## 2 Materials and Methods  
One hundred implants with a 3.75 mm diameter and 10 mm length (_MultiNeOTM_, _Alpha Bio-Tech_, _Petah-Tikval_, _Israel_) (Figure 1) were used in this study. The implant grade 5 titanium body with SLA coating is slightly tapered and has a straight coronal section. In the apical portion, the threads have a 35\({}^{\circ}\) attack angle, which varies along the implant thread slope. Two internal micro-threads inserted between the main threads and coronal micro- threads increase surface area. The coronal buttress shape threads mean to resists lateral stress after insertion. The main thread's pitch and depth are 1.2 and 0.65 mm, respectively. The implants were divided into four equally sized groups. In group D3.65, the implants were placed according to the manufacturer's instructions, with a final drill diameter of 3.65 mm. The implants in groups D3.2, D2.8 were placed in accordance with an underdrilling protocol with final drill diameters of 3.2 and 2.8 mm, respectively (Table 1). Figure 1: Illustration of _MultiNeOTM_ implant. In group C, the control group, brand new implants were used for surface topography analysis only. All implants, except for those in the control group, were placed in osteotomies prepared in artificial bone (_Unti-Cortical, Bone-Sim Laboratories, Cassopolis, MI, USA_) with the following characteristics:  
Disk diameter: 58 mm  
Disk thickness: 20 mm (Figure 2)  
Cortical layer: thickness--2 mm, density--597-1137 HU, [PERSON]'s modulus--1500 MPa  
Trabecular layer: thickness--18 mm, density--550-750 HU, [PERSON]'s modulus--850 MPa porosity--39% (Figure 3)  
The osteotomies were prepared with a depth of 10 mm and a distance of 5 mm from one another and from the disk margins using stainless steel straight drills (_Alpha Bio-Tech, Petah-Tikvah, Israel_) at 1000 rpm. The drills were replaced with new ones after 10 preparations. The implants were placed at room temperature (24 \({}^{\circ}\)C) at a constant placement speed of 30 RPM, and an axial torsion load cell and torque meter (_Model 1516, Interface, Scottsdale, AR, USA_) were used for constant monitoring of the insertion torque. The implant surface temperature was measured with a thermal camera (_Optris PI 160, Optris, Berlin, Germany_), which monitored a 5 \(\times\) 5 mm area that included the implant bed orifice in which the implant was placed (Figure 4). The temperature \begin{table}
\begin{tabular}{c c c c c} \hline \hline  & **Drill 1 Pilot** & **Drill 2** & **Drill 3** & **Drill 4** & **Drill 5** \\ \hline
**D3.65** & 2 mm & 2.5 mm & 2.8 mm & 3.2 mm & 3.65 mm final \\
**D3.2** & 2 mm & 2.5 mm & 2.8 mm & 3.2 mm final & \\
**D2.8** & 2 mm & 2.5 mm & 2.8 mm final & \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Implant bed preparation protocols for the study groups. The values represent the drill diameters (in mm). Figure 3: -Ray density measurement of the artificial bone expressed in Hounsfield units (HU). amplitude (Temp-Amp) for every study group was calculated by subtracting the room temperature from the measured implant surface temperature. Implant surface analysis was performed by a 3D measurement system (Nanofocus usurf explorer, NanoFocus AG, Germany) with a 160S lens (0.9/X100) and processed with appropriate software (usoft analysis standard, NanoFocusAG, Germany). The lateral resolution was \(0.16\times 0.16\) um, and the measurement distance was 1 mm. Standardized ISO parameters (ISO 25178-2) were measured using Mountains Map Premium software, version 7.3.7 (DigitalSurf). A total of 30 ISO roughness parameters were divided into 6 main groups, each representing distinctive characteristics of the surface texture: height, function (plane), space, hybrid characteristics, functional (volume), and feature. Sa was selected as a common parameter for surface roughness measurements (Sa expresses, as an absolute value, the difference in height of each point compared to the arithmetical mean of the surface).