*Article* **A Novel Osteotomy Preparation Technique to Preserve Implant Site Viability and Enhance Osteogenesis**

**Chih-Hao Chen 1,2,†, Benjamin R. Coyac 1,†, Masaki Arioka 1,3,†, Brian Leahy 1, U. Serdar Tulu 1, Maziar Aghvami 1, Stefan Holst 4,5, Waldemar Hoffmann 4, Antony Quarry 4, Oded Bahat 6, Benjamin Salmon 7,8, John B. Brunski <sup>1</sup> and Jill A. Helms 1,\***


Received: 6 January 2019; Accepted: 27 January 2019; Published: 1 February 2019

**Abstract:** The preservation of bone viability at an osteotomy site is a critical variable for subsequent implant osseointegration. Recent biomechanical studies evaluating the consequences of site preparation led us to rethink the design of bone-cutting drills, especially those intended for implant site preparation. We present here a novel drill design that is designed to efficiently cut bone at a very low rotational velocity, obviating the need for irrigation as a coolant. The low-speed cutting produces little heat and, consequently, osteocyte viability is maintained. The lack of irrigation, coupled with the unique design of the cutting flutes, channels into the osteotomy autologous bone chips and osseous coagulum that have inherent osteogenic potential. Collectively, these features result in robust, new bone formation at rates significantly faster than those observed with conventional drilling protocols. These preclinical data have practical implications for the clinical preparation of osteotomies and alveolar bone reconstructive surgeries.

**Keywords:** osteogenesis; osteotomy; bone healing; bone chips; drilling tool design
