Comparison Between Cortical Drill and Cortical Tap and Their Influence on Primary Stability of Macro-Thread Tapered Implant in Thin Crestal Cortical Bone and Low-Density Bone.

OBJECTIVE: To evaluate the effect of different surgical techniques on primary stability, particularly in poor-quality bone with or without a crestal cortical bone. MATERIALS AND METHODS: Three implant site preparation techniques-undersized drilling (UD), undersized drilling and coronal widening with a cortical drill (UD + CD), undersized drilling and coronal tapping with a cortical tap (UD + CT)-were compared in 2 different low-density polyurethane bone models either with or without the crestal cortical bone. Insertion torque values (ITVs) for each technique was recorded. RESULTS: Statistically significant difference was observed for all 3 surgical techniques. In the presence of a crestal cortical bone, the peak ITV for UD was the highest, UD + CT the second, and UD + CD the lowest. All peak ITVs remained significantly lower in the absence of a crestal cortical bone. CONCLUSION: Our findings suggested that UD + CTmay be the most effective implant surgical technique to achieve an ideal primary stability in low-density bone with a thin crestal cortical bone layer. Also, this technique may prevent compression necrosis of the dense cortical bone.