Auto-stop Drilling Device for Implant Site Preparation: In Vitro Test of Eccentric Sensor Position

Purpose: To quantify the reliability of a new drilling system for implant osteotomy characterized by an eccentric sensor that automatically stops the drill upon contact with soft tissue. This safety mechanism aims to minimize surgical trauma to nerves, vessels, and the maxillary sinus mucosa. The benefits of the eccentric sensor position on planar and angulated surfaces were tested in vitro. Materials and Methods: Predicted drill protrusion after auto-stop was validated against experiments on four human cadaver mandibles (30 osteotomies with varying angles). Measurement of the drill's exit holes allowed calculation of the amount of drill protrusion, and postoperative computed tomographic scans of the mandibles were acquired to determine the drill's exit angles. Results: Mean drill protrusion into human jawbone was 0.46 ± 0.26 mm and differed significantly from expected drill protrusion, which was based on mathematical modeling, of 0.64 ± 0.3 mm. Detection of bone passage on angulated walls was seen up to 71 degrees. A central sensor position, by contrast, may result in significantly greater drill protrusion into soft tissue (mean difference: 0.55 ± 0.49 mm) that increases with the drill's exit angle (r = 0.93). Conclusion: Auto-stop drills may significantly enhance safety for the patient during osteotomy. The benefits of eccentric sensor positioning were particularly apparent when applied on angulated surfaces, whereas drill angulation was not found to influence this safety mechanism. Keywords: dental implants, drill device, osteotomy, resistance sensor, safety stop, sinus floor elevation, surgical complication