Effect of Osteotomy Site Preparation using Conventional Drill Osteotomy and Piezoelectric Osteotomy on Implant Stability and Crestal Bone Loss: A Randomized Control Study

Background: Traditional rotating drills can cause bone overheating and damage to adjacent tissues. Piezoelectric osteotomy, a nonrotational alternative, has been suggested to overcome these limitations. Aim: To evaluate the implant stability quotient (ISQ) values at 0, 2, 4, 8, and 12 weeks using a resonance frequency analyzer and to assess crestal bone loss at 3 and 6 months via periapical radiographs obtained using the paralleling cone technique. Materials and Methods: A total of 10 participants, each with at least two missing teeth in the maxillary anterior or premolar region (D2 or D3 bone quality), were enrolled in the study. Participants were randomly assigned to one of the two groups. Group 1 underwent osteotomy preparation using the piezoelectric osteotomy technique, whereas Group 2 received the conventional drilling technique. Implant stability was measured at baseline and at 2, 4, 8, and 12 weeks postsurgery, and crestal bone loss was evaluated at 3 and 6 months postimplantation. Results: The analysis showed a statistically significant difference in implant stability between the two groups. At 12 weeks, the mean ISQ value in the piezoelectric group was 76.6 (±4.5) compared to 73.9 (±5.1) in the conventional group ( P = 0.03). Secondary stability continued to improve in the piezoelectric group, whereas no significant change was observed in the conventional group. For crestal bone loss, no significant difference was found between the groups at 3 or 6 months ( P = 0.25 and P = 0.18, respectively). Conclusion: Piezoelectric osteotomy demonstrated a significant increase in implant stability up to 12 weeks postsurgery. This technique can be a reliable alternative to conventional drilling for osteotomy preparation.