title: Multistepped Drill Design for Single-Stage Implant Site Preparation: Experimental Study in Type 2 Bone.
abstract: OBJECTIVE
  To evaluate an experimental multistepped drill for single-stage implant site preparation by means of real-time analysis of thermal variations during and postdrilling, and by implant stability evaluation.
  
  
  METHODS
  Temperature and time were recorded in real time by paired microprobe thermocouples during simulated osteotomy in type 2 bone similes at the cortical and cancellous zones. Three different drilling groups with a new multistepped drill design were compared: Control (2-mm diameter pilot drill + 3.3-mm three-stepped drill + 4.1-mm three-stepped drill); Test A (3.3-mm three-stepped drill); and Test B (4.1-mm three-stepped drill). Implants were inserted, and implant stability was evaluated with the Perio Test Value (PTV). Two-way anova was used to test the independent effects of osteotomy and implant diameter on temperature and stability.
  
  
  RESULTS
  All the drills induced thermal changes without significant differences between groups (p > .05). Drilling in cortical bone produced significant increase of the temperatures in a range of 1.8 ± 0.9°C compared with drilling in cancellous bone (p < .05). ΔT temperatures were significantly higher for test groups in cortical and cancellous bone (p < .05); ΔT10 for all groups showed a reduction of the temperature in a range of 1.7 ± 0.3°C without significant differences between groups (p > .05); the mean time to accomplish drilling was significantly longer in the control group (p < .05); test groups took 10 ± 0.3 seconds less to reach the required drilling depth. PTV values were higher in test groups compared with controls (p < .05).
  
  
  CONCLUSIONS
  The multistepped drills used for single-stage implant site preparation Increase temperature as in comparison with a conventional incremental protocol; Induce the temperature increment in cortical bone compared with the cancellous bone; Reduce drilling time when a multistepped drill is used alone; and Increase implant stability twofold compared with a conventional incremental protocol.
authors.affiliation: Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Marcus
authors.initials: M
authors.lastname: Abboud
authors.affiliation: Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Rafael Arcesio
authors.identifier: http://orcid.org/0000-0003-1721-0509
authors.initials: RA
authors.lastname: Delgado-Ruiz
authors.affiliation: Department of Oral Surgery, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Kucine
authors.affiliation: Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Sihana
authors.initials: S
authors.lastname: Rugova
authors.affiliation: Department of Prosthodontics, Faculty of Dentistry, Universidad del Valle, Cali, Colombia.
authors.forename: Julian
authors.initials: J
authors.lastname: Balanta
authors.affiliation: Implant Dentistry, Faculty of Medicine and Dentistry, Murcia University, Murcia, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Calvo-Guirado
mesh_terms: D003758:Dental Implantation, Endosseous / Q000379:methods*; D003762:Dental Instruments; D006801:Humans; D013696:Temperature
keywords: dental implants; implant stability; single-stage implant site preparation; surgical drills design