu, C., Sentineri, R., Cuneo, T., Di Alberti, L., Carossa, S. & Schierano, G. Ultrasonic implant site preparation using piezosurgery: a multicenter case series study analyzing 3,579 implants with a 1- to 3-year followup. International Journal of Periodontics and Restorative Dentistry2014;34: 11–18
30. Mounir M, Beheiri G, El-Beialy W. Assessment of marginal bone loss using full thickness versus partial thickness flaps for alveolar ridge splitting and immediate implant placement in the anterior maxilla. Int J Oral Maxillofac Surg. 2014;43:1373-80