Effects of Osseodensification on Immediate Implant Placement: Retrospective Analysis of 211 Implants

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.

Conventional Versus Osseodensification Drilling in the Narrow Alveolar Ridge: A Prospective Randomized Controlled Trial

Background Conventionally, undersized osteotomies were used to increase initial bone-to-implant contact to achieve primary stability in implantology. This is particularly evident in regions with low bone density. The potential for severe bone compression and ischemia poses a challenge to secondary stability. Instead, lateral bone compaction is caused by the idea of osseodensification. Research on the potential benefits of this method for narrow ridges is lacking. This study aimed to determine if the osseodensification drilling technique affects primary stability and how much the alveolar ridge expands following implant site preparation. Methodology A total of 30 participants aged 20 to 80 years were included in this randomized controlled clinical investigation. Each participant was randomly assigned to one of the following two groups: one that received standard drill preparation, and another that received osseodensification drill preparation. Implant stability using implant stability quotient values, crest width, apical width (5 mm from crest), and bone density were assessed both before and after six months using cone-beam computed tomography. Results Osseodensification impacted the width at the apex (5 mm from the crest) and radiographic bone density, adding to the quality, but did not affect implant stability and crestal width after osseointegration. The mean difference in conventional and osseodensification groups was 0.46 and 0.68 mm, respectively, concerning the crestal width. Moreover, the mean difference was 0.74 and 0.58 mm for conventional and osseodensification groups, respectively, concerning the width at the apex (5 mm from the crest). Conclusions This study demonstrates that the osseodensification process increased both the radiographic bone density and the width at the apex, demonstrating that osseodensification drilling techniques allow for the placement of implants with larger diameters in narrow alveolar ridges.

Cone-Beam Computed Tomography (CBCT)-Based Assessment of the Alveolar Bone Anatomy of the Maxillary and Mandibular Molars: Implication for Immediate Implant Placement

Purpose This study aims to examine specific aspects of socket morphology, including buccal and palatal/lingual bone width, interradicular bone (IRB) width, and assessments of root apices and furcation proximity to the vital structures of the maxillary and mandibular first and second molars using cone-beam computed tomography (CBCT). Materials and methods The study involved the analysis of 400 maxillary and mandibular first and second molars. Various measurements were taken to assess socket morphology, including mesiodistal (MD) and buccolingual (BL) width, buccal and lingual bone thickness at 2 mm apical to the alveolar crest, IRB width at 2 mm from the furcation, and the distance between the root apices and furcation to vital structures, such as the floor of the maxillary sinus (FMS) and inferior alveolar nerve (IAN). Results The mesiobuccal (MB) root of the second molar commonly intruded into the sinus, followed by the palatal root of the maxillary first molar. The mean FMS-F distance was 7.17 + 3.98 mm, and it was 7.2 + 2.72 mm for maxillary first and second molars, respectively. The mean IRB width was 2.77 + 0.96 and 2.29 + 0.74 mm for the first and second molars. The mandibular second molar had the shortest distance to the IAN in comparison to the first molar. For maxillary teeth, 7% of the first and 4% of the second molars presented alveolar anatomy adequate for immediate implant placement, compared to 84% and 50% of mandibular first and second molars. Conclusion Understanding the local alveolar bone anatomy of molars and its relationship to vital structures is crucial for the effective planning of implant treatments.

Effects of Osseodensification on Primary Stability of Cylindrical and Conical Implants-An Ex Vivo Study

Primary stability is an important factor for dental implant success. In the past years, a new method for bone site preparation was introduced, named osseodensification (OD). OD produces a condensation of the trabecular portion of the bone, increasing bone-to-implant contact and primary stability. This study aims to compare the effect of OD in cylindrical and conical implants to conventional instrumentation. A total of forty implants, divided into four groups, were placed in porcine tibia: cylindrical conventional (1a), cylindrical OD (1b), conical conventional (2a) and conical OD (2b). Each implant was measured for implant stability quotient (ISQ), insertion torque (IT) and removal torque (RT). Group 2b showed the higher values for each of the evaluated parameters; groups 1b and 2b showed better results than 1a and 2a, respectively. Regarding the IT and RT, group 1b achieved higher values than group 2a, but not for ISQ. The inter-group comparison showed significant difference between groups 1a vs 2a, 1a vs 2b and 1b vs 2b for ISQ and 1a vs 1b and 1a vs 2b for RT analysis. OD resulted in improved ISQ, IT and RT of both cylindrical and conical implants.

Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials

The aim of this study was to assess and compare the stress–strain pattern of zygomatic dental implants supporting different superstructures using 3D finite element analysis (FEA). A model of a tridimensional edentulous maxilla with four dental implants was designed using the computer-aided design (CAD) software. Two standard and two zygomatic implants were positioned to support the U-shaped bar superstructure. In the computer-aided engineering (CAE) software, different materials have been simulated for the superstructure: cobalt–chrome (CoCr) alloy, titanium alloy (Ti), zirconia (Zr), carbon-fiber polymers (CF) and polyetheretherketone (PEEK). An axial load of 500 N was applied in the posterior regions near the zygomatic implants. Considering the mechanical response of the bone tissue, all superstructure materials resulted in homogeneous strain and thus could reconstruct the edentulous maxilla. However, with the aim to reduce the stress in the zygomatic implants and prosthetic screws, stiffer materials, such Zr, CoCr and Ti, appeared to be a preferable option.