Effect of Drilling Technique in Dental Implants

Abstract

Step-drilling is a common drilling technique used in many dental implant cases to create a hole to place a tooth implant in the jaw bone. The step-drilling requires multiple pilot drill-bits of increasing diameter prior to a main drill bit to create an implant site. It has been reported that the use of the pilot drill-bits with smaller diameters can reduce forces significantly in drilling during dental implants. However, few of studies have been performed to investigate the effect of step-drilling techniques to the temperature rise in bone. Reducing thermal damage in bone is one of the critical factors which can lead to success of dental implant cases. The objective of this study is to investigate the effects of drilling techniques on temperature and forces in dental implant cases. In this study, different drilling techniques were designed using two different drilling depths and drill bits with two different diameters. Using the combinations of the drilling depths and drill-bit diameters, a custom drilling procedure was created to replicate step-drilling in common dental implant cases. Each drilling test was performed on bovine cortical bone samples with a Computer Numerically Controlled (CNC) machine to ensure precision and repeatability between trials. Force and temperature signals were collected using a dynamometer and an infrared thermal camera, respectively. The results indicate that using a pilot hole with drilling depth equivalent to the main larger hole depth reduced maximum force and torque, while showing higher maximum temperature. This study also observed that reducing pilot hole drilling depth to half of the main hole depth led to larger maximum forces, whereas a lower maximum temperature was recorded. The findings of this study can provide a general understanding of how different drilling techniques can influence thermal effect in dental implant cases