The effect of piezoelectric surgery implant osteotomy on radiological and molecular parameters of peri‐implant crestal bone loss: a randomized, controlled, split‐mouth trial

Abstract

AIM: To evaluate the effect of piezoelectric surgery (PS) implant osteotomy on biochemical and radiological parameters of crestal bone (CB) loss. MATERIAL AND METHODS: In this randomized, controlled, clinical study, 38 osteotomies were prepared with PS and drilling in the posterior maxilla in a split-mouth design. Implants were placed and left for non-submerged healing. Osteotomy time, insertion torque, pain perception, probing depth, and modified gingival and plaque indices were recorded. Peri-implant sulcular fluid (PISF) was collected from four sites of each implant at 2, 4, 8, 12, and 24 weeks. PISF samples were analyzed by ELISA for receptor activator of nuclear factor kappa-B-ligand (RANKL) and osteoprotegerin. CB loss was assessed on periapical radiographs at the 12th and on cone beam computed tomography (CBCT) at the 24th weeks. The influence of time and osteotomy method on biochemical and radiological parameters of CB loss employed statistical method of Brunner-Langer. RESULTS: Osteotomy time for PS group was significantly longer than the drill group (P < 0.05). Pain perception that was lower in the PS than in the drill group depended on osteotomy method (P < 0.05). PS group had lower RANKL total amount than the drill group (P < 0.05). Mean CB loss on periapical radiographs at the 12th week for PS and drill groups were 0.11 and 0.18 mm, respectively (P > 0.05). At the 24th week, PS and drill groups showed 0.11 and 0.12 mm CB losses on CBCT, respectively (P > 0.05). However, CB loss values did not depend on osteotomy modality (P > 0.05). CONCLUSION: PS may modify and reduce bone-destructive inflammatory response during implant osseointegration. Therefore, on the molecular level, it might be a less traumatic osteotomy modality than drilling although this was not reflected by CB loss values in the present study. Results: Osteotomy time for PS group was significantly longer than the drill group (p<0.05). Pain perception that was lower in the PS than the drill group depended to osteotomy method (p<0.05). PS group had lower RANKL total amount than the drill group (p<0.05). Mean CB loss on periapical radiographs at 12 th week for PS and drill groups were 0.11 mm and 0.18 mm, respectively (p>0.05). At 24 th week PS and drill groups showed 0.11 mm and 0.12 mm CB loss on CBCT, respectively (p>0.05). However, CB loss values did not depend on osteotomy modality (p>0.05). Conclusion:PS may modify and reduce bone-destructive inflammatory response during implant osseointegration. Therefore, it might be a less traumatic osteotomy modality than drilling although this was not reflected by CB loss values in the present study.

Piezoelectric versus conventional implant site preparation: A systematic review and meta‐analysis

“…The full‐text of the remaining 7 articles were scrutinized for eligibility. Only 4 articles fulfilled the inclusion criteria and were included in the review (Table ). Only one trial used a split‐mouth design.…”

“…Only 4 articles fulfilled the inclusion criteria and were included in the review (Table ). Only one trial used a split‐mouth design.…”

“… Systemically healthy adults Full mouth plaque score and full mouth bleeding score ≤ 25% or < 20% Partially edentulous posterior mandible with at least 6 months of healing and sufficient bone height and width to allow placement of 2 dental implants without any augmentation procedures …”

“…Partially edentulous posterior mandible with at least 6 months of healing and sufficient bone height and width to allow placement of 2 dental implants without any augmentation procedures Partially edentulous posterior maxilla with at least 6 months of healing and sufficient bone height and width in which bone augmentation was not required Partially edentulous maxillary premolar region with at least 6 months of healing and sufficient bone height and width in which bone augmentation was not required …”

“…Partially edentulous maxillary premolar region with at least 6 months of healing and sufficient bone height and width in which bone augmentation was not required Width of keratinized mucosa of at least 2 mm …”