Abstract
Primary implant stability is a prerequisite for successful implant osseointegration. The osseodensification technique (OD) is a non-subtractive drilling technique that preserves the bone tissue, increases osteotomy wall density, and improves the primary stability. This study aimed to investigate the hypothesis that OD, through a wider osteotomy, produces healing chambers (HCs) at the implant-bone interface without impacting low-density bone primary stability. Twenty implants (3.5 × 10 mm) with a nanohydroxyapatite (nHA) surface were inserted in the ilium of ten sheep. Implant beds were prepared as follows: (i) 2.7-mm-wide using subtractive conventional drilling (SCD) technique (n = 10); (ii) 3.8-mm-wide using an OD bur system (n = 10). The sheep were randomized to two groups, with samples collected at either 14-(n = 5) or 28-days (n = 5) post-surgery and processed for histological and histomorphometric evaluation of bone-implant contact (BIC) and bone area fraction occupancy (BAFO). No significant group differences were found with respect to final insertion torque and implant stability quotient (p > 0.050). BIC values were higher for SCD after 14 and 28 days (p < 0.050); however, BAFO values were similar (p > 0.050). It was possible to conclude that the OD technique allowed a wider implant bed preparation without prejudice on primary stability and bone remodeling.
Highlights
Primary implant stability is a prerequisite for successful implant osseointegration
scanning electron microscopy (SEM) micrographs of the implants surface showed a homogeneous topography of the implant surface at 50 ×, 1000 ×, 5000 ×, and 15,000 ×, and the energy-dispersive X-ray spectroscopy (EDS) showed the presence of calcium (Fig. 1)
The osseodensification technique (OD) group presented a similar reaction after 14 days, presenting new bone trabeculae islands surrounded by connective tissue permeating the implant surface (Fig. 2d)
Summary
Primary implant stability is a prerequisite for successful implant osseointegration. The osseodensification technique (OD) is a non-subtractive drilling technique that preserves the bone tissue, increases osteotomy wall density, and improves the primary stability. It was possible to conclude that the OD technique allowed a wider implant bed preparation without prejudice on primary stability and bone remodeling. Dental implants failure may be caused by local (low-density bone, compromised bone volume, and immediate implant placement) and systemic factors (systemic diseases, titanium allergy and tobacco use)[1,2,3]. Several factors may influence this primary stability such as material biocompatibility, bone type and volume at the host site, loading conditions, surface technology (micronano topography and chemical composition), macrogeometry (implant body and thread design), and surgical preparation of the implant site[5]. The use of plasma- sprayed HA coating may lead to implant failure caused by a rupture of the HA-titanium interface, leading to increased bacterial adhesion, and peri-implantitis[10]. Because bone tissue deposition on the surface of implant devices is strongly dependent on cellular interactions with the s urface[12,13], the nHA coating may accelerate osseointegration because it creates a hydrophilic surface with nanostructures-resembling the extracellular matrix of the bone tissue with respect to the size, shape, and crystallinity— which provides more substantial anchoring points at the surface for bone cells[14,15]
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