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To compare and contrast the accuracy of piezoelectric ultrasonic insert (PUI) and trephine bur (TB) osteotomy site preparation techniques for apical location. (1) Material and methods: A total of 138 osteotomy site preparations were randomly distributed into one of two study groups. Group A: TB technique ( n = 69) and B: PUI technique ( n = 69). A preoperative cone-beam computed tomography scan and an intraoral scan were performed and uploaded to implant-planning software to plan the virtual osteotomy site preparations for apical location. Subsequently, the osteotomy site preparations were performed in the experimental models with both osteotomy site preparation techniques and a postoperative CBCT scan was performed and uploaded into the implant-planning software and matched with the virtually planned osteotomy site preparations to measure the deviation angle and horizontal deviation as captured at the coronal entry point and apical end-point between osteotomy site preparations using Student's t -test statistical analysis. (2) Results: The paired t -test found statistically significant differences at the coronal entry-point deviations ( p = 0.0104) and apical end-point deviations ( p = 0.0104) between the TB and PUI study groups; however, no statistically significant differences were found in the angular deviations ( p = 0.309) between the trephine bur and piezoelectric ultrasonic insert study groups. (3) Conclusions: The results showed that the TB is more accurate than the PUI for apical location.

A Comparative Analysis of the Piezoelectric Ultrasonic Appliance and Trephine Bur for Apical Location: An In Vitro Study