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Khubchandani SR, Dahane T, Dubey SA. Osseodensification: An Innovative Technique With Manifold Gains. Cureus 2024; 16:e60255. [PMID: 38872641 PMCID: PMC11170060 DOI: 10.7759/cureus.60255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024] Open
Abstract
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.
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Affiliation(s)
- Sheetal R Khubchandani
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Trupti Dahane
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Surekha A Dubey
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Fontes Pereira J, Costa R, Nunes Vasques M, Salazar F, Mendes JM, Infante da Câmara M. Osseodensification: An Alternative to Conventional Osteotomy in Implant Site Preparation: A Systematic Review. J Clin Med 2023; 12:7046. [PMID: 38002660 PMCID: PMC10672029 DOI: 10.3390/jcm12227046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/01/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Osseodensification is an innovative method of preparing the implant osteotomy using drills that promote bone self-compaction. The main objective of this technique is to promote peri-implant bone densification and compaction of autologous bone and to increase the primary stability of the implant due to the viscoelastic characteristics of the alveolar bone using Densah® burs in a counterclockwise direction at a speed of 800 to 1500 rpm. The objective of this review is the analysis of the scientific literature regarding the applicability of the osseodensification technique in oral implantology. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used and registered at PROSPERO. The search strategy included electronic databases from 2016 to 2023 and was performed by two independent reviewers. The results demonstrate the advantage of the osseodensification technique in relation to conventional drilling, allowing an increase in the bone density and primary stability of the implant, bone density, and bone-implant contact. The osseodensification technique can be applied in different clinical situations: sub-antral bone grafts, narrow alveolar bone crests, low-density bone areas, and immediate implant placement in post-extraction sockets.
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Affiliation(s)
- João Fontes Pereira
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Rosana Costa
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Miguel Nunes Vasques
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Filomena Salazar
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - José Manuel Mendes
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Marco Infante da Câmara
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
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Althobaiti AK, Ashour AW, Halteet FA, Alghamdi SI, AboShetaih MM, Al-Hayazi AM, Saaduddin AM. A Comparative Assessment of Primary Implant Stability Using Osseodensification vs. Conventional Drilling Methods: A Systematic Review. Cureus 2023; 15:e46841. [PMID: 37954787 PMCID: PMC10636496 DOI: 10.7759/cureus.46841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
Osseodensification is a novel biomechanical bone preparation technique that has been established to replace conventional bone drilling and therefore will optimize the implant site. The purpose of this systematic review was to compare the implant stability obtained by osseodensification drilling to those associated with conventional drilling techniques. An electronic search was performed in the PubMed, Scopus, EMBASE, Cochrane Oral Health Group, and Dentistry and Oral Science Source databases searched through Elton B. Stephens Company (EBSCO) for potentially relevant publications in the English language from January 2013 to December 2022. Randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs), contrasting osseodensification drilling with conventional drilling, studies documenting implant stability quotient (ISQ), and studies reporting the immediate outcome and at least three months of follow-up after dental implant placement were included. Two independent investigators evaluated the quality of the reviewed studies to determine the risk of bias using the version 2 of Cochrane risk-of-bias (RoB) tool for RCTs (RoB 2) and RoB for NRSIs (ROBINS-I). Majority of the studies showed that bone density was significantly higher in the osseodensification group. The overall RoB for the NRSIs was reported to be low with respect to confounding, selection, classification, incomplete data, deviance from interventions, outcome evaluation, and selective reporting. The quality assessment of the RCT studies included in the review using the RoB 2 tool showed a high overall risk. The findings of the current review reveal that osseodensification drilling exhibited higher resonance frequency analysis (RFA) and ISQ values than conventional drilling protocols. Similarly, when osseodensification regions were contrasted with traditional drilling, bone density at the implant surface was augmented.
