Clinical effects of conventional and underprepared drilling preparation of the implant site based on bone density: A systematic review and meta-regression

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  • Antonacci Donato
    Private practice, Bari, Italy
  • Del fabbro Massimo
    Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
  • Bollero Patrizio
    Department of System Medicine, University of Rome “Tor Vergata”, 00133, Rome, Italy
  • Stocchero Michele
    Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
  • Jinno Yohei
    Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
  • Canullo Luigi
    Department of surgery and implant dentistry, University of Genova, Genova, Italy

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<p>Purpose: There is no clinical consensus to determine the right balance between underpreparation and marginal bone level changes. The purpose of this systematic review and meta-regression was to investigate the influence of the type of drilling preparation of the implant site in relation to the bone mineral density on the clinical success, expressed in terms of the MBL and implant failure rate.</p><p>Study Selection: A thorough search was performed using the digital databases MEDLINE PubMed, EMBASE, and Cochrane Central Register of Controlled Trials by entering research lines or various combinations of free words. The main keywords used were “dental implants”, “bone density”, and “torque”.</p><p>Results: The mean bone resorption in the conventional preparation group was -0.43 (± 0.28) mm, whereas it was -0.80 (± 0.37) mm in the underprepared group. For the D1/D2/D3 bone group, the slope was significantly different from zero and linearity; the D4 bone group slope was not significantly different from zero and was almost parallel, although it was significantly different from linearity. The box and whiskers plot shows that the MBL in underprepared sites tended to be significantly higher with a higher variation than that in conventionally prepared sites.</p><p>Conclusions: Within its limits, our meta-regression analysis showed that MBL is influenced by the type of drilling preparation and bone mineral density. In particular, a lower MBL was observed in the D1 bone with conventional preparation than with underpreparation. Moreover, a greater implant-to-osteotomy site mismatch was positively associated with greater MBLs in the bone densities of D1/D2/D3.</p>

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