Initial Stability Of Implants Research Articles

Influencing factors and evaluation methods for early stability of immediate implant.

At present, implant restoration has become a hot research topic in the field of prosthodontics. The in-depth studies of new materials and new technologies enable immediate implantation, immediate and early loading to be realized, which meets the needs of patients for shortening the course of implant restoration and obtaining better aesthetic effects. However, compared with the traditional delayed implantation technology, it is equally challenging for clinicians how to achieve and even improve the initial and long-term stability of implants in order to raise the success rate of implant restoration. The initial stability of the implant is influenced by a combination of factors, including the implant, the patient's condition, and the surgical procedure. Recently, there have been a lot of studies on the influencing factors and common research methods for immediate implant stability and bone healing. Summarizing and analyzing them can provide reference for preoperative evaluation, surgical plan and loading timing of immediate implant restoration in the later stage.

Study of cell adhesion, osteogenesis, and angiogenesis of a “groove” structure micro-arc oxidation titanium

The use of titanium alloy-based dental implant restorations has gained popularity due to their attractive properties. Current research on the surface modification of titanium materials primarily centers around the surface integration of various metal ions, the incorporation of different drugs, or other materials. By simply adjusting the process parameters of micro-arc oxidation, we were able to form a “groove” structure in titanium chips. Scanning Electron Microscopy (SEM) observations revealed that Bone Marrow Stem Cells (BMSCs) noticeably elongated along the “grooves”. Immunofluorescence results indicated an elevated expression of Osteocalcin (OCN) and CD31 in “groove” structure group. Furthermore, “groove” structure group also amplified the expression of osteogenic genes (Alkaline Phosphatase, ALP; Osteocalcin, OCN) and angiogenic genes (CD31, Vascular Endothelial Growth Factor, VEGF; Angiopoietin-2, ANG2; and Fibroblast Growth Factor, FGF) on the material surface (P < 0.05). This study suggests that the “groove” structure enhances early cell adhesion on the material surface and improves osteogenic and angiogenic differentiation on the titanium surface, thereby providing potential research implications for enhancing the initial stability of implants.

Machine Learning-Based Diagnosis in Laser Resonance Frequency Analysis for Implant Stability of Orthopedic Pedicle Screws.

Evaluation of the initial stability of implants is essential to reduce the number of implant failures of pedicle screws after orthopedic surgeries. Laser resonance frequency analysis (L-RFA) has been recently proposed as a viable diagnostic scheme in this regard. In a previous study, L-RFA was used to demonstrate the diagnosis of implant stability of monoaxial screws with a fixed head. However, polyaxial screws with movable heads are also frequently used in practice. In this paper, we clarify the characteristics of the laser-induced vibrational spectra of polyaxial screws which are required for making L-RFA diagnoses of implant stability. In addition, a novel analysis scheme of a vibrational spectrum using L-RFA based on machine learning is demonstrated and proposed. The proposed machine learning-based diagnosis method demonstrates a highly accurate prediction of implant stability (peak torque) for polyaxial pedicle screws. This achievement will contribute an important analytical method for implant stability diagnosis using L-RFA for implants with moving parts and shapes used in various clinical situations.

Can the design of the instruments used for undersized osteotomies influence the initial stability of implants installed in low-density bone? An in vitro pilot study.

ObjectivesThe aims of this study were to compare the initial implant stability obtained using four different osteotomy techniques in low-density synthetic bone, to evaluate the instrument design in comparison to the implant design, and to determinate a possible correlation between the insertion torque and initial stability quotient (ISQ).Materials and methodsFour groups were identified in accordance with the osteotomy technique used (n = 10 implants per group): group G1, osteotomy using the recommended drilling sequence; group G2, osteotomy using an undersized compactor drill; group G3, osteotomy using an undersized drill; and group G4, osteotomy using universal osseodensification drills. Two polyurethane blocks were used: block 1, with a medullary portion of 10 pounds per cubic foot (PCF 10) and with a 1 mm cortical portion of PCF 40, and block 2, with a medullary of PCF 15 and with a 2 mm cortical portion of PCF 40. Tapered implants of 4 mm in diameter and 11 mm in length were used. The insertion torque (IT) and ISQ were measured. The dimensions of the final instrument used in each group and the dimensions of the implant were used to calculate the total area of each part, and these data were compared.ResultsDifferences between the four groups were found for IT and ISQ values depending on the technique used for the osteotomy in the two synthetic bone models (p < 0.0001). All groups showed lower values of initial stability in block 1 than in block 2.ConclusionsUndersized osteotomies with instruments designed according to the implant body significantly increased the initial stability values compared to beds prepared with universal drills and using the drilling sequence standardized by the manufacturer.

