Sadek Mohamed Ahmed Galal, Amer Mohamed Zaghlool, El-Gohary Nesma, Elsheikh Heba Abo-Elfetouh
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Department of Fixed Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
BMC Oral Health. 2025 Jun 21;25(1):956. doi: 10.1186/s12903-025-06360-0.
Implant placement in the posterior maxilla is challenging, so modifications of the surgical techniques were introduced to overcome these challenges. The undersized drilling technique uses a final drill smaller than the diameter of the implant. The single drilling technique is a simplified method where the osteotomy is made using a single drill without sequential widening. This study was directed to evaluate the peri-implant bone behavior of the undersized drilling technique versus the single drilling technique of immediately loaded dental implants inserted in the posterior maxilla.
32 patients were selected for prosthetic replacement of a missing maxillary posterior single tooth by an immediately loaded dental implant and divided randomly into two equal groups. In Group I: 16 patients received 16 implants using the undersized drilling technique, while in Group II: 16 patients received 16 implants using the single drilling technique. Insertion torque, implant stability, modified sulcus bleeding index (mBI), peri-implant probing depth, bone density, and marginal bone height were evaluated for both groups. Statistical analysis was made for clinical and radiographic data.
32 implants were inserted in the posterior maxilla. During a 12-month follow-up, every dental implant was successful with no complications. Both techniques showed high insertion torque (≥ 35 Ncm) and primary stability (> 70 ISQ) with no significant difference between the two groups (P > 0.05). Also, there were no significant differences between the study groups regarding peri-implant soft tissue health, bone density, and marginal bone loss (P > 0.05).
Both techniques revealed comparable, promising clinical and radiographic outcomes over a 12-month post-loading follow-up period when the immediate loading protocol was used in the posterior maxilla, where bone density is poor, but preparing the implant bed using the single drilling technique offers several merits for both the patient and clinician. In addition to avoiding excessive heat generation, mechanical damage, and high frictional forces during drilling procedures, surgical operations, and surgical site exposure take less time.
Clinical-Trials.gov PRS ( https://register.
gov ) had this study registered under the identifier number. NCT06770231 on 01/01/2025.
在上颌后牙区植入种植体具有挑战性，因此引入了手术技术的改进方法来克服这些挑战。小号钻孔技术使用的最终钻头小于种植体的直径。单钻孔技术是一种简化方法，即使用单个钻头进行截骨，无需逐步扩孔。本研究旨在评估在上颌后牙区植入即刻负重牙种植体时，小号钻孔技术与单钻孔技术的种植体周围骨组织情况。
选择32例患者，通过即刻负重牙种植体修复上颌后牙区单颗缺失牙，并随机分为两组，每组16例。第一组：16例患者使用小号钻孔技术植入16颗种植体；第二组：16例患者使用单钻孔技术植入16颗种植体。评估两组的植入扭矩、种植体稳定性、改良龈沟出血指数（mBI）、种植体周围探诊深度、骨密度和边缘骨高度。对临床和影像学数据进行统计分析。
32颗种植体植入上颌后牙区。在12个月的随访期间，每颗牙种植体均成功，无并发症。两种技术均显示出高植入扭矩（≥35 Ncm）和初期稳定性（>70 ISQ），两组之间无显著差异（P>0.05）。此外，在种植体周围软组织健康、骨密度和边缘骨丢失方面，研究组之间也无显著差异（P>0.05）。
当在上颌后牙区使用即刻负重方案时，在12个月的加载后随访期内，两种技术均显示出相当且良好的临床和影像学结果，上颌后牙区骨密度较差，但使用单钻孔技术准备种植窝对患者和临床医生都有诸多优点。除了在钻孔过程中避免产生过多热量、机械损伤和高摩擦力外，手术操作和手术部位暴露所需时间更短。
ClinicalTrials.gov PRS（https://register.
gov）于2025年1月1日将本研究注册，标识符为NCT06770231。
