Evaluation of specifically designed implants placed in the low-density jaw bones: A clinico-radiographical study

Osseodensification: An Innovative Technique With Manifold Gains

Prosthodontics, which is removable and fixed, is the branch dealing with the replacement of missing teeth. Implant therapy is the popular treatment modality and commonly preferred treatment option by many patients and clinicians for missing teeth in recent years. Primary implant stability (PIS) is one of the crucial factors for osseointegration. It has been considered a crucial factor in the success of implants. Moreover, several factors influence PIS. On the other hand, both secondary implant stability and osseointegration are influenced by the PIS. Bone density, bone volume, bone-to-implant contact, and other factors that enhance or degrade the primary stability. Certain host sites such as the maxillary posterior region demand more dense bone to achieve desired results as they are the low-density areas of the jaw. So, a new promising and growing innovative concept of osseodensification (OD) offers a great solution with multiple benefits and desirable results. This review article aims to enlighten the multiple benefits of OD technique and their mechanism of action.

Osseodensification implant site preparation technique and subsequent implant stability: A pilot study

OBJECTIVE

The objective of the present study was to evaluate and compare primary and secondary implant stability of conical endosteal implants placed using osseodensification osteotomy and conventional osteotomy techniques.

MATERIALS AND METHODS

The present invivo study was designed as a prospective, observational study in which a total of 26 endosteal implants were placed in the posterior edentulous regions of upper and lower jaws in 13 patients divided into two groups, Group A and Group B. In Group A, implants were placed using osseodensification osteotomy technique while in Group B, conventional osteotomy technique was used. Primary implant stability was measured in both groups immediately after implant placement while secondary implant stability was measured in both groups at an interval of 4 months. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20.00 (SPSS Inc., Chicago, IL, USA) while an independent t-test, also, called Student's t-test was used to conduct the analysis.

RESULTS

The mean value of primary implant stability in Group A was found to be 74.5 as against that in Group B which was 62.08 (P-value 0.001). Likewise, the mean value of secondary implant stability in Group A after 4 months' interval was 70.92 while in Group B, it was found to be 63.69 (P-value 0.001).

CONCLUSIONS

The dental implants placed with the osseodensification technique showed higher mean primary and secondary implant stability values when compared to implants placed by the conventional technique.

Implant Placement Post Maxillary Sinus Lift Using Osseodensification Concept: A Case Report

Pneumatisation of the maxillary sinus is a roadblock to the successful placement of endosseous implants in the posterior maxilla. It is mandatory that the sinus has to be elevated to facilitate implant placement, for which the operating clinician should be well versed with the anatomy of the sinus to avoid intraoperative mishaps. Many techniques of sinus augmentation have been tried and tested with successful outcomes. This article presents a report of a 60-year-old female who had root stumps in relation to upper left first maxillary molar. She wanted an implant to replace the root stumps, however, on cone-beam computed tomography (CBCT) examination the sinus was pneumatised and required augmentation. The root stumps were extracted and after a six-month waiting window, she was treated with an indirect sinus augmentation procedure using Densah™ burs (Jackson, MI: Versah, LLC) after which an implant (5 mm x 8 mm) was placed with good osseointegration at three-month follow-up. The Densah™ bur facilitated sinus lift procedure is a good option for pneumatised sinuses with inadequate residual bone height.

Osseodensification - A novel approach in implant dentistry

Primary stability in dental implants is an essential factor for achieving successful osseointegration. Surgical procedure and bone quality are among the most common factors that affect primary stability. It is also crucial to achieve high-insertion torque which is important for obtaining primary stability. Maintaining sufficient bone bulk and density is essential to achieve necessary bone-to-implant contact for obtaining a biomechanically stable implant. A new concept for osteotomy called osseodensification (OD) has been at the forefront of changes in surgical site preparation in implantology. This relatively new concept with universally compatible drills has been proposed to help in better osteotomy preparation, bone densification, and indirect sinus lift and also achieve bone expansion at different sites of varying bone densities. This procedure has also shown improvement in achieving better implant primary stability and better osteotomy than conventional implant drills. A systematic review was undertaken to analyze if OD procedure had any advantages over conventional osteotomy on bone density and primary stability. An electronic database search was conducted in PubMed using keywords such as "OD," "implant primary stability," "implant bone density," and "implant osteotomy." A total of 195 articles were collected and subjected to screening using inclusion and exclusion criteria. A literature review was done, following which it was seen that the use of versah drills for bone OD resulted in undersized osteotomy compared to conventional drills. It also resulted in improved bone density and increase in percentage bone volume and bone-to-implant contact, thereby improving implant stability.

New Osseodensification Implant Site Preparation Method to Increase Bone Density in Low-Density Bone: In Vivo Evaluation in Sheep

PURPOSE

The aim of this study was to evaluate a new surgical technique for implant site preparation that could allow to enhance bone density, ridge width, and implant secondary stability.

MATERIALS AND METHODS

The edges of the iliac crests of 2 sheep were exposed and ten 3.8 × 10-mm Dynamix implants (Cortex) were inserted in the left sides using the conventional drilling method (control group). Ten 5 × 10-mm Dynamix implants (Cortex) were inserted in the right sides (test group) using the osseodensification procedure (Versah). After 2 months of healing, the sheep were killed, and biomechanical and histological examinations were performed.

RESULTS

No implant failures were observed after 2 months of healing. A significant increase of ridge width and bone volume percentage (%BV) (approximately 30% higher) was detected in the test group. Significantly better removal torque values and micromotion under lateral forces (value of actual micromotion) were recorded for the test group in respect with the control group.

CONCLUSION

Osseodensification technique used in the present in vivo study was demonstrated to be able to increase the %BV around dental implants inserted in low-density bone in respect to conventional implant drilling techniques, which may play a role in enhancing implant stability and reduce micromotion.