INTRODUCTION:Osteotomies done for implant placement has been classically performed using drills of various shapes to conform the site to the implant's geometry. Drilling procedures may cause not only mechanical trauma to the bone but also heat-induced bone necrosis, representing a significant risk for failed osseointegration. As an alternative, ultrasonic drilling for implant placement allows precise and effective bone cutting without damaging adjacent soft tissues. OBJECTIVES: This study evaluated the effect of Piezoelectric drilling in decreasing the peri-implant marginal bone loss as well as increasing the implant stability values throughout a 6 months healing period. MATERIALS AND METHODS:A clinical and radiographic study with a split-mouth design was carried out on 10 patients. Each patient received two implants in both sides of anterior maxilla, one implant was placed with piezoelectric drilling (study group) and the other was placed with conventional drilling (control group). Assessments included measurements of implant stability using Osstell and measurements of the linear changes in the peri-implant marginal bone using cone beam computed tomography images. Measurements were done immediately post-operative, at 3 months and 6 months. RESULTS:The clinical and radiographical results of the Piezoelectric study sides were better than the conventional control sides. Marginal bone loss was significantly lower in the study group. Implant Stability Quotient (ISQ) values were significantly higher in the study group at the immediate time of placement and at 6 months. CONCLUSIONS:Within the limitations of this clinical trial, it can be concluded that the piezoelectric drilling for implant placement in the anterior maxilla is a successful option for reducing marginal bone loss and increasing implant stability throughout the healing period.