Clinical Safety Assessment of Autologous Freeze-Drying Platelet-Rich Plasma for Bone Regeneration in Maxillary Sinus Floor Augmentation: A Pilot Study.

The purpose of this clinical study is to evaluate the safety and preliminary efficacy of autologous freeze-drying platelet-rich plasma (FD-PRP) on bone regeneration in maxillary sinus floor augmentation as a preliminary pilot study. Five patients that required sinus floor augmentation to facilitate the placement of dental implants participated in this clinical study. The PRP was prepared from the autologous peripheral blood and was lyophilized and stored at −20 °C for 4 weeks before surgery. At surgery, triple-concentrated FD-PRP (x3FD-PRP) mixed with synthetic bone grafting materials was rehydrated following the transplantation into the sinus floor. The primary outcome was a safety verification of x3FD-PRP, evaluated in terms of the clinical course and consecutive blood tests. The secondary outcome was clinical efficacy focused on bone regeneration in sinus floor augmentation evaluated by radiographic examination and implant stability. There were no adverse events, such as systemic complications, excessive inflammatory reactions, severe infection, or local site healing complications, besides those on the usual course associated with surgery. Vertical augmented height was maintained, and the initial stability of implants was achieved post-operatively in 6 months. The results obtained in this study suggest that x3FD-PRP can be used safely for bone engineering in clinical practice. Further studies are required to draw a conclusion concerning the efficacy of x3FD-PRP since this was a pilot study with a single arm and a small sample size.

Osseointegration of Plasma Jet Treated Titanium Implant Surface in an Animal Model.

Osseointegration of titanium implant is important for the success of both dental and medical implants. Previous studies have attempted to improve osseointegration by considering the use of plasma jet technology, where information with animal models and parameters related to osseointegration is still lacking. Therefore, this study investigated the effects of non-thermal atmospheric pressure plasma jet (NTAPPJ) treatment on titanium implants in terms of osseointegration in mongrel dogs. A total of 41 implants; 21 NTAPPJ treated and 20 control, were placed in the maxilla and mandible of six mongrel dogs for either 4 or 8 weeks. The bone volume (BV) and bone-to-implant contact (BIC) ratio were determined by region of interest (ROI). Statistical analysis was performed with the Wilcoxon rank-sum test. The NTAPPJ group at 4 weeks showed higher numbers in both BV and BIC (p < 0.05) compared to the control group. However, at 8 weeks there were less significant differences between the control or experimental group as the control group had caught up with the experimental group. Hence, NTAPPJ may be an effective treatment for the initial healing period which is critical to ensure reliable long-term predictability. The BV and BIC have been clinically proven to accelerate in the initial stages with the use of NTAPPJ to aid in the healing and initial stability of implants.

Micro/nano hierarchical structured titanium treated by NH4OH/H2O2 for enhancing cell response.

In this paper, two kinds of titanium surfaces with novel micro/nano hierarchical structures, namely Etched (E) surface and Sandblast and etched (SE) surface, were successfully fabricated by NH4OH and H2O2 mixture. And their cellular responses of MG63 were investigated compared with Sandblast and acid-etching (SLA) surface. Scanning electron microscope (SEM), Surface profiler, X-ray photoelectron spectroscopy (XPS), and Contact angle instrument were employed to assess the surface morphologies, roughness, chemistry and wettability respectively. Hierarchical structures with micro holes of 10–30 μm in diameter and nano pits of tens of nanometers in diameter formed on both E and SE surfaces. The size of micro holes is very close to osteoblast cell, which makes them wonderful beds for osteoblast. Moreover, these two kinds of surfaces possess similar roughness and superior hydrophilicity to SLA. Reactive oxygen species were detected on E and SE surface, and thus considerable antimicrobial performance and well fixation can be speculated on them. The cell experiments also demonstrated a boost in cell attachment, and that proliferation and osteogenic differentiation were achieved on them, especially on SE surface. The results indicate that the treatment of pure titanium with H2O2/NH4OH is an effective technique to improve the initial stability of implants and enhance the osseointegration, which may be a promising surface treatment to titanium implant.

