Bone remodeling around a conical connection implant system using a short drilling protocol

Objectives: The main objective is to optimize a short drilling technique that will not produce changes at the periimplant level. In this study a reduced number of drills, with a final one of special design will be evaluated in order to obtain similar or better results compared to the standard drilling protocol. Methods: In this study 32 C1 implants with diameter of 4.2 mm were inserted in pairs in mandibular free end situations, in consolidated bone. All patients were non-smokers. The mesial implant was inserted with the standard drilling protocol. The distal implant was inserted with the short protocol drilling sequence: round bur, pilot drill with integrated stopper and final single use drill. Insertion torque did not exceed 55Ncm. After insertion, all implants received healing screws. Impressions were taken 3 month after the surgical phase. The analyze for bone reshaping was radiographically accomplished for each patient. Bone measurements were taken on the retro-alveolar radiographies at insertion, at 3 months, 6 months and one year after insertion. The results were analyzed using software Image J 1.46r. Each radiographic image was calibrated at a 1:1 scale, knowing the length in mm for the implants, from the platform level until its apex. Bone loss was measured in mm distally for each implant. Results: The study was conducted over o period of one year and there were no implants lost. The primary stability was accomplished in all cases. There were no significant differences between women and men regarding bone loss. All the implants were osteointegrated and all the patients completed the follow up examination.The mean values of crestal bone loss at time of the insertion of the final restoration were 1.30 mm for the standard protocol and 1.27 mm with short drill protocol. Following our research it was determined that the drilling time was reduced up to 50%, without significant differences between the bone reshaping for the two protocols. The final precalibrated single use drill, found together with the implant, is fine cutting and doesn?t create pressures or heat at the bone level. Due to the guiding marks of the final drill the drilling depth is correspondent for each implant. Conclusions: Short drill protocol seems to limit crestal bone remodeling same as standard techniques. This may be especially beneficial when is need to insert more implants and the operator time is reduced more than 50%, reducing also the healing process. By using the single use sharp final drill with the short drilling technique the overheating is limited therefore the bone loss is minimum. Keywords: short drilling protocol, bone remodeling, conical conection, periimplant level