The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis.

Alessio Danilo Inchingolo,Francesco Inchingolo,Ioana Roxana Bordea,Felice Lorusso,Ciro Gargiulo Isacco,Giuseppina Malcangi,Grazia Marinelli,Antonio Scarano,Maria Contaldo,Gianna Dipalma,Carlo Maria Felice Zappone,Mario Romeo,Edit Xhajanka,Donato Mario Romeo,Andrea Ballini,Angelo Michele Inchingolo

doi:10.3390/ma14051147

Abstract

Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis—11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.

Highlights

In recent years, the osseointegrated dental implant has become the gold standard therapy to avoid missing teeth loss [1,2,3]
The purpose of this review is to perform an analysis of scientific texts issued until now about this topic and the bone-to-implant contact % (BIC), bone area fraction occupied% (BAFO), and insertion torque meta-analysis evaluation
The aim of this article is to analyze the results of modern studies on osseodensification technique and evaluate the cases in which it could be beneficial in comparison to the common technique, the anatomical areas where the technique is more effective because of their peculiar kind of cut, and the capacity of this technique to reach a primary stability value higher than the common methods, especially in difficult cases

Summary

Introduction

The osseointegrated dental implant has become the gold standard therapy to avoid missing teeth loss [1,2,3]. We analyzed the osseodensification technique operating in the opposite rotatory direction than the conventional drills due to the use of different drills with an exclusive and patented design. Because of this technique, it is possible the bone condensing toward the osteotomy walls within the same surgery moment of the implant site preparation [9,10,11,12,13,14,15]

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Conclusion