NEED FOR THE STUDY:

Dental implantology aims at functional and esthetic rehabilitation of a patient affected by complete or partial edentulism.  

The success of implant therapy depends on the attainment of osseointegration, osseointegration is the direct structural and functional connection between bone and the surface of an implant. The surgical technique of implant placement also plays a vital role in establishing osseointegration.

Various drilling protocols have been established for implant placement namely conventional, under preparation or Osseo densification and reverse drilling protocol.

Conventional drills are used to perform osteotomy in the alveolar bone during dental implant surgery. Abundant bone dust will be produced during the process, it seems disgrace to wash away these precious autogenous bones with cooling water.

There have been numerous methods in the past trying to collect these bone dust, for example, the bone trap connected to the saliva tube to collect bone chips from suction, or a low-speed drilling without irrigation to collect the bone chips.

Recently, there is a new model adjustment in the osteotomy preparation named Osseo densification, which was designed through a counterclockwise rotation using uniquely designed burs that promotes lateralization of autogenous bone in to the surrounding cancellous structure and expands the surrounding osseous environment to provide three major effects.

First, it claims to collect these bone dust on the spot and fill them around the implant socket in the purpose of increasing bone density and increasing the initial stability of the implant.  Second, because of reverse drilling technique, it has the effect of alveolar ridge split at the same time. Third, it is used in the posterior area of the upper jaw, it can push the collected bone particles into the maxillary sinus and achieve the effect of sinus lifting simultaneously.

The scientific data regarding the reverse drilling protocol and its comparison to conventional drilling protocol is scant. Hence, the study is designed to evaluate and compare the reverse and conventional drilling protocol.

REVERSE DRILLING PROTOCOL:

In reverse drilling protocol the lance drill will be placed in clock wise direction.

The remaining sequential drilling will be done in counter clock wise direction with 30NCM torque.