However, caution is recommended when using under-dimensioned drilling protocols: although high insertion torques ensure a greater initial implant stability and prevent adverse micromotions under loading, the induced over-compression could jeopardize the healing process. In addition, high stress is known to alter angiogenesis and impair new vessel formations, to induce local hypoxia and necrosis, inhibiting new bone formation and to adversely affect implant stability. Also, higher degrees of primary stability do not necessarily translate into high degrees of secondary stability. After a latency of 1 week, necrotic bone fills the space between bone and implant whereupon a bone remodeling takes place within 1 to 3 weeks. By using larger drilling dimensions, the bone-implant interface is filled with a blood clot so intermembranous-like ossification takes place without a formation of necrotic bone spots. With a shorter healing period of two instead of 4 weeks, this “healing chamber” is considered a key factor for secondary stability. Due to its different healing patterns, it does not have to undergo tissue remodeling. Contrary to this, ODPs could lead to displacements above 50–150 μm resulting in fibrous bone formation and a poor long-term stability. With a reduction in primary stability and a secondary stability similar to SPs, test results have shown a shorter healing period with lower degrees of compressive stress transferred to the surrounding bone. Nevertheless, in this study, implants inserted via ODP exceeded the clinically established lower limits for primary insertion. A minimum of 45 Ncm in IT and 70 units in ISQ was reported to be required to obtain the necessary stability for primary insertion. Therefore, based on the results at hand, the use of ODPs might be preferable to reduce the level of compressive stress, especially in patients with dense bone.