Influence of dental implant site preparation method on three aspects of the site: magnetodynamic mallet versus conventional drill.

The increasingly widespread use of dental implants and the need for less traumatic techniques has favored the development of ever more performing and less invasive instruments for the patient for the preparation of the implant bone site. In particular, alternative technologies to the classic use of the drill have been proposed and studied since early 2000’s such as, for example, piezoelectric instrumentation, and in recent years osseodensification drills and magnetodynamics, in order to reduce the inflammatory response and amplify the biomolecular factors involved in healing bone and in osseointegration. Magneto-dynamic technology applies physical principles of electromagnetism to give controlled forces on a body minimizing the impact time. The control and steadiness of the applied forces make the procedures safe for patients and surgeons. Furthermore, the magnetodynamic technology working through the principle of osteocondensation allows a more conservative approach towards the tissues. Bone loss is probably more limited compared to the use of drills and the primary stability of the implant has been demonstrated by Stacchi et al. to be comparable to that obtained with a preparation with drills. Other authors such as Negidah et al. even maintain that in vivo the results in terms of implant stability quotient (ISQ) are better than with drills. Despite this study has a major shortcoming given by the small number of the sample analyzed. Magnetic mallet is composed of a handpiece energized by a power control device, delivering forces by the timing of application. Different inserts could be attached to the handpiece. Mallet can be set on four forces: 75, 90, 130, and 260 daN. Impact time is 80 μs. Magnetodynamic instrumentation, applied to bone surgery, has given new impetus in recent years and the first results of use seem to be encouraging, in particular as regards the preparation of the implant site. As shown by Bennardo et al. in a recent review, magnetodynamic could be helpful in implant surgery, in terms of tissue healing, surgery outcome, and complication rate compared to traditional instruments. However, some aspects of the use of magnetodynamics for the preparation of the implant site require further investigation, also in relation to the comparison with the instruments of choice, i.e., the drills. An extremely important aspect is that of bone overheating during the site preparation phases, the evaluation of the temperature increase is a fundamental aspect that influences post-operative bone healing. Heat production as demonstrated by Bhargava et al. turns out to be essentially zero in the use of manual osteotomes. This has yet to be demonstrated in use with magnetodynamic technology. The purpose of the present study was to compare two methods of dental implant site preparation (conventional drill and magnetic mallet) on three aspects of the site. These were the difference between the diameter of the site and the diameter of the last drill used (an index of the accuracy of the preparation), the weight loss of the porcine rib specimen on which the site was prepared (index of the extent of damage at the site caused by the preparation), and the change of temperature at the site (an index of the change to the porcine rib specimen at the site). The null hypothesis is that drills and magnetodynamic instruments have the same behavior.