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Affiliation(s)
| | | | | | | | - Mohamed M AboShetaih
- Oral and Maxillofacial Surgery, Dental Sector, Ministry of Health, Dakahlia Governorate, Mansoura, EGY
| | | | - Ahmed M Saaduddin
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura, EGY
- Division of Oral and Maxillofacial Surgery, Department of Clinical Dental Sciences, Dentistry Program, Batterjee Medical College, Jeddah, SAU
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Witek L, Parente PEL, Torroni A, Greenberg M, Nayak VV, Hacquebord JH, Coelho PG. Evaluation of instrumentation and pedicle screw design for posterior lumbar fixation: A pre-clinical in vivo/ex vivo ovine model. JOR Spine 2023; 6:e1245. [PMID: 37361331 PMCID: PMC10285755 DOI: 10.1002/jsp2.1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/10/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023] Open
Abstract
Background Stabilization procedures of the lumbar spine are routinely performed for various conditions, such as spondylolisthesis and scoliosis. Spine surgery has become even more common, with the incidence rates increasing ~30% between 2004 and 2015. Various solutions to increase the success of lumbar stabilization procedures have been proposed, ranging from the device's geometrical configuration to bone quality enhancement via grafting and, recently, through modified drilling instrumentation. Conventional (manual) instrumentation renders the excavated bony fragments ineffective, whereas the "additive" osseodensification rotary drilling compacts the bone fragments into the osteotomy walls, creating nucleating sites for regeneration. Methods This study aimed to compare both manual versus rotary Osseodensification (OD) instrumentation as well as two different pedicle screw thread designs in a controlled split animal model in posterior lumbar stabilization to determine the feasibility and potential advantages of each variable with respect to mechanical stability and histomorphology. A total of 164 single thread (82 per thread configuration), pedicle screws (4.5 × 35 mm) were used for the study. Each animal received eight pedicles (four per thread design) screws, which were placed in the lumbar spine of 21 adult sheep. One side of the lumbar spine underwent rotary osseodensification instrumentation, while the contralateral underwent conventional, hand, instrumentation. The animals were euthanized after 6- and 24-weeks of healing, and the vertebrae were removed for biomechanical and histomorphometric analyses. Pullout strength and histologic analysis were performed on all harvested samples. Results The rotary instrumentation yielded statistically (p = 0.026) greater pullout strength (1060.6 N ± 181) relative to hand instrumentation (769.3 N ± 181) at the 24-week healing time point. Histomorphometric analysis exhibited significantly higher degrees of bone to implant contact for the rotary instrumentation only at the early healing time point (6 weeks), whereas bone area fraction occupancy was statistically higher for rotary instrumentation at both healing times. The levels of soft tissue infiltration were lower for pedicle screws placed in osteotomies prepared using OD instrumentation relative to hand instrumentation, independent of healing time. Conclusion The rotary instrumentation yielded enhanced mechanical and histologic results relative to the conventional hand instrumentation in this lumbar spine stabilization model.
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Affiliation(s)
- Lukasz Witek
- Biomaterials DivisionNew York University College of DentistryNew YorkNew YorkUSA
- Department of Biomedical EngineeringNew York University Tandon School of EngineeringBrooklynNew YorkUSA
| | | | - Andrea Torroni
- Hansjörg Wyss Department of Plastic SurgeryNew York University School of MedicineNew YorkNew YorkUSA
| | - Michael Greenberg
- Biomaterials DivisionNew York University College of DentistryNew YorkNew YorkUSA
| | - Vasudev Vivekanand Nayak
- Biomaterials DivisionNew York University College of DentistryNew YorkNew YorkUSA
- Department of Mechanical and Aerospace EngineeringNew York University Tandon School of EngineeringBrooklynNew YorkUSA
| | - Jacques Henri Hacquebord
- Hansjörg Wyss Department of Plastic SurgeryNew York University School of MedicineNew YorkNew YorkUSA
- Department of Orthopedic SurgeryNew York University School of MedicineNew YorkNew YorkUSA
| | - Paulo G. Coelho
- Division of Plastic Surgery, Department of SurgeryUniversity of Miami Miller School of MedicineMiamiFloridaUSA
- Department of Biochemistry and Molecular BiologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
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de Carvalho Formiga M, da Silva HDP, Ghiraldini B, Siroma RS, Ardelean LC, Piattelli A, Shibli JA. Effects of Osseodensification on Primary Stability of Cylindrical and Conical Implants-An Ex Vivo Study. J Clin Med 2023; 12:jcm12113736. [PMID: 37297938 DOI: 10.3390/jcm12113736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
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.
