Primary Implant Stability Analysis of Different Dental Implant Connections and Designs-An In Vitro Comparative Study

The Effectiveness of Osseodensification Drilling versus the Conventional Surgical Technique on Implant Stability: A Clinical Trial

Background/Objective: To ensure that implants are able to support prosthetic rehabilitation, a stable and functional union between the bone and the implant surface is crucial to its stability and success. To increase bone volume and density and excel bone-implant contact, a novel drilling method, called osseodensification (OD), was performed. To assess the effectiveness of the osseodensification drilling protocol versus the conventional surgical technique on implant stability. Methods: Bone Level Tapered Straumann implants were placed side-by-side with both OD and subtractive conventional drilling (SD) in 90 patients from CESPU-Famalicão clinical unit. IT was measured using a manual torque wrench, and the Implant stability quotient (ISQ) value was registered using the Osstell® IDX. Results: According to the multifactorial ANOVA, there were statistically significant differences in the mean IT values due to the arch only (F(1.270) = 4.702, p-value = 0.031 < 0.05). Regarding the length of the implant, there were statistically significant differences in the mean IT in the OD group (p = 0.041), with significantly lower mean IT values for the Regular implants compared to the Long. With respect to the arch, the analyses of the overall ISQ values showed an upward trend in both groups in the maxilla and mandible. High levels of IT also showed high ISQ values, which represent good indicators of primary stability. Conclusions: OD does not have a negative influence on osseointegration compared to conventional subtractive osteotomy.

Are Torque-Induced Bone Texture Alterations Related to Early Marginal Jawbone Loss?

The reason why marginal bone loss (MBL) occurs after dental implant insertion without loading has not yet been clearly investigated. There are publications that confirm or reject the notion that there are factors that induce marginal bone loss, but no research investigates what exactly occurs in the bone surrounding the implant neck. In this study, 2196 samples of dental implant neck bone radiographs were analyzed. The follow-up period was 3 months without functional loading of the implant. Marginal bone loss was evaluated in relation to the torque used during the final phase of implant insertion. Radiographic texture features were also analyzed and evaluated. The analyses were performed individually for the anterior and posterior part of the alveolar crest in both the mandible and maxilla. After 3 months, an MBL relation with higher torque (higher than 40 Ncm; p < 0.05) was observed, but only in the lower jaw. The texture features Sum Average (SumAverg), Entropy, Difference Entropy (DifEntr), Long-Run Emphasis (LngREmph), Short-Run Emphasis (ShrtREmph), and discrete wavelet decomposition transform features were changed over time. This study presents that MBL is related to the torque value during dental implant insertion and the location of the procedure. The increasing values of SumAverg and LngREmph correlated with MBL, which were 64.21 to 64.35 and 1.71 to 2.01, respectively. The decreasing values of Entr, DifEntr, and ShrtREmph also correlated with MBL, which were 2.58 to 2.47, 1.11 to 1.01, and 0.88 to 0.84, respectively. The analyzed texture features may become good indicators of MBL in digital dental surgery.