Abstract
Background: It is difficult to achieve good primary stability of dental implants in soft bone, such as that in the posterior maxillae. Osseodensification (OD) burs, working in a non-subtractive fashion, condense the implant osteotomy bone in lateral direction and increase in the bone implant contact. Also, dental implants with deeper threads, and decreased thread pitch can increase initial bone implant anchorage. Methods: This study utilized 48 custom-made machined surface dental implants that were 13 mm long, with a major diameter of 4.5 mm and a minor diameter of 3.5 mm, a thread pitch of 1 mm, a thread depth of 0.5 mm, and a 4 mm long cutting flute at the apex. The implants were divided into 4 groups, each group was made of 12 implants with a different thread design; V-shaped, trapezoid, buttress, and reverse buttress. The implants were inserted in 4-mm thick cancellous bone slices obtained from the head of Cow femur bone. The ostoetomies were prepared by conventional drilling and by OD drilling. Each inserted implant was then tested for primary stability using the Periotest. The Periotest values (PTVs) for the implant stability were tabulated and analyzed using a chi square test at significance level p< 0.05. Results: The results of this this study revealed no statistically significant difference between the Periotest readings for the implants in each category placed in either the OD or the regular osteotomies. However, it has been found that the implants placed in regular drilling ostoetomies had a significantly better primary stability than the implants placed in OD osteotomies. Conclusions: It was concluded that OD is not necessary in situations where there is bone of good quality and quantity.
Highlights
The primary stability of dental implants depends on the quantity and quality of the available bone, the implant macro- and microdesign, the implant surface features, and the surgical technique used for creating the osteotomy
Comparison of regular and OD ostoetomies When all the implants placed in regular drilling ostoetomies were compared to all the implants placed in OD ostoetomies, statistical analysis of the Periotest readings for primary stability has shown that the implants placed in regular drilling ostoetomies were significantly more stable than the implants placed in OD osteotomies (Table 2)
The aim of this study was to evaluate the effect of dental implant osteotomy preparation, using the OD technique, on the dental implant primary stability compared to conventional drilling
Summary
The primary stability of dental implants depends on the quantity and quality of the available bone, the implant macro- and microdesign, the implant surface features, and the surgical technique used for creating the osteotomy. Ostoetomies are created with bone-removing drills, and the last drill had a smaller diameter than that of the implant to ensure primary stability This technique is only effective up to certain limits in soft bone, such as that in the posterior maxillae[1]. It has been claimed that OD increases the implant bone bed density, but does not improve implant primary stability[7] Another maneuver to increase implant primary stability in a poor bone quality situation, is to use an implant with deeper threads, and decreased thread pitch, to increase initial bone implant anchorage. This principle can be applied to different dental implant thread designs; V-shaped, buttress, reversebuttress, and trapezoid. Conclusions: It was concluded that OD is not necessary in situations where there is bone of good quality and quantity
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