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Affiliation(s)
- Márcio de Carvalho Formiga
- Department of Periodontology and Oral Implantology, Unisul, Palhoça, 515 Felipe Schmidt Str., Florianopolis 88101-001, SC, Brazil
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Helio Doyle Pereira da Silva
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Bruna Ghiraldini
- Dental Research Division, Paulista University, 303 Borges de Figueiredo Str., São Paulo 03110-010, SP, Brazil
| | - Rafael Shinoske Siroma
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Lavinia Cosmina Ardelean
- Department of Technology of Materials and Devices in Dental Medicine, Faculty of Dental Medicine, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, 332 Viale Abruzzo Str., 66100 Chieti, Italy
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
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Elghobashy MTM, Shaaban AM, Melek LNF. Radiographic comparison between Densah burs and osteotome for graftless internal sinus lifting with simultaneous implant placement: a randomized clinical trial. Int J Oral Maxillofac Surg 2023; 52:388-395. [PMID: 35840446 DOI: 10.1016/j.ijom.2022.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
Implant placement in the posterior maxilla is not an easy procedure, not only due to the low quality of bone, but also the physiological pneumatization, which decreases the remaining bone height to the maxillary sinus. Sinus lifting is an alternative for implant placement in these cases. The aim of this study was to radiographically compare the effect of Densah densifying burs versus osteotome in transcrestal sinus lifting. Twelve patients with missing premolars or molars and limited residual bone height were enrolled in the study and divided equally (by coin toss) into two groups: group A underwent densifying bur sinus lifting and group B underwent osteotome sinus lifting. Follow-up was performed over 6 months. Bone density (measured around the implant and at the implant apex) and bone height gain (measured using three reference points across the implant length) were measured using OnDemand 3D software. Bone density around the implant was found to be significantly higher for the densifying burs (P = 0.010); however, no significant difference in bone height gain (P = 0.985) or apical bone density (P = 0.337) was detected between the two groups. Densifying burs significantly improved bone density around dental implants, but did not prove to provide a significantly higher bone height gain or apical density compared to osteotomes in graftless internal sinus lifting. TRIAL REGISTRATION NUMBER: Clinical trial.gov registration ID #NCT04688957.
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Affiliation(s)
- M T M Elghobashy
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - A M Shaaban
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - L N F Melek
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Bandela V, Shetty N, Munagapati B, Basany RB, Kanaparthi S. Comparative Evaluation of Osseodensification Versus Conventional Osteotomy Technique on Dental Implant Primary Stability: An Ex Vivo Study. Cureus 2022; 14:e30843. [DOI: 10.7759/cureus.30843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
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Comparative evaluation of implant stability using bone expanders and conventional osteotomy. J Oral Biol Craniofac Res 2022; 12:885-889. [DOI: 10.1016/j.jobcr.2022.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/24/2022] [Accepted: 08/28/2022] [Indexed: 10/31/2022] Open
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Frizzera F, Spin-Neto R, Padilha V, Nicchio N, Ghiraldini B, Bezerra F, Marcantonio E. Effect of osseodensification on the increase in ridge thickness and the prevention of buccal peri-implant defects: an in vitro randomized split mouth pilot study. BMC Oral Health 2022; 22:233. [PMID: 35698117 PMCID: PMC9195241 DOI: 10.1186/s12903-022-02242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implant installation with conventional drilling can create buccal bone defects in areas of limited ridge thickness. Implant installation with osseodensification may aid in preventing buccal bone defects in these situations. This in vitro pilot study evaluated the impact of osseodensification on the increase in alveolar ridge thickness and the prevention of buccal peri-implant defects. METHODS Ten fresh pig mandibles with limited bone thickness were selected for use in an experimental randomized split mouth pilot study. Two site-preparation protocols were used: conventional drilling with cutting burs (CTL, n = 10) and osseodensification with Densah® burs (OD, n = 10). After implant bed preparation, 20 implants (4.5 × 10 mm) were placed in the prepared sites and the insertion torque was recorded. Clinical and photographic analysis evaluated ridge thickness and the extent (height, width, and area) of bone defects in the buccal and lingual bone walls following implant placement. Three-dimensional measurements were performed using STL files to analyze the increase in buccal ridge thickness following site preparation and implant placement. The height of the buccal bone defect was considered as the primary outcome of this study. Defect width, area, implant insertion torque, and linear buccal ridge increase after implant site preparation and installation were also assessed. Non-parametric evaluations were carried out with the Mann-Whitney test to verify intergroup differences. RESULTS There was no statistically significant difference between groups in the baseline ridge thickness. OD presented a significantly higher insertion torque, associated with reduced buccal and lingual bone defect width, in comparison to CTL. CONCLUSIONS The increase in buccal ridge thickness after site preparation and implant placement was significantly higher in OD compared to CTL. Osseodensification increased the ridge thickness through expansion and reduced buccal bone defects after implant installation.