Improvement in the Initial Implant Stability Quotient Through Use of a Modified Surgical Technique.

To ensure similar primary implant stability measured by resonance frequency analysis (RFA) could be obtained in different jawbone densities by using a specific surgical drilling protocol and, to correlate those RFA measurements with factors related to the implant design, width, and length, we are performed a 1-year prospective clinical study was carried out using 27 subjects. A total of 67 hydrophilic titanium implants were placed using a standard 2-stage implant placement protocol. The bone type at each implant site was determined by evaluation of a preoperative, high-resolution cone beam computerized tomography (CBCT) scan. A modified drilling protocol was used in softer bone (types 2, 3, and 4) that allowed for greater implant thread contact with the surrounding bone. The implant stability quotient (ISQ) was measured at 4 different times during the study: initially it was determined immediately after implant placement, then again at stage 2 uncovering surgery, then at 6 months' postplacement and, and finally at 1 year postplacement. Data collected immediately after implant surgery demonstrated a high correlation (R2 = .99) between the ISQ and bone type classification. An overall trend toward a higher ISQ was found over the 1-year study period for all types of bone. Implants remained clinically and radiographically stable during the 1-year study period. Our data allow conclude that the primary stability of 2-staged loaded implants placed in different bone types can be optimized by applying this surgical drilling protocol during the implant placement. The ISQ method was found to be a reliable predictor of implant stability.

A resonance frequency analysis of sandblasted and acid-etched implants with different diameters: a prospective clinical study during the initial healing period.

PurposeThe possibility of immediate or early loading has become popular in implant dentistry. A prerequisite for the immediate or early loading of an implant prosthesis is the achievement of initial stability in the implant. Moreover, in response to clinicians' interest in verifying clinical stability to determine the optimal time point for functional loading, a non-invasive method to assess implant stability has been developed on the basis of resonance frequency analysis (RFA). The primary objective of this study was to monitor the stability of sandblasted, large-grit, and acid-etched (SLA) implants with different diameters during the early phases of healing by RFA. The secondary objective was to evaluate how the initial stability of implants varied depending on different surface modifications and other contributing factors.MethodsThirty-five implants (25 SLA implants and 10 resorbable blasting media [RBM] implants) placed in 20 subjects were included. To measure implant stability, RFA was performed at baseline and at 1, 2, 3, 4, 6, and 10 weeks after surgery.ResultsThe longitudinal changes in the implant stability quotient (ISQ) values were similar for the SLA implants with different diameters and for the RBM implants. During the initial healing period, the ISQ decreased after installation and reached its lowest values at 1 week and 2 weeks, respectively. The mean ISQ values in the SLA implants were significantly higher in Ø 5.0 mm implants than in Ø 4.0 mm implants. Men showed a higher ISQ than women. Mandibular sites showed a higher ISQ than maxillary sites.ConclusionsAll implants used in this study are suitable for immediate or early loading under appropriate indications. A wider diameter and SLA surface treatment of implants could improve the stability, if the implant is fixed with at least 30 Ncm of insertion torque.

Evaluation of initial stability and crestal bone loss in immediate implant placement: An in vivo study.

Objectives:(1) To measure the crestal bone levels around implants immediately, and one month, three months, and six months after immediate implant placement, to evaluate the amount of bone level changes in six months. (2) To measure the initial stability in immediate implant placement.Materials and Methods:Ten patients were selected and a total of ten implants were placed in the immediate extraction sites. The change in the level of crestal bone was measured on standardized digital periapical radiographs taken at baseline, first month, third month, and sixth months for each patient, using the SOPRO imaging software. The initial stability of implants was measured with resonance frequency analysis (RFA) and an engine-driven torque. The measurements were statistically analyzed. The student's t-test was used, to identify the significance of the study parameters.Results:When mesial and distal bone losses were averaged, the radiographic evaluation with the SOPRO imaging software showed an average of 0.80 mm, with a standard deviation of ± 0.18 mm bone loss at the first month, followed by 1.03 mm with a standard deviation of ± 0.19 mm at the third month, and 1.23 mm with standard deviation of ± 0.6 mm at the sixth month. The initial stability with the RFA instrument showed a mean of 55 implant stability quotient (ISQ) values and the torque showed a value of 36.50 Nm.Conclusions:The implant has to be placed 2 mm below the crestal bone level to compensate the crestal bone loss. The initial stability is achieved by apical preparation of the socket wall and use of straight screw implants. When the defect is more than 2 mm, autogenous grafts with membranes are the best choice.

