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Effects of Asymmetric Oscillatory Drilling on Bone Densification, Heat Generation, and Implant Stability
Purpose:
To evaluate the effects of an oscillatory drilling technique on bone densification, heat generation, and implant stability.
Materials And Methods:
An in vitro study was conducted using pig rib segments to simulate low-density bone. Drilling protocols were performed using three techniques: clockwise (CW) cutting, counterclockwise (CC) densifying, and oscillatory movement (OM) at 60 degrees clockwise and 240 degrees counterclockwise. There were six drilling sites and six implants per group to ensure sufficient statistical reliability. Drilling was performed with an automated handpiece under controlled conditions. Thermal changes were recorded using a laser thermometer and infrared imaging, and bone densification was assessed using microCT analysis. The final insertion torque (IT) was measured to determine the primary stability, and removal torque (RT) was recorded to assess the stability loss for each implant.
Results:
The CC and OM groups demonstrated significantly higher bone volume, intersection surface, and reduced trabecular separation compared to the CW group (P < .05). Although the CC group exhibited the highest temperature increase, all final temperatures remained below the critical threshold of 47°C. Infrared imaging showed less overall heat retained within the body of the drill in the CW group compared to the CC and OM groups. The OM drills exhibited lower heat generation than the CC group, with a peak temperature at approximately 5 mm above the drill tip. The OM and CC groups showed significantly higher IT than the CW group (P < .05). Implant removal revealed a stability reduction of 27.8% ± 10.2%, 24.8% ± 13.6%, and 20.2% ± 8.2% for CW, CC, and OM groups, respectively (P > .05).
Conclusions:
During implant site preparation, the OM group enhanced bone densification, improved primary stability, and maintained safe thermal levels. These findings suggest that OM could serve as a promising alternative to conventional drilling techniques, particularly in low-density bone. Further studies are needed to explore its clinical applicability and long-term outcomes.