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Affiliation(s)
| | - Rubens Spin-Neto
- Aarhus University, Department of Dentistry and Oral Health, Aarhus, Denmark
| | - Victor Padilha
- Brazilian Dental Association at Espírito Santo, Serra, Brazil
| | - Nicolas Nicchio
- São Paulo State University (UNESP), School of Dentistry, Department of Diagnostic and Surgery, Araraquara, Brazil
| | - Bruna Ghiraldini
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - Fábio Bezerra
- São Paulo State University (UNESP), Department of Chemical and Biological Sciences, Institute of Biosciences, Botucatu, Brazil
| | - Elcio Marcantonio
- São Paulo State University (UNESP), School of Dentistry, Department of Diagnostic and Surgery, Araraquara, Brazil
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de Carvalho Formiga M, Grzech-Leśniak K, Moraschini V, Shibli JA, Neiva R. Effects of Osseodensification on Immediate Implant Placement: Retrospective Analysis of 211 Implants. MATERIALS 2022; 15:ma15103539. [PMID: 35629566 PMCID: PMC9147081 DOI: 10.3390/ma15103539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 01/14/2023]
Abstract
Osseodensification is a new method of bone instrumentation for dental implant placement that preserves bulk bone and increases primary implant stability, and may accelerate the implant rehabilitation treatment period and provide higher success and survival rates than conventional methods. The aim of this retrospective study was to evaluate and discuss results obtained on immediate implant placement with immediate and delayed loading protocols under Osseodensification bone instrumentation. This study included private practice patients that required dental implant rehabilitation, between February 2017 and October 2019. All implants were placed under Osseodensification and had to be in function for at least 12 months to be included on the study. A total of 211 implants were included in the study, with a 98.1% total survival rate (97.9% in the maxilla and 98.5% in the mandible). For immediate implants with immediate load, 99.2% survival rate was achieved, and 100% survival rate for immediate implant placement without immediate load cases. A total of four implants were lost during this period, and all of them were lost within two months after placement. Within the limitations of this study, it can be concluded that Osseodensification bone instrumentation provided similar or better results on survival rates than conventional bone instrumentation.
