Definition of a drilling protocol for mini dental implants in different bone qualities

Area of Science:

• Dental Implantology
• Biomaterials Science
• Surgical Protocols

Background:

• Mini dental implants (MDIs) offer a viable solution for elderly edentulous patients with narrow residual ridges.
• Optimizing MDI placement requires understanding the interplay between drilling protocols, implant diameter, and bone quality.

Purpose of the Study:

• To establish precise drilling protocols for various mini dental implant (MDI) diameters across different bone qualities.
• To investigate the influence of drilling parameters on implant insertion torque and primary stability.

Main Methods:

• Forty-eight mini dental implants (MDIs) of four diameters (1.8mm, 2.1mm, 2.4mm, 2.9mm) were placed using three distinct drilling protocols in four bone qualities (Q1-Q4).
• Insertion torque and primary stability were measured, and unscrewing torque was analyzed to assess implant retention and potential failure modes.

Main Results:

• Drilling protocols 1 and 2 yielded significantly higher insertion torques than protocol 3, irrespective of implant diameter and bone quality.
• Bone quality Q1 demonstrated significantly higher insertion torques compared to Q2-Q4.
• High unscrewing torques, up to double the insertion torques, were observed, leading to implant bending and fractures.

Conclusions:

• Drilling protocol 3 is recommended for mini dental implants (MDIs) to minimize excessive insertion and unscrewing torques, thereby preventing implant bending and fractures.
• Tailoring drilling protocols to specific bone qualities and MDI diameters is crucial for successful implant integration and long-term stability.