Evaluating single drilling protocol versus gradual drilling protocol for implant bed osteotomy: a comparative in vivo study

Introduction: The study aims to evaluate the effectiveness of the mini-surgical kit and the single drilling protocol in the success of dental implants, comparing them with the traditional gradual drilling protocol. This will involve assessing marginal bone loss, and the maximum torque achieved during drilling with both techniques. Materials and methods: A comparative study was conducted on 10 patients (and 30 implants). The sample was divided into two groups: (1) Control sample: 15 implant beds were prepared using the gradual drilling protocol. (2) Study sample: 15 implant beds were prepared using the single drilling protocol. The study utilized a split-mouth method, selecting patients who had lost a minimum of two teeth. One implant was inserted using the single drilling protocol, while the other one was inserted using the gradual drilling protocol. Cone beam computed tomography (CBCT) images were taken presurgery, followed by periapical x-rays immediately post-surgery to assess implant positions. Six months later, CBCT images were taken, and the following variables were evaluated: (1) marginal bone loss, (2) maximum torque achieved during drilling. Results: The success rate of the implants was 100%. The average marginal bone loss rate in the single drilling protocol was 0.65 ± 0.1 at 6 months post-surgery, while in the gradual drilling protocol, it was 0.51 ± 0.6, measurements showed no statistically significant ( P -value = 0.4). The highest torque achieved by the drill in the single drilling protocol was 35.08 ± 5.40, whereas the average highest torque reached by the drills in the gradual drilling protocol was 27.18 ± 3.30, both measurements showed statistically significant ( P -value = 0.001). Conclusions: Within the limits of this study, we determined that the single drilling protocol can be considered as a safe and effective method for achieving successful dental implants when compared to the gradual drilling protocol. Additionally, it plays a crucial role in decreasing surgical time and minimizing drill usage.