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Affiliation(s)
| | - Kinga Grzech-Leśniak
- Laser Laboratory Oral Surgery Department, Medical University of Wroclaw, 50-425 Wroclaw, Poland;
| | - Vittorio Moraschini
- Department of Periodontology, Veiga de Almeida University, Rio de Janeiro 20271-020, Brazil;
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos 07023-040, Brazil
- Correspondence:
| | - Rodrigo Neiva
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
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Alhayati JZ, Al-Anee AM. Evaluation of crestal sinus floor elevations using versah burs with simultaneous implant placement, at residual bone height ≥ 2.0 _ < 6.0 mm. A prospective clinical study. Oral Maxillofac Surg 2022:10.1007/s10006-022-01071-0. [PMID: 35567659 DOI: 10.1007/s10006-022-01071-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the efficacy of Versah drills in breaching the maxillary sinus floor while keeping the membrane intact, as well as measure the implant stability (primary stability at the time of implant placement by the osseous densification of the residual bone height (RBH) of ≥ 2.0 _ < 6.0 mm, and secondary stability after 6 months of osseous healing period). METHODS This prospective clinical study, which included twenty crestal sinus floor elevations, was conducted on 17 patients (10 males and 7 females, ages 29 to 70 years). The sinus membrane integrity was clinically checked at the time of osseodensification sinus lifting and confirmed by CBCT after sinus augmentation and implant insertion. Time of operation has been recorded from the first drill to implant installation. Primary implant stability was measured using an Osstell beacon at the time of implant placement, and secondary stability was measured after 6 months of osseous healing. RESULTS The mean of secondary stability in the current study is significantly higher than the mean of primary stability (P ≤ 0.011), which was 74.22 ± 8.11 and 69.85 ± 9.74, respectively, in RBH 3.81 mm as a mean. There was no clinical evidence of membrane perforation or complication reports, and the average operation time was 11.2 ± 1.85 min. CONCLUSION The current study found that at highly atrophic posterior maxilla with a residual bone height of ≥ 2.0 _ < 6.0 mm, osseodensification using Versah drills was effective in crestal sinus elevation with no membrane perforation, which was confirmed by cone-beam CT scan postoperatively, and showed higher primary and secondary implant stability.
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Affiliation(s)
- Jenna Z Alhayati
- Department of Oral & Maxillofacial Surgery/Dental Implant Unit, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Auday M Al-Anee
- Department of Oral & Maxillofacial Surgery/Dental Implant Unit, College of Dentistry, University of Baghdad, Baghdad, Iraq. .,Oral & Maxillofacial Surgery, Medical City, Al-Shaheed Gazi Alhariri Teaching Hospital for Specialized Surgeries, Baghdad, Iraq.
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Cochran DL, Jones AA, Sugita R, Brown MC, Prasad H, Kay GW. Twelve Month Evaluation of a Novel Mineral Organic Adhesive Material Used to Stabilize Dental Implants Placed in Oversized Osteotomies in Vivo in an Animal Model. Clin Oral Implants Res 2022; 33:391-404. [PMID: 35132693 DOI: 10.1111/clr.13899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate long-term in vivo stability of dental implants stabilized at time of placement in oversized osteotomies with a novel, self-setting, mineral-organic bone adhesive. MATERIALS/METHODS Canine (26) mandibular teeth were removed, and 3 oversized osteotomies prepared bilaterally. Implants were placed with either adhesive, particulate xenograft or with blood clot filling the implant/osteotomy gaps. Removal torque and histology were assessed. RESULTS The adhesive provided significant and clinically relevant immediate implant stability of 22.2N-cm (95%CI 5.3; 39.0) which continued throughout the early postoperative course and persisted through the nine- (155N-cm 95%CI 113; 197) and twelve-month (171N-cm 95%CI 134.2; 209.4) time points. This is in comparison to the blood clot of 1.4N-cm (95%CI 0.7; 2.1), 128.6N-cm (95%CI 66.8; 190.4), and 140.7N-cm (95%CI 78.8; 202.5) and particulate xenograft, 1.3N-cm (95%CI 0.6; 2.0), 132.1N-cm (95%CI 94.5; 169.7), and 101.5 (95%CI 59.5; 143.5) respectively. Histological examination shows the adhesive establishes intimate contact with the implant and bony walls and is replaced with new bone without compromising stability. Soft tissue does not penetrate the adhesive and marginal bone/biomaterial level is maintained. Control sites filled with xenograft or blood clot heal with reduced bone levels and, in some cases, xenograft particles were encapsulated in connective tissue. CONCLUSIONS Implants placed in oversized osteotomies and lacking primary stability can be stabilized at placement with a novel, highly osteoconductive and resorbable adhesive. Gradual replacement of the biomaterial allows osseointegration without loss of stability through 12 months of follow-up. This novel adhesive has the potential to stabilize implants placed in sites with inadequate bony support.
