Atraumatic surgical technique and implant bed preparation.

The issues of bone necrosis and implant bed congruency are both central to the success or failure of endosseous dental implants to achieve osseointegration. Use of internally irrigated drilling instruments has been postulated to minimize bone necrosis. The ability of the cutting instruments to produce a smooth, congruent implant bed and retain fine bone structures is also critical to achieving primary integration. In the experiment conducted, the use of internally cooled instruments reduced the likelihood of thermal bone damage, particularly when trephine mills were used. Trephine mills were able to retain the fine bone structures of the walls of the implant bed site. No visible degradation occurred from multiple uses of the instruments.