Treatment planning implant dentistry with a 2-mm twist drill

Drilling with a 2-mm twist drill is the first time a clinician can assess variations in bone density for the length of bone where an implant will be placed. Evaluation of bone density is critically important with respect to making decisions regarding depth and width of an osteotomy, undersizing the drilling sequence, submerging vs not submerging an implant, supracrestal vs subcrestal implant placement, selecting a tapered vs nontapered implant, countersinking, platform switching, immediate loading, healing time, etc. This article addresses how information acquired with a 2-mm twist drill can affect treatment planning. In particular, this article underscores that the clinician must be prepared to alter drilling protocols based on tactile feedback from a 2-mm twist drill.