Upper Left Premolar #35 with Autogenous Bone Harvesting

This case shows an implant placed at the upper left second premolar (#35), combined with autogenous bone harvesting during osteotomy preparation. The bone chips produced by the drill itself are collected chairside and used to graft the peri-implant area at the time of placement, without a separate donor-site procedure.

In a conventional high-speed protocol, continuous saline irrigation is required to prevent thermal injury to the bone. That same irrigation washes bone particles out of the osteotomy and into the suction line, where they are discarded. Any autogenous grafting material in that workflow has to come from a separate anatomical site.

The Crown Down 2-drill protocol runs at low speed (approximately 250 rpm) without continuous external irrigation, because the solid tungsten carbide drill conducts frictional heat away from the cutting interface instead of accumulating it in the bone. Because there is no saline flow across the osteotomy, the autogenous bone particles produced during drilling remain in and around the site — where they can be collected and used as a local graft during the same appointment.