Clinical Oral Investigations

, Volume 20, Issue 9, pp 2475–2480 | Cite as

Differences in crestal bone-to-implant contact following an under-drilling compared to an over-drilling protocol. A study in the rabbit tibia

  • Omer Cohen
  • Zeev Ormianer
  • Haim Tal
  • Daniel Rothamel
  • Miron Weinreb
  • Ofer Moses
Original Article



The objective of this study is to compare bone-to-implant contact (BIC) between implants inserted at high torque due to under-drilling of the crestal bone to those inserted at low torque due to over-drilling of the crestal bone.

Materials and methods

Forty implants with diameters of 3.75 mm (group A) or 3.55 mm (group B) were inserted in the proximal tibiae of NZW rabbits in two separate surgeries on day 0 or 21. Osteotomy of the crestal bone was finalized with a 3.65-mm drill. In group A, implants were inserted at torque ≥35 Ncm (under-drilling) and in group B with torque <10 Ncm (over-drilling). Implants and their surrounding bone were retrieved on day 42, thus creating 3- and 6-week observation periods, processed for non-decalcified histology and stained with toluidine blue. Crestal BIC (c-BIC) and total BIC (t-BIC) were measured. Wilcoxon test was used to evaluate differences between groups.


Three weeks post-surgery, the mean c-BIC in group A was 16.3 ± 3.3 vs 31.5 ± 3.4 % in group B (P < 0.05). At 6 weeks, a similar trend was observed (group A: 28.7 ± 3.6 %; group B: 38.4 ± 4.9 %) (P > 0.05). No differences in t-BIC were noted at 3 weeks and at 6 weeks between the groups.


Insertion of implants with an over-drilling protocol of the crestal aspect of the osteotomy resulted in increased short-term crestal bone-to-implant contact.

Clinical relevance

Insertion of implants with a high torque following an under-drilling protocol, commonly used for immediate loading, may reduce crestal bone-to-implant contact at early healing stages.


BIC Insertion Torque Implants Over-drilling Under-drilling 


Compliance with ethical standards

This study protocol was approved by the ethical committee for Animal Experimentation of Harlan Laboratories Ltd. (Kiryat Weizmann, Rehovot, Israel) No. IL-12-02-032.

Conflict of interest

Author A declares that he has no conflict of interest. Author B declares that he serves as an external advisor of Alpha Biotech Ltd. Author C declares that he has no conflict of interest. Author D declares that he has no conflict of interest. Author E declares that he has no conflict of interest. Author F declares that he serves as an external advisor of Alpha Biotech Ltd.


This study was funded by Alpha Biotech Ltd. (Petah Tikva, Israel) (grant number 0601914231). Grant recipients: Ofer Moses and Zeev Ormianer.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

Informed consent

This study is an animal model study. For this type of study, informed consent is not required.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Omer Cohen
    • 1
  • Zeev Ormianer
    • 2
  • Haim Tal
    • 1
  • Daniel Rothamel
    • 4
  • Miron Weinreb
    • 3
  • Ofer Moses
    • 1
  1. 1.Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental MedicineTel Aviv UniversityTel AvivIsrael
  2. 2.Department of Oral Rehabilitation, School of Dental MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Department of Oral Biology, School of Dental MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Department of Oral and Maxillo-facial Plastic SurgeryUniversity of CologneCologneGermany

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