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Affiliation(s)
- David L Cochran
- Department of Periodontics, UT Health Science Center, San Antonio, TX, USA
| | - Archie A Jones
- Department of Periodontics, UT Health Science Center, San Antonio, TX, USA
| | - Ryushiro Sugita
- Department of Periodontics, UT Health Science Center, San Antonio, TX, USA
| | | | - Hari Prasad
- Hard Tissue Research Laboratory, University of Minnesota, Minneapolis, Minnesota, USA
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CARDOZO CGT, CARDOSO JDM, ZACHARÍAS AD, FONTÃO FNGK, OLIVEIRA GJPLD, MARCANTONIO JUNIOR E. Comparação da expansão óssea promovida pela técnica de osseodensificação com dois tipos de conjunto de fresas. REVISTA DE ODONTOLOGIA DA UNESP 2022. [DOI: 10.1590/1807-2577.04422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo Introdução A estabilidade primária é um importante indicador de sucesso da osseointegração. Porém, fatores locais com osso de baixa intensidade podem interferir negativamente na obtenção da estabilidade primária. Objetivo O presente estudo avaliou o efeito de diferentes direções, velocidades de rotação e sistemas de fresagem na expansão de perfurações e estabilidade de implantes instalados em blocos mimetizando osso do tipo IV. Material e método Foram instalados 50 implantes em blocos de poliuretano sólido rígido. Esses implantes foram igualmente divididos em cinco grupos (n = 10): 1) Fresa Maximus (utilizadas no sentido horário a 1200rpm); 2) Fresa Maximus (utilizadas no sentido horário a 600rpm); 3) Fresa Neodent (utilizadas no sentido horário a 800rpm); 4) Fresa Neodent (utilizadas no sentido anti-horário a 800rpm); 5) Fresa Neodent (utilizadas no sentido anti-horário a 600rpm). Foram executadas análises de estabilidade dos implantes através de testes de torque de inserção e remoção, além das análises de frequência de ressonância. Adicionalmente, a expansão associada às perfurações promovida pelas brocas foi avaliada por meio de análises tomográficas. Resultado Verificou-se que os implantes instalados após o preparo da perfuração com as brocas Maximus a 600rpm apresentaram valores de torque de inserção maiores, quando comparados ao grupo de implantes instalados em perfurações confeccionadas com brocas Neodent. Ademais, as brocas Maximus apresentaram valores de expansão maiores que as brocas Neodent. Conclusão As brocas Maximus são mais eficientes em promover a osseodensificação, e sua utilização está associada ao aumento da estabilidade dos implantes instalados em blocos mimetizando osso do tipo IV.
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Affiliation(s)
| | | | | | | | | | - Elcio MARCANTONIO JUNIOR
- Instituto Latino-Americano de Pesquisa Odontológica, Brasil; Universidade Estadual Paulista “Júlio de Mesquita Filho”, Brasil
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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. PLoS One 2021; 16:e0257985. [PMID: 34618848 PMCID: PMC8496820 DOI: 10.1371/journal.pone.0257985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/14/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives The 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 methods Four 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. Results Differences 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. Conclusions Undersized 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.
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Inchingolo AD, Inchingolo AM, Bordea IR, Xhajanka E, Romeo DM, Romeo M, Zappone CMF, Malcangi G, Scarano A, Lorusso F, Isacco CG, Marinelli G, Contaldo M, Ballini A, Inchingolo F, Dipalma G. The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis. MATERIALS 2021; 14:ma14051147. [PMID: 33671038 PMCID: PMC7957527 DOI: 10.3390/ma14051147] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/11/2022]
Abstract
Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis—11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (I.R.B.); (F.L.); Tel.:+4-07-4491-9319 (I.R.B.); +39-087-1455-4100 (F.L.)
| | - Edit Xhajanka
- Department of Dental Prosthesis, University of Tirana, Nr 183 Tirana, Albania;
| | - Donato Mario Romeo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Mario Romeo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Carlo Maria Felice Zappone
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (I.R.B.); (F.L.); Tel.:+4-07-4491-9319 (I.R.B.); +39-087-1455-4100 (F.L.)