Initial Implant Stability Predicts Migration But Not Failure in Cementless Acetabular Revision with Bone Grafting

Host bone contact of less than 50% is perceived but not proven to cause migration and loosening after actetabular revision. A prospective analysis of cementless acetabular revision cases with impaction grafting was performed to determine if this was an independent risk factor for these events. Sixty-two hips in 54 patients were assessed at a mean follow-up of 84.5months (range 61–112) yielding a probability of 94.6% of retaining the acetabular component using revision for aseptic loosening as the end point. No single factor was independently causative for loosening, although Type III fixation was associated with migration (p=0.0159); subanalysis suggested that achieving host–bone contact in at least part of the dome and posterior column is important.

Histomorphometric Study of Implants Initially Stabilized through Bone Graft Packing into the Osteotomy before Implant Placement in Case of Wide Defects

Purpose: This study sought to evaluate the effects of bone graft wedging on the initial stability of implants in bone sites of unfavorable quality. Materials and Methods: Three male beagle dogs were used in this study. Osteotomies were performed with parallel drills (<TEX>${\O}4.1{\times}10mm$</TEX>), and fixtures (<TEX>${\O}3.3{\times}8mm$</TEX>) were placed. The control group was given implants without bone graft. Experiment group A was given implants with minimal initial stability using autobone grafts, whereas experiment group B was given xenografts. Groups were also divided by healing times at 4, 8, and 12 weeks. Results: All implants in the control group failed to osseointegrate. On the other hand, all implants in the experiment groups were clinically well-maintained during the entire experiment period. After 4, 8, and 12 weeks, bone-to-implant contact (BIC) ratio and implant stability quotient (ISQ) increased in the experiment groups. The differences between experiment groups A and B were not statistically significant, however. Conclusion: In unfavorable bone regions for dental implants, bone graft packing into the osteotomy prior to implant placement secured minimal initial stability and showed reasonable BIC ratios and ISQ values throughout the study period.

Assessment of Bone Density in the Posterior Maxilla Based on Hounsfield Units to Enhance the Initial Stability of Implants

The poor bone quality that exists in the posterior maxilla is associated with lower initial stability and higher failure rates in implants. This study examined the bone densities of edentulous posterior maxillae by computed tomography (CT). Based on CT images, the voxel values representing implant replacement in the posterior maxillary regions of 30 patients were calculated in the range from 150 to 2,000 Hounsfield units (HU). The bone densities of these regions were categorized according to Misch's classification and compared among individuals and between sexes. The average of the median individual CT values was 495 HU (95% confidence interval: 442-547 HU) and was significantly higher in males than in females. Most of the bone in the posterior maxillae was classified as D3 (350-850 HU) or D4 (150-350 HU) according to Misch's classification, comprising 50% and 32% of the entire regions, respectively. More than 80% of the edentulous posterior maxillae consisted of porous cortical crest or no cortical bone according to CT, although the bone densities varied markedly among individuals. More detailed assessments of bone density may be useful to enhance initial stability of implants in the posterior maxilla.

A comparative study on the initial stability of different implants placed above the bone level using resonance frequency analysis

PURPOSEThis study evaluated the initial stability of different implants placed above the bone level in different types of bone.MATERIALS AND METHODSAs described by Lekholm and Zarb, cortical layers of bovine bone specimens were trimmed to a thickness of 2 mm, 1 mm or totally removed to reproduce bone types II, III, and IV respectively. Three Implant system (Brånemark System® Mk III TiUnite™, Straumann Standard Implant SLA®, and Astra Tech Microthread™-OsseoSpeed™) were tested. Control group implants were placed in level with the bone, while test group implants were placed 1, 2, 3, and 4 mm above the bone level. Initial stability was evaluated by resonance frequency analysis. Data was statistically analyzed by one-way analysis of variance in confidence level of 95%. The effective implant length and the Implant Stability Quotient (ISQ) were compared using simple linear regression analysis.RESULTSIn the control group, there was a significant difference in the ISQ values of the 3 implants in bone types III and IV (P<.05). The ISQ values of each implant decreased with increased effective implant length in all types of bone. In type II bone, the decrease in ISQ value per 1-mm increase in effective implant length of the Brånemark and Astra implants was less than that of the Straumann implant. In bone types III and IV, this value in the Astra implant was less than that in the other 2 implants.CONCLUSIONThe initial stability was much affected by the implant design in bone types III, IV and the implant design such as the short pitch interval was beneficial to the initial stability of implants placed above the bone level.

