Analyzing those, a decrease in primary and an increase in secondary stability with a shorter healing period for implants became apparent. Kim et al. compared the effect of oversized drilling sockets regarding bone-to-implant contact and bone density after 4 and 8 weeks in an in vivo dog model. They used a final drill of 4.00 mm for implants with a diameter of 4 mm in the oversized group and a final drill of 2.85 mm in the control group. The analysis could show that while the initial bone-to-implant contact at 4 weeks was lower in the oversized group, it increased within the following 4 weeks up to values of 77.38% which was higher than the values in the control group (69.52%). After 8 weeks, the mean bone density was shown to be comparable between both groups. No difference could be observed regarding the healing period. Within a study analyzing the differences between under-, over-dimensioned, and intermediate-sized drilling sockets in dogs after a healing period of 2 weeks, Campos et al. could show that although the undersized drilling condition led to the highest insertion torque, new bone formation was most active in the intermediate-sized group. They concluded that high insertion torque values do not necessarily result in the most favorable biologic response. The purpose of this study was to examine the effect of either standard (SP) or ODP, using three different means of quantifying dental implant primary stability. To our best knowledge, only one study evaluated the effect of manual and machine-driven insertion mode so that further analysis was done to quantify the hypothesized differences.

The research hypotheses were that a manual insertion mode is more advantageous and that implants inserted by ODP were expected to show a decrease in dental implant primary stability, as described previously.