| | - Ciro Gargiulo Isacco
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Human Stem Cells Research Center HSC of Ho Chi Minh, Ho Chi Minh 70000, Vietnam
- Embryology and Regenerative Medicine and Immunology, Pham Chau Trinh University of Medicine Hoi An, Hoi An 70000, Vietnam
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy;
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario “Ernesto Quagliariello” University of Bari “Aldo Moro”, 70125 Bari, Italy;
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
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Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238623] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: This study aims to analyze bone compaction and osseodensification techniques and to investigate how cancellous bone compaction could influence primary implant stability (PS). Methods: Two different surgical protocols (bone compactors—BC; osseodensification drills—OD) were compared by placing 20 implants into 20 fresh pig ribs for each procedure. Peak insertion torque (PIT) and peak removal torque (PRT) were investigated using an MGT-12 digital torque gauge, and implant stability quotient (ISQ) was analyzed using an Osstell® Beacon device. Results: Analysis of our data (T-test p < 0.05) evidenced no statistically significant difference between BC and OD in terms of PIT (p = 0.33) or ISQ (p = 0.97). The comparison of PRT values showed a statistically significant difference between BC and OD protocols (p = 0.009). Conclusions: Cancellous bone compaction seems to improve PS, preserving a significant amount of bone and evenly spreading trabeculae on the entire implant site. While the PIT and ISQ values obtained are similar, the PRT values suggest different physical responses from the surrounding bone tissue. Nevertheless, a larger sample and further in vivo studies are necessary to validate the usefulness of BC protocol in several clinical settings.
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Brum JR, Macedo FR, Oliveira MB, Paranhos LR, Brito-Júnior RB, Ramacciato JC. Assessment of the stresses produced on the bone implant/tissue interface to the different insertion angulations of the implant - a three-dimensional analysis by the finite elements method. J Clin Exp Dent 2020; 12:e930-e937. [PMID: 33154794 PMCID: PMC7600206 DOI: 10.4317/jced.57387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/02/2020] [Indexed: 11/29/2022] Open
Abstract
Background The present study aimed to assess the stresses produced on the surface of the bone tissue around dental implants with three different insertion angulations subjected to axial and oblique loading.
Material and Methods The study was created according to the recommendations of the Checklist for Reporting In-vitro Studies (CRIS). The Straumann™ bone level RC (4.1 x 10 mm) implant, Cone Morse connection (CM), RC Straumann Variobase™ with abutment (3.5 mm) was placed in the region of element 16, with the platform positioned at the height of the bone crest. Three assessment models were produced: model M1 or control - implant perpendicular to the bone crest; model M2 - implant angulated at 17° relative to the bone crest; and model M3 - implant angulated at 30° relative to the bone crest. The masticatory loads were simulated with 100 N of intensity and two loading patterns (axial and oblique) were applied to each model. Then, the models were exported to the finite elements simulation software Ansys Workbench V19.2 (Ansys Inc., Canonsburg, PA, USA). To assess the finite elements, qualitative and quantitative analyses were performed.
Results It was observed that, under axial loading, qualitatively, the peaks occurred in the cavosurface region, palatal aspect in M1 and M2, and buccal aspect in M3. Quantitatively, the greatest angulation resulted in a low stress peak. Under oblique loading, qualitatively, the peaks occurred in the cavosurface region, buccal aspect in the three groups. Quantitatively, the greatest angulation of the implant resulted in an increase in stress peaks on the buccal aspect.
Conclusions Under axial loading, the three insertion angulations of the implant - M1, M2, and M3 - were clinically viable. When subjected to oblique loading, the 30° angulation (M3) suggested a significant risk of bone loss and it was contraindicated. Key words:Finite element analysis, dental implants, load support.
