Drilling down to success: Comparative insight on single-drill and sequential-drill techniques for dental implant osseointegration using osteoprotegerin levels - A randomized control trial.

Background: To evaluate and compare osteoblastic activity and osseointegration between single-drill and sequential-drill implant site preparation techniques, using osteoprotegerin (OPG) levels as a biomarker. Methods: A randomized controlled trial with a split-mouth design was conducted, involving 12 participants (24 dental implants). The study included two groups: a single-drill group and a sequential-drill group. Gingival crevicular fluid samples were collected at baseline, 15-, 30- and 60-days post-implantation. Osteoprotegerin levels were measured using an enzyme-linked immunosorbent assay (ELISA). Results: Intragroup analysis showed significant variations in OPG levels over time (p < 0.0001). Intergroup comparisons revealed no significant differences at baseline (p = 0.9563) or at 15 days (p = 0.7617); however, significant differences were detected between groups at 30 days (p = 0.0391) and 60 days (p = 0.0005). The single-drill group exhibited higher initial OPG levels, while the sequential-drill group had elevated OPG levels at 30 and 60 days. Conclusion: The single-drill technique may provide an early advantage in osteoblastic response, while the sequential-drill technique supports increased osteoblastic activity at later stages. Both techniques effectively support osseointegration, with selection depending on specific clinical requirements.