The objective of this study was to compare the effects of preparing for implant site osteotomy with conventional drilling or piezosurgery on the stability of oral implants after a 5 month follow-up period. Thirty patients participated in this randomized clinical trial and received two implants in posterior mandible in bone of the same quality. All surgical procedures were performed by the same surgeon. Implant stability amounts were measured by resonance frequency analysis using the Osstell Mentor device and are reported in the format of implant stability quotient (ISQ) values at baseline and 90 and 150 days after surgery. All implants were well osseointegrated. Differences in ISQ levels were statistically significant in the piezosurgery group at all time intervals, whereas those in the conventional drill group were not significant as analyzed by analysis of variance. The significance of differences between the two groups in each time interval was assessed with Student's t test. In the second interval (90 days), there were statistically significant differences in ISQ levels between the two groups at the buccal, lingual side of implants and mean of two measurements, but at baseline and 150 days, there were no significant differences between these techniques. The early increase of ISQ values in piezoelectric sites shows that piezosurgery is a less traumatic bone osteotomy method with a shorter inflammatory phase and little resorption compared with sites prepared by conventional drilling. ISQ values of up to 60-65 at the time of insertion of the implant predict a good prognosis for immediate implant loading. In this study, the ISQ values were almost always higher than this, offering the safe condition for immediate or early loading protocols after the piezoelectric method of implant site osteotomy. These results may increase predictability of immediate-loading procedure in oral implantology.
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