Comparison of Proliferation and Differentiation of Human Osteoblast-Like Cells Harvested During Implant Osteotomy Preparation Using Two Different Drilling Protocols

Radiographic comparisons of crestal bone levels around implants placed with low-speed drilling and standard drilling protocols: Preliminary results

“…The major concern of clinicians while choosing the drilling-protocol without irrigation is the potential of temperature increase due to mechanical friction between drill and host-bone. Several in vitro ( Augustin et al, 2008 , Benington et al, 2002 , Kim et al, 2010 , Scarano et al, 2011 , Stelzle et al, 2014 , Tabassum et al, 2020 ), and in vivo ( Flanagan, 2010 , Gaspar et al, 2013 , Giro et al, 2011 ) studies have been performed to study the relationship between drilling-speed, irrigation system and thermal osteonecrosis. In addition, Kim et al (2010) investigated the temperature threshold using infrared thermography by employing low-speed-drilling (50 rpm).…”

“…The main reason surgeons are interested in employing a low-speed-drilling protocol in their daily routines is the main advantage of this protocol i.e., collection of autogenous bone generated during the drilling ( Tabassum et al, 2020 ). The bone-chips remain attached to the drill flukes/threads due in the absence of saline-irrigation, and higher osteogenic efficacy of these bone-particles as compared to the bone collected by using a standard-protocol has been reported ( Liang et al, 2017 , Tabassum et al, 2020 ). Saline-irrigation and high-drilling-speed can affect the vitality of cells and reduce the number of growth factors ( Liang et al, 2017 , Tabassum et al, 2020 ).…”

“…It has been reported by several authors that the low-speed-drilling protocol is safe to employ for implant-site preparation, as it minimizes frictional heat generation ( Anitua et al, 2007 , Flanagan, 2010 , Giro et al, 2011 , Kim et al, 2010 ), and a histologically similar bone healing response has been observed ( Gaspar et al, 2013 , Giro et al, 2011 , Tehemar, 1999 ). The major advantage of this surgical technique is that it allows for the collection of vital autogenous bone, which can be used for bone augmentation procedures ( Augustin et al, 2008 , Tabassum et al, 2020 ).…”

Autogenous bone grafts and titanium mesh-guided alveolar ridge augmentation for dental implantation

“…According to studies by Robey and Termine 7 and by Sodek and Berkman, 8 the bone chips collected from the cortical bone, eliminated any soft tissue parts, stored in an isotonic solution to maintain the vitality of the cells, and cultured in a dish for several days still possessed the ability to differentiate into osteoblast-like cells which could express bone cell markers such as alkaline phosphate and osteocalcin. These cells were commonly cultured for in-vitro studies and could be utilized in researches on bone tissue engineering.…”

“…Studies showed bone chips acquired by hand instrument or by low speed drilling (bellow 200 rpm without irrigation) contained higher cell vitality and activity than those collected by drill sludge at a standard implant drilling procedure (>800 rpm with irrigation) or by piezosurgry. 8 , 9 The cells in the former bone chips also expressed higher amount of growth factors including bone morphogenesis protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) and better mineralization after differentiating medium induction. 10 Therefore, a bone scraper or low speed drilling sequence was essential for bone harvesting in the new autogenous bone grafts and titanium mesh-guided alveolar ridge augmentation technique for osteoblast-forced new bone formation.…”