The Effect of Drilling Speed on Implant Stability and Postoperative Pain Levels: A Randomized Controlled Clinical Trial

Aylin Avcı,* Mehmet Emin Kaval,† Nejat Nizam*




To evaluate the discomfort, postoperative pain levels and the implant stability after implant site preparation either with low speed drilling(50rpm) without irrigation or high speed drilling(800rpm) with irrigation.


Fifteen patients with bilateral missing mandibular first molars were included in the study. Each site was randomly assigned either in Test Group (50rpm, without irrigation) or in Control Group (800rpm with irrigation) and received an implant. The implant stability, resonance frequency analysis(RFA), hard tissues changes, pulp vitality of the adjacent teeth, keratinized tissue width(KTW), discomfort during the surgery and pain levels during the early healing period were evaluated.


KTW was similar in both groups at baseline and 3 months, but a significant difference was found in intragroup comparisons for both groups (p<0.01, both). RFA and vitality values were similar both within and between groups during the follow up. First bone to implant contact(fBIC) was significantly lower in both groups at 3rd month compared to baseline (p<0.5). Marginal bone level changes and discomfort during the surgery were similar between groups.
Postoperative pain level was significantly higher in the Test group at 2nd day(p<0.05). Postoperative pain level in the Test and Control groups were significantly higher in the first day than 6,7 days and 5,6,7 days, respectively (p< 0.05).


It can be concluded that both drilling protocols are safe for implant site preparation and there seems to be a slight advantage in favor of high-speed drilling in terms of pain perception after.

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