The Effect of Osseodensification and Conventional Implant Site Preparation on Implant Stability of Tapered and Cylindrical Dental Implants: A Randomized Controlled Study.
Aug 2026· The Journal of craniofacial surgery (Print)· 0 citations· 23 references
Medicine
TL;DR
Neither the choice of drilling technique nor the implant macrogeometry significantly influences insertion torque or stability levels in regions of low bone density in this randomized controlled clinical study.
Abstract
Background
Primary stability is a critical factor for dental implant success, especially in areas with poor bone quality. This randomized controlled clinical study aimed to evaluate the impact of 2 different osteotomy preparation techniques: osseodensification (OD) and conventional drilling, combined with 2 different implant macrogeometries (tapered and cylindrical), on implant stability in low bone density regions.
Methods
The study involved 20 patients who received 36 dental implants in the maxilla or mandible. Sites were randomly allocated into 4 groups based on preparation technique (conventional versus OD) and implant design (tapered versus cylindrical). Primary stability and insertion torque (IT) were recorded postinsertion immediately. Secondary stability was assessed at 12 weeks using resonance frequency analysis (RFA). Preoperative CBCT was utilized to evaluate bone density and alveolar dimensions.
Results
Statistical analysis revealed no significant differences between the groups regarding primary stability (P=0.935), insertion torque (P=0.784), and secondary stability (P=0.136), despite the implants placed using the OD technique demonstrating higher primary stability compared with conventional drilling. In addition, tapered implants showed a more pronounced increase in stability than cylindrical designs under the same preparation conditions.
Conclusions
Neither the choice of drilling technique nor the implant macrogeometry significantly influences insertion torque or stability levels in regions of low bone density. All tested combinations provided comparable and satisfactory clinical outcomes.
The use of sequential osseodensification protocols yielded superior mechanical stability parameters, specifically in IT and RT, in synthetic (polyurethane) bone models, but improvements in ISQ were predominantly noted in the denser type III model.
Silvio Yoshiaki Okagawa, Alex Sandro de Souza, Paulo Sérgio Perri de Carvalho et al.· International Journal of Den...· 0 citations
The aim of this clinical trial was to compare the implant stability in terms of primary and secondary stability with three different osteotomy techniques, to establish a protocol that can consistently help achieve increased implant stability in the maxillary posterior region. A total of 30 patients (19 males, 11 females; mean age 46.3 ± 8.7 years) requiring single implant placement in the maxillary posterior region were divided into three groups. Endosseous implants (Straumann Bone Level Tapered, SLActive surface, 4 mm × 10 mm) were placed in Group I using conventional osteotomy, Group II with Summers’ osteotome technique, and Group III with the osseodensification technique. All implants were placed with an emerged (non-submerged) technique and immediately restored with provisional prostheses adjusted to eliminate centric and eccentric contacts (immediate restoration without functional loading). The stability was assessed at the time of implant placement, at three months and at six months using resonance frequency analysis (Osstell). One-way ANOVA and Tukey post-hoc test were used to compare the ISQ values between groups, and repeated measures ANOVA for intragroup comparisons. No statistically significant differences were observed in the ISQ values at the time of placement, three months, and six months after implant placement between Group I (Conventional osteotomy), Group II (Summers’ osteotome technique), and Group III (Osseodensification). However, numerical trends indicated slightly lower initial primary stability in Group II and slightly higher values in Group III throughout the observation period. All implants achieved 100% survival at six months. Within the limitations of this exploratory study, all three osteotomy techniques achieved adequate primary stability for immediate restoration in the maxillary posterior region. While no statistically significant differences were detected between techniques, numerical trends suggest that osseodensification may offer marginally better primary stability and Summers’ osteotome technique showed slightly lower initial values. These findings should be interpreted cautiously given the small sample size and relatively short follow-up period. Further large-scale, adequately powered studies are needed to definitively establish clinical superiority of any technique. CLINICAL TRIAL REGISTRY OF INDIA (CTRIICMR) REGISTRATION NO. CTRI/2021/09/036513. Registered retrospectively on 15/09/2021 (enrollment began September 2020). Available at https://www.ctri.nic.in.
