Abstract
BackgroundThe aims of this study were to evaluate the effect of implant site preparation in low-density bone using osseodensification method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT. Material and MethodsThis prospective observational clinical study included 24 patients who received 46 dental implants that were installed in low-density bone using the osseodensification method. CBCT was used to measure the bone density pre- and postoperatively and implant stability was measured using Periotest® immediately after implant insertion and then after 6 weeks and 12 weeks postoperatively. The data were analyzed using paired t-test and the probability value <0.05 was considered statistically significant. ResultsOf the 46 implants, 43 were osseointegrated making the early survival of the implants 93.5%. There was a significant increase in bone density postoperatively; 337.6 ±182.9 compared to 265.3 ±173.9 Hounsfield units preoperatively. The primary implant stability was -2.7 ± 2.13 Periotest values (PTV), at the 6th week it decreased significantly (p<0.0001) to become 0.7 (± 4) PTV, and at the 12th week (secondary stability) it increased significantly (p<0.0001) to become -2.1 (± 2.8) PTV. The difference between primary and secondary stability was statistically non-significant (p=0.0814). ConclusionsOsseodensification resulted in high primary stability and increased peri-implant bone density but it did not prevent the implant stability drop during the first 6 weeks after insertion of implants. Key words:Osseodensification, implant stability, low-density bone.
Highlights
The conventional implant site preparation techniques are subtractive in nature that use successively increasing-diameter drills rotating in a clockwise direction under copious irrigation to excavate bone and prepare the implant bed [1], but recently a new non-subtractive drilling technique, osseodensification (OD), was introduced where a specially designed drills rotate in an counterclockwise direction compacting bone at the osteotomy walls allowing more intimate engagement of the implant with the osteotomy site and increasing the primary stability [2,3]
Despite the fact that many studies conducted on animal models have demonstrated a favorable outcome of OD over conventional drilling techniques [1,2,6,7,8,9], its clinical effect on implant stability during the osseous healing period of dental implants installed in low-density bone is not clear, the aims of the study were to evaluate the effect of implant site preparation in low-density bone using OD method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT
Of the 43 dental implants that were osseointegrated at the end of this study, the primary implant stability was -2.7 (± 2.13) Periotest values (PTV), at the 6th week it decreased significantly (p 0.0001) to become 0.7 (± 4) PTV, and at the 12th week it increased significantly (p 0.0001) to become -2.1 (± 2.8) PTV
Summary
The conventional implant site preparation techniques are subtractive in nature that use successively increasing-diameter drills rotating in a clockwise direction under copious irrigation to excavate bone and prepare the implant bed [1], but recently a new non-subtractive drilling technique, osseodensification (OD), was introduced where a specially designed drills rotate in an counterclockwise direction compacting bone at the osteotomy walls allowing more intimate engagement of the implant with the osteotomy site and increasing the primary stability [2,3]. e474Compared with conventional drilling, OD was reported to result in higher insertion and removal torque, increased primary and secondary stability, higher bone-to-implant contact and higher bone volume around implants [4] this favorable outcome is possible because of the drills that have many lands with large negative rake angles which work as a noncutting edges to expand the implant site and increase the density of the bone [2]. Despite the fact that many studies conducted on animal models have demonstrated a favorable outcome of OD over conventional drilling techniques [1,2,6,7,8,9], its clinical effect on implant stability during the osseous healing period of dental implants installed in low-density bone is not clear, the aims of the study were to evaluate the effect of implant site preparation in low-density bone using OD method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT. The aims of this study were to evaluate the effect of implant site preparation in low-density bone using osseodensification method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT. Conclusions: Osseodensification resulted in high primary stability and increased peri-implant bone density but it did not prevent the implant stability drop during the first 6 weeks after insertion of implants
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