Comparison of conventional drill and piezoelectric devices in the preparation of titanium screw sockets: An ex vivo study on chicken femur bones

Abstract

Aim: To compare the primary stability, assessed by axial pull-out strength, of intermaxillary fixation screws placed in chicken femoral cortical bone prepared using conventional drilling versus piezosurgery.

Method: A paired design was applied using fifty fresh chicken femurs, with each bone randomly assigned to the piezosurgery group on one side and the conventional drilling group on the contralateral side. In both groups, 5-mm deep holes were prepared, and 1.6-mm intermaxillary fixation screws were inserted. Primary stability was evaluated using axial pull-out testing at a constant speed of 1 mm/min with a calibrated force measurement device. Statistical analysis included the Shapiro–Wilk test, paired t-test, and Wilcoxon signed-rank test (p < 0.05).

Results: The mean pull-out strength was 5.199 ± 1.108 kgf in the piezosurgery group and 4.621 ± 1.104 kgf in the conventional drilling group, representing a 12.5% higher value in the piezosurgery group. The difference between groups was statistically significant (paired t-test: t(49) = 2.643, p = 0.011; Wilcoxon test: Z = 2.802, p = 0.005). The effect size (Cohen’s d) was calculated as 0.374.

Conclusion: The findings of this study demonstrate that osteotomies prepared using piezosurgery provide higher primary stability for intermaxillary fixation screws under press-fit conditions compared to conventional drilling methods and may represent a reliable alternative in clinical practice.