Comparison of flap and flapless procedures for the stability of chemically modified SLA titanium implants: an experimental study in a canine model

Flapless implant surgery has been shown to accelerate recovery and increase the vascularity of the peri-implant mucosa after implant placement. The aim of this study was to compare dental implant stabilization patterns between flap and flapless implant surgeries over the first 8 weeks after implant placement. In 6 mongrel dogs, bilateral, edentulated, and flat alveolar ridges were created in the mandible. After 3 months of healing, 2 implants (Straumann SLA-active) were placed in each side of the mandible using either a flap or flapless procedure. The implant stability quotient (ISQ) that was obtained from Osstell Mentor was measured at the time of implantation and weekly over the first 8 weeks after implant placement. Implants stabilized more quickly without flap elevation than with flap elevation. For flapless implants, an increase in stability occurred after 2 weeks without a period of decreasing stability. However, for flap implants, a shift in implant stability from decreasing stability to increasing stability occurred after 2 weeks. In the canine model, flapless surgical placement of implants may increase the initial stability of implants compared with implants placed after the reflection of the mucoperiosteal flap.

A clinical study of alveolar bone quality using the fractal dimension and the implant stability quotient

PurposeIt has been suggested that primary implant stability plays an essential role in successful osseointegration. Resonance frequency analysis (RFA) is widely used to measure the initial stability of implants because it provides superior reproducibility and non-invasiveness. The purpose of this study is to investigate whether the fractal dimension from the panoramic radiograph is related to the primary stability of the implant as represented by RFA.MethodsThis study included 22 patients who underwent dental implant installation at the Department of Periodontology of Seoul National University Dental Hospital. Morphometric analysis and fractal analysis of the bone trabecular pattern were performed using panoramic radiographs, and the implant stability quotient (ISQ) values were measured after implant installation using RFA. The radiographs of 52 implant sites were analyzed, and the ISQ values were compared with the results from the morphometric analysis and fractal analysis.ResultsThe Pearson correlation showed a linear correlation between the ISQ values of RFA and the parameters of morphometric analysis but not of statistical significance. The fractal dimension had a linear correlation that was statistically significant. The correlation was more pronounced in the mandible.ConclusionsIn conclusion, we suggest that the fractal dimension acquired from the panoramic radiograph may be a useful predictor of the initial stability of dental implants.

Influence of Defect Depth on Resonance Frequency Analysis and Insertion Torque Values for Implants Placed in Fresh Extraction Sockets: A Human Cadaver Study

Clinical studies show promising outcomes with implants inserted at the time of extraction. However, this often results in an initial bone defect at the marginal region which preferably should heal for an optimal function. Therefore, monitoring of these implants is vital. The aims of this study were to determine the initial stability of implants placed into fresh extraction sockets, and to explore the correlations between the peri-implant bone levels and implant stability parameters. Six human cadaver mandibles including all natural teeth were selected for this study. All natural teeth were gently extracted, and 84 implants were immediately placed into fresh extraction sockets with five different implant depths. The maximum insertion torque values were recorded, and primary implant stability measurements were performed by means of resonance frequency analysis (RFA). The vertical distance between implant/abutment junction and the first bone-implant contact was recorded using a periodontal probe. It was found that the insertion torque and RFA were 28.9 +/- 7 Ncm and 65.6 +/- 9 implant stability quotient (ISQ), respectively, for 420 measurements from all 84 implants. Statistically significant correlation was found between insertion torque and ISQ values (r = 0.86; p < .001) for all implants. Both insertion torque and ISQ values dramatically decreased when the amount of peri-implant vertical bone defect increased. The results of this study demonstrated a linear relationship between peri-implant vertical bone defect depth and RFA value. It is proposed that the RFA method is sensitive to detect changes of the marginal bone level and may be used to monitor healing of peri-implant bone defects.

