Awad Mostafa M, El Nawawy Marwa, El Refaie Ibrahim, Zahran Amr F
Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University; Department of Oral Medicine and Periodontology, Faculty of Dentistry, Modern University for Technology and Information, Cairo, Egypt, Phone: +2 01000356793, e-mail:
Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt.
J Contemp Dent Pract. 2025 Jan 1;26(1):10-17. doi: 10.5005/jp-journals-10024-3808.
The current study was conducted to evaluate the potential of a dental implant placed with a new reverse drilling technique (test group) as an alternative treatment option to a dental implant placed with an osteotome technique (control group) according to primary implant stability.
With fourteen patients in each group, twenty-eight implants were positioned in the posterior maxilla and split equally between two groups: Group A (new reverse drilling technique) and group B (osteotome technique). Periotest M (PTV) was used to measure implant stability, cone-beam computed tomography (CBCT) was used to measure crestal bone loss (mm) and bone density Hounsfield units (HU), and the visual analog scale (VAS) was used to measure pain and swelling. The patients were monitored for 5 months. For statistical analysis, SPSS (version 20) was utilized, and statistical significance was established at < 0.05.
Regarding the primary outcome of the study, the primary stability of the control group (osteotome technique) showed higher primary stability than the test group (reverse drilling technique). The Mann-Whitney test revealed that this difference was not statistically significant ( = 0.4820) with a mean value of 0.23 and ±0.33 standard deviation. Crestal bone loss was 0.13 ± 0.06 mm greater measured mesially in the osteotome group and 0.04 ± 0.07 mm greater measured distally in the osteotome group. In each case, the differences were not statistically significant according to independent samples -tests (mesial: = 0.05974; distal: = 0.55541).
The two implant placement protocols showed comparable implant stability (PTV) and implant success; the reverse drilling technique is potentially a viable option for the treatment of patients with poor bone quality.
The reverse drilling technique can be used as an alternative to the osteotome technique when placing implants in the posterior maxilla for its comparatively reduced invasiveness and higher patient acceptance in terms of pain and swelling. How to cite this article: Awad MM, El Nawawy M, El Refaie I, Clinical Evaluation of Implant Stability in Poor Quality Maxillary Bone: Reverse Drilling vs Osteotome Techniques: A Randomized Controlled Clinical Trial. J Contemp Dent Pract 2025;26(1):10-17.
本研究旨在根据种植体初期稳定性，评估采用新型反向钻孔技术植入的牙种植体（试验组）作为采用骨凿技术植入的牙种植体（对照组）的替代治疗方案的潜力。
每组14例患者，28枚种植体植入上颌后牙区，并平均分为两组：A组（新型反向钻孔技术）和B组（骨凿技术）。使用Periotest M（PTV）测量种植体稳定性，使用锥形束计算机断层扫描（CBCT）测量牙槽嵴骨吸收（mm）和骨密度亨氏单位（HU），并使用视觉模拟量表（VAS）测量疼痛和肿胀情况。对患者进行5个月的监测。采用SPSS（20版）进行统计分析，以P<0.05为差异有统计学意义。
关于本研究的主要结果，对照组（骨凿技术）的初期稳定性高于试验组（反向钻孔技术）。曼-惠特尼检验显示，这种差异无统计学意义（P = 0.4820），平均值为0.23，标准差为±0.33。骨凿组近中牙槽嵴骨吸收比试验组多0.13±0.06mm，远中牙槽嵴骨吸收比试验组多0.04±0.07mm。在每种情况下，根据独立样本检验，差异均无统计学意义（近中：P = 0.05974；远中：P = 0.55541）。
两种种植体植入方案显示出相当的种植体稳定性（PTV）和种植成功率；反向钻孔技术可能是治疗骨质量差的患者的一种可行选择。
在上颌后牙区植入种植体时，反向钻孔技术可作为骨凿技术的替代方法，因为其侵入性相对较小，患者在疼痛和肿胀方面的接受度更高。如何引用本文：Awad MM, El Nawawy M, El Refaie I, 上颌骨质量差时种植体稳定性的临床评估：反向钻孔与骨凿技术：一项随机对照临床试验。《当代牙科实践杂志》2025；26(1):10 - 17。
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