13 May 2021

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Implant bed preparation: conventional drilling vs piezoelectric osteotomy

Lara Figini

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Conventional rotary drilling is the most common approach for preparing the implant bed, but there are other predictable ways to achieve this preparation, including the piezoelectric osteotomy (PO), first applied by Vercellotti, which allows hard tissue to be cut without damaging soft tissues such as oral mucosa, blood vessels, nerves, or Schneider’s membrane, as it is less invasive. The main disadvantage of the PO, however, is the time required to prepare the implant site, greater than the conventional drilling.

Materials and methods
In a Spanish study, published on Med Oral Patol Oral Cir Bucal, March 2021, the authors compared the primary and secondary implant stability between placement with piezoelectric osteotomy and conventional drilling, comparing marginal bone losses as a secondary objective.
An electronic search was conducted using PubMed (MEDLINE), Scopus, and Cochrane Library (Wiley) databases, besides a manual search.

Results
A total of 153 articles were retrieved, 39 from Pubmed, 44 from Scopus, and 70 from the Cochrane Library. After removing duplicates, 112 articles (1 from the manual search) were screened, and 9 were finally selected for qualitative and statistical analyses. Piezoelectric surgery is a predict medium- and long-term survival rates and marginal bone losses were similar between the two comparison groups, piezoelectric osteotomy and conventional preparation, and there was no difference for the ISQ implant stability quotient values for primary stability. However, implants placed with piezoelectric osteotomy showed a smaller decrease in the implant stability quotient (ISQ) during the osseointegration period and a higher ISQ value for secondary stability.

Conclusions
From the results of this review, which must be compared with other data from similar reviews, it can be concluded that piezoelectric surgery is a predictable and valid alternative to conventional drilling for implant bed preparation.

Clinical implications
This study contributes further information on peri-implant bone tissue at 3 and 6 months after implant placement with piezoelectric osteotomy or conventional drilling and provides an updated meta-analysis of comparative studies.

For additional information: Stability and marginal bone loss in implants placed using piezoelectric osteotomy versus conventional drilling: systematic review and meta-analysis.