Clinical and Radiographic Evaluation of Piezoelectric versus Conventional Implant Osteotomy Preparation

Abstract

Background: Preparation of the implant osteotomy influences primary stability, tissue response, and subsequent osseointegration. Piezoelectric osteotomy has been proposed as a more controlled alternative to conventional rotary drilling because of its selective cutting action and irrigation-assisted operating mechanism.

Objective: To compare clinical implant stability and radiographic bone-density changes following implant osteotomy prepared with piezoelectric inserts or conventional drills.

Methods: Eight adult patients received 16 implants in the maxillary anterior or premolar region. Eight implant sites were prepared using conventional drills (control group) and eight using dedicated piezoelectric inserts (study group). Implant stability was recorded with the Osstell device immediately after implant placement and at 6 months. Standardized digital periapical radiographs were obtained immediately after placement and at 3 and 6 months. Relative radiographic bone density was assessed at the mesial, distal, and apical regions using Digora software.

Results: Implant stability increased significantly in both groups over 6 months. At baseline, the difference between groups was not statistically significant (57.4±5.4 versus 53.8±5.6 ISQ; P=0.209), whereas the piezoelectric group showed a significantly higher 6-month value than the conventional group (76.6±5.1 versus 66.6±6.0; P=0.003). Radiographic bone density also increased significantly with time in both groups. At 6 months, total bone-density values were 195.7±4.1 in the piezoelectric group and 180.4±6.8 in the conventional group (P<0.001). A significant positive correlation between implant stability and radiographic bone-density measurements was observed at 6 months (r=0.568, P=0.022).

Conclusion: Within the limitations of this small clinical study, piezoelectric osteotomy was associated with greater improvement in implant stability and radiographic bone density during the 6-month healing period than conventional drilling in maxillary implant sites.