Osseointegration in relation to drilling speed in the preparation of dental implants sites: A systematic review

Statement of problem. The drilling speed used for preparing dental implants may affect boneimplant contact (BIC), implant stability quotient (ISQ), and bone area fraction occupancy (BAFO). Different rotational speeds and the presence or absence of irrigation during site preparation have been investigated, but an established protocol for achieving the best osseointegration results is lacking. Purpose. The purpose of this systematic review was to investigate the influence of drill rotational speed on bone drilling for dental implant placement and its relationship with osseointegration. Material and methods. This review included the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and was registered in the international prospective register of systematic reviews (PROSPERO) database. Electronic searches were performed in the MEDLINE (PubMed), Scopus, Science Direct, and Embase databases. The risk of bias was analyzed by using the systematic review center for laboratory animal experimentation (SYRCLE). Results. A total of 1282 articles were found, and after removing duplicates and applying the eligibility criteria to in vivo articles on animals that addressed drilling speed and its relationship to osseointegration, 8 articles were selected for analysis. Of these, 5 articles showed no statistical differences, and 3 others showed significantly better osseointegration results by analyzing the parameters of BIC, BAFO, ISQs, and pull-out forces (PoFs). In all selected articles, high-speed drilling was performed with irrigation. Conclusions. Although drilling speed seems to affect bone perforation, no definitive protocol was found in the literature consulted. The results vary depending on the combination of different factors, including bone type, irrigation, and drilling speed. (J Prosthet Dent 2025;133:394-401)