N. Venkatesh, M. Shetty, C. Hegde et al.· BMC Oral Health· 1 citation· ⚡1
Background/Objectives: The primary aim of this study is to evaluate the impact of two different drilling methods on the primary stability of implants inserted into polyurethane blocks simulating different bone densities. The secondary aim is to analyse the indication provided by three different methods used to assess primary stability. Methods: The study was performed on two artificial bone blocks of solid rigid polyurethane without cortical layer and one laminated one. A total of 48 implants were placed following either a Regular Primary Stability (RPS) or an Enhanced Primary Stability (EPS) protocol based on site underpreparation. Immediately after implant placement, artificial intelligence tool (AIT) indication, peak insertion torque (pIT) and Resonance Frequency Analysis (RFA) values were recorded. The values were then categorised as suitable or not suitable for single-crown immediate loading by bone density and drilling protocol. Results: EPS drilling protocol produced significantly higher primary stability values than those in all bone densities, regardless of the primary stability measurement method used, except for the implants placed in D4 and evaluated by AIT. The grouping of values shows that implants placed in D3 and D4 never reached the immediate loading threshold for a single crown. In D2, EPS and RPS protocols both reach the threshold for all implants when evaluated with pIT or RFA; when AIT is used, RPS protocol was not able to reach the single-crown threshold in 50% of cases. Conclusions: Within the limitations of this in vitro study, underpreparation appears a viable technique to improve primary stability, nevertheless it might be insufficient to reach the threshold of immediate loading suitability in low density bone. All systems used are able to report the primary stability increase obtained by underpreparation, but AIT showed the potential to detect a loss of primary stability related to torque drop during insertion. These findings require further confirmation.
The available evidence indicates that this technique represents a promising alternative for optimizing implant site preparation and promoting greater primary stability, particularly in low-density bone, however, prospective long-term clinical studies are still required to establish its indications, limitations, and clinical outcomes.
Fagner Santos de Carvalho· Revista de Estudos Interdisc...· 0 citations
BACKGROUND
Immediate implant placement has become a widely accepted treatment modality because of reduced treatment time and preservation of alveolar bone architecture. Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been proposed to enhance peri-implant bone regeneration and implant stability. This study evaluated the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with biphasic calcium phosphate graft on implant stability and peri-implant bone preservation following immediate implant placement.
METHODS
Twenty-four patients who received 32 immediate dental implants were randomly assigned to 2 groups. The control group received a biphasic calcium phosphate graft alone in the jumping gap, whereas the study group received the graft combined with 0.1 mg rhBMP-2. Implant stability, marginal bone level, and buccal bone thickness were evaluated clinically and radiographically over 16 weeks.
RESULTS
Thirty implants were analyzed. Both groups showed a significant increase in implant stability over 16 weeks. The control group demonstrated a slightly higher relative percentage increase than the study group (11.17%±4.34 versus 9.57%±3.83), with no statistically significant difference between groups (P=0.637). No statistically significant differences were observed regarding marginal bone loss or buccal bone thickness changes at 1 mm and 2 mm below the implant screw (P>0.05).
CONCLUSIONS
The addition of rhBMP-2 to a biphasic calcium phosphate graft did not confer significant clinical advantages over the graft alone following immediate dental implant placement, suggesting limited additional benefit relative to its cost.
Aya A. Saeed, A. Abbas· The Journal of craniofacial...· 0 citations
The Bone Ring Technique (BRT) is a newer viable option for restoring complex defects around dental implants with three-dimensional bone augmentation with significant height and width augmentation of buccal bone.
Priyadharshini Annamalai Senthur Pandian, Aniz Amanullah, Lakshmiganthan Mahalingam et al.· Journal of Clinical and Diag...· 0 citations
