What is the ideal dental implant drilling technique?
Dental implant drilling techniques vary from system to system. So what is the ideal form one implant may not be ideal for another. Furthermore bone density plays a role in dermingin ideal implant drilling technique too. However, there are some general guidelines that are useful.
Forward drilling vs reverse drill rotation vs expansion
Forward is clockwise and reverse is counter-clockwise. It is basically, bone removal vs bone expansion or osseodensification. Osseodensification is popular due to one major drill company, Versah. The forward conventional method of drilling is slowly increasing diameter of implant drills that remove bone. A variation of that is under-sizing the osteotomy in which the final drill is left out. Compaction and or expanding of the bone of the bone and
Implant drilling techniques influence on primary stability.
This is fairly straight forward. The more undersized the osteotomy and the more osseodensification then the more primary stability you will have. Other factors are bone quality and the surface of the dental implant.
Drilling techniques influence on crestal bone loss and failure rate.
The issue with this topic is there are far more important variables in play. That makes the topic challenging to study. We discuss drill speed on another page and similar to those results, the “best” depends on many factors.
Modified versions of dental implant drilling technique may be the best option
We feel it is the surgeon’s skill and experience that determine the success rate far over any other factor. The feel of the bone and how dense or how vascular the bone is are traits that should influence the drilling technique. Therefore, it is possible that a modified version of the conventional drilling technique ends up being the best. For example, Suny JOMI 2022, shows a modified dental implant drilling technique that is the conventional drilling sequence until he last drill which is used in reverse. There exists a large number of variations of this type and how the bone feels may be the best guide to use as to when to do what.