Scanning Electron Microscope Evaluation of Dental Implant Socket Hole: Drilling Versus Osteotome Technique.

Drilling and expanding by osteotome are among the used techniques for preparation of implant sites. Considering the small number of scanning electron microscopic studies in this respect, this study sought to compare drilling and expanding methods for implant hole preparation in animal models. In this experimental study, 4 implant sites were prepared in each left and right mandibular quadrant of 3 sheep. Implant holes were prepared at the sites by alternate use of drill and osteotome. Immediately after surgery and vital perfusion of mandibular specimens with Osmium tetroxide and graded alcohols, specimens were prepared for scanning electron microscopic analysis. Microfractures, smooth margins, and presence of debris were evaluated. The amount of microfracture was significantly lower in the drill compared with the osteotome group (17.8% versus 82.4%). The percentage of smooth margins was 4% in the osteotome and 94% in the drill group. The margins had more indentations in the osteotome group. The amount of debris was 16.2% in the osteotome and 83.7% in the drill group. Debris was free and separated from the cavity wall in the drill group; whereas, in the osteotome group, debris had been compacted into the cavity wall. Osteotome caused more microfractures and greater indentations in the walls of prepared implant sites. The amount of debris in holes prepared by osteotome was less than that in the drilled holes and debris was compacted in the walls in the former group. Free debris was more frequent in the drilled holes. (C) 2016 by Mutaz B. Habal, MD.

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