Assessing Double Acid-Etched Implants Submitted to Orthodontic Forces and Used as Prosthetic Anchorages in Partially Edentulous Patients

:The use of implants as anchorage for orthodontic forces seems to be a good alternative in partially edentulous patients needing orthodontic treatment. This study is aimed at assessing the performance and behavior of microtextured surface endosseous implants obtained by means of a double acid etching against orthodontic forces, as well as their adequacy to be used first as anchorage and later as fixtures for the definitive prosthesis.Materials and Methods: A total of 93 double acid-etched surface parallel wall implants (Osseotite® Implants, Implant Innovations Inc., Palm Beach, Florida, USA) were inserted in 38 partially edentulous patients prior to orthodontic treatment This was carried out by following two-stage surgery protocols in the maxilla as well as in the mandible.After a healing period of six months for the maxilla and four months for the mandible, the implants were used as anchorage for sliding, compression and traction orthodontic forces between 100 to 200 g by means of Ni-TI springs.Bone level and Resonance Frequency Analysis (RFA) were measured before and after the introduction of the orthodontics forces.Results: After removal of the orthodontics appliances, all the implants remained stabile and served as support for prosthetic replacement of missing teeth. The bone level showed no variationeven when a positive difference 0.02 ± 0.38mm was noticed. The RFA scored a significant difference (p≤ 0.03) between the initial Implant Stability Quotient (ISQ) values (66) and the final ones (68).Conclusions: These findings showed that Osseotite implants were able to support the orthodontic forces applied during this investigation, maintaining osseointegration without significant variation in bone level. Therefore, they can be used to support dental prosthesis once they have been used as orthodontic anchorage under the cited conditions.

Biomechanical aspects of initial intraosseous stability and implant design: a quantitative micro‐morphometric analysis

The objective of this biomechanical study was to explore the effect of bone micro-morphology on initial intraosseous stability of implants with different designs. Straumann and Astra Tech dental implants were placed into anterior and posterior regions of completely edentulous maxilla and mandible of a human cadaver. Experiments were undertaken to quantify initial implant stability and bone micro-morphology. Installation torque values (ITVs) and implant stability quotients (ISQs) were measured to determine initial intraosseous implant stability. For quantification of relative bone volume and micro-architecture, sectioned implant-bone and bone core specimens of each implant placement site were consecutively scanned and trabecular bone was analyzed in a micro-computed tomography (micro-CT) unit. Experimental outcomes were evaluated for correlations among implant designs, initial intraosseous implant stability and bone micro-structural parameters. ITVs correlated higher with bone volume fraction (BV/TV) than ISQs, at 88.1% and 68.9% levels, respectively. Correlations between ITVs and micro-morphometric parameters were significant at the 95% confidence level (P<0.05) while ISQs were not. Differences in ITVs, ISQs and BV/TV data in regards to implant designs used were not significant at the 95% confidence level (P>0.05). Bone micro-morphology has a prevailing effect over implant design on intraosseus initial implant stability, and ITV is more sensitive in terms of revealing biomechanical properties at the bone-implant interface in comparison with ISQ.

Clinical Evaluation of Association of Bovine Organic Osseous Matrix and Bovine Bone Morphogenetic Protein Versus Autogenous Bone Graft in Sinus Floor Augmentation

The purpose of the present study is to evaluate clinically and radiographically the behavior of the association between bovine organic osseous matrix (BOM) and bovine bone morphogenetic protein (bBMP) versus autogenous bone graft in promoting bone healing in maxillary sinus lifting procedures. Ten nonsmoking and systemically healthy patients who needed bilateral maxillary sinus grafting for the placement of osseointegrated implants were treated. In all patients, 1 side was selected as test (bBMP + BOM) and the other as control using autogenous particulated bone graft from mandibular ramus. After a period varying from 6 to 11 months, the implants were placed. The radiographic analysis was realized by panoramic-rx. The clinical analysis consisted of transoperative evaluation by visual observation of bone formation of grafted area and initial stability of implants. Radiographically, the images were evaluated observing radio-opaque aspect. Clinically, a better bone formation pattern of the grafted area in the side grafted with autogenous bone could be observed. The initial stability of the implants in the side grafted with autogenous bone was better than in the test side. The placement torque of the implants in the test side was more than 30 N-cm. In the present study, the association of bovine organic osseous matrix and bBMP as a growth factor showed different results when compared with autogenous graft. It was observed in the absence of an radio-opaque image, making it difficult to select the implants. Clinically, the bone formation was partial and showed the presence of the fibrous tissue in the grafted area when using the association of bovine organic osseous matrix and bBMP, and the placement torque of implants was less than the control side.