Piezoelectric surgery versus conventional drilling for implant site preparation: a meta-analysis.

PURPOSE: To answer the PICO question: "Among patients to whom an implant is placed, does the piezoelectric surgery (PS) compared to the conventional drilling (CS) achieve higher implant stability, increase surgical time or improve implant survival rate?" STUDY SELECTION: Two independent authors screened the literature through MEDLINE, Cochrane Library and Scopus. Randomized or non-randomized controlled trials, prospective and retrospective cohort studies comparing implant stability and/or clinical outcomes with PS versus CS used for implant site preparation published in the last 10 years were included in the search. RESULTS: Five of the 177 articles initially found were included in the meta-analysis. No statistically significant differences were found between PS and CS for implant stability quotient (ISQ) at baseline (SMD: 0.31; 95 %CI: -0.59 to 1.20; p=0.5). However, ISQ values were significantly higher at 2 months (SMD: 0.52; 95 %CI: 0.03-1.00; p=0.04) and at 3 months (SMD: 0.74; 95 %CI: 0.17-1.32; p=0.01) for CS. PS needed significantly more time than CS (SMD: 1.74; 95 %CI: 0.42-3.06; p=0.01) in order to be performed. No differences for implant survival rates were found when comparing both techniques (RR: 0.52; 95 %CI: 0.09-2.88; p=0.45). CONCLUSIONS: PS has not demonstrated superiority to conventional drilling for implant stability during the healing period. PS needs significantly longer surgery time than CS. Differences for implant survival rate were not found between the two techniques.