What dental implant drill speed is ideal? What are the benefits of different drill speeds?

Dental implant drill speed is something that has a decent amount of research on it but the topic is still controversial. We feel the main reasons are that there are other factors that come into play and probably play a more important role in the healing process.

What implant drill speeds are available?

Different dentists will use different speeds for different circumstances when placing their implants. Typically the slowest speed is down around 50 rpm and the highest speed is up around 2500 rpm. There is no consensus on the ideal speed, although many consider 800-1200 rpm ideal.

Advantages of slow speed drilling.

You can collect a decent amount of autogenous bone using a slow speed drilling protocol. The slow drilling is often done without irrigation. There is also some that feel this will increase the amount of bone cell death, although that is not shown in all studies. Gaspar Acta Med Port 2013

Advantages of high speed drilling.

You get done faster is the most obvious advantage. Some research shows that very high implant drilling results in less heat generation, which may reduce cell death. Sharawy 2002 JOMS

Research on drill speed

The only end result that really matters clinically is bone loss. Many factors that studies test are indicative of possible implant problems but not necessarily resulting in bone loss or implant loss. Overall it seems that other criteria like practitioner experience and patient healing abilities are far more important than the implant drill speed. Also local factors such as thickness of cortical bone and general bone density in the area are likely to impact the results to such an extent that the implant drill speed becomes mute. Ozcan JOI 2022 shows no significant differences in cortical bone temperature, stability, or bone/tissue volume when the speed goes from 400 to 2000 rpm.

So what is the ideal dental implant drill speed?

The ideal speed probably depends on the situation you are in and what your preference is. Basically that means there is no ideal. If you want to collect some bone then the slower speed is ideal. Otherwise the faster you can get done with the surgery the better off you and the patient will be.