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Affiliation(s)
| | | | - Millena-Barroso Oliveira
- DDs, Post-Graduation Program in Dentistry, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil
| | - Luiz-Renato Paranhos
- DDs, MSc, PhD, Department of Community and Preventive Dentistry, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil
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Gaikwad AM, Joshi AA, Nadgere JB. Biomechanical and histomorphometric analysis of endosteal implants placed by using the osseodensification technique in animal models: A systematic review and meta-analysis. J Prosthet Dent 2020; 127:61-70. [PMID: 33139057 DOI: 10.1016/j.prosdent.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Osseodensification, a counterclockwise drilling technique for the placement of endosseous implants is a popular clinical technique. However, the effect of the osseodensification technique on primary implant stability, bone-implant contact, and bone area frequency occupancy is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification technique in animal models. MATERIAL AND METHODS An electronic search through Medline/PubMed, Lilacs, and Science Direct databases, and an additional manual search of the reference list of included articles was conducted by using specific keywords and Medical Subject Headings (MeSH) terms for articles in the English language and published up to April 31, 2020. Only animal studies comparing the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification and conventional drilling protocol were included. The SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using Animal Research: Reporting in Vivo Experiments (ARRIVE) guidelines. RESULTS Nine studies were included. The results of the meta-analysis showed that the pooled weighted mean difference of the insertion torque value for the primary implant stability of endosseous dental implants placed by using the osseodensification technique was 2.270 (95% confidence interval [CI]=1.147 to 3.393; P<.001), the weighted mean difference of the percentage of bone-implant contact at 3 weeks was 0.487 (95% CI=0.220 to 0.754; P=.114), the weighted mean difference of the percentage of bone-implant contact at 6 weeks was 0.565 (95% CI=0.219 to 0.911; P=.448), the weighted mean difference of the percentage of bone area frequency occupancy at 3 weeks was 0.679 (95% CI=0.265 to 1.093; P=.073), and the weighted mean difference of the percentage of bone area frequency occupancy at 6 weeks was 0.391 (95% CI=-0.204 to 0.986; P=.027). CONCLUSIONS Limited data from animal studies suggest that the primary implant stability, bone-implant contact, and bone area frequency occupancy significantly improved for the endosteal implants placed by using the osseodensification technique compared with conventional drilling protocol. However, additional laboratory and clinical studies are recommended to provide stronger evidence.
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Affiliation(s)
- Amit M Gaikwad
- Assistant Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India.
| | - Amruta A Joshi
- Tutor, Department of Periodontics, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Jyoti B Nadgere
- Professor and HOD, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Coyac BR, Salvi G, Leahy B, Li Z, Salmon B, Hoffmann W, Helms JA. A novel system exploits bone debris for implant osseointegration. J Periodontol 2020; 92:716-726. [PMID: 32829495 DOI: 10.1002/jper.20-0099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Bone debris generated during site preparation is generally evacuated with irrigation; here, we evaluated whether retention of this autologous material improved the rate of peri-implant bone formation. METHODS In 25 rats, a miniature implant system composed of an osseo-shaping tool and a tri-oval-shaped implant was compared against a conventional drill and round implant system. A split-mouth design was used, and fresh extraction sockets served as implant sites. Histology/histomorphometry, immunohistochemistry, and microcomputed tomography (μCT) imaging were performed immediately after implant placement, and on post-surgery days 3, 7, 14, and 28. RESULTS Compared with a conventional drill design, the osseo-shaping tool produced a textured osteotomy surface and viable bone debris that was retained in the peri-implant environment. Proliferating osteoprogenitor cells, identified by PCNA and Runx2 expression, contributed to faster peri-implant bone formation. Although all implants osseointegrated, sites prepared with the osseo-shaping tool showed evidence of new peri-implant bone sooner than controls. CONCLUSION Bone debris produced by an osseo-shaping tool directly contributed to faster peri-implant bone formation and implant osseointegration.
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Affiliation(s)
- Benjamin R Coyac
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Giuseppe Salvi
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Brian Leahy
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Zhijun Li
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA.,Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Benjamin Salmon
- Dental Medicine Department, Bretonneau Hospital, Montrouge, France, University of Paris, Paris, France
| | | | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
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Hindi AR, Bede SY. The effect of osseodensification on implant stability and bone density: A prospective observational study. J Clin Exp Dent 2020; 12:e474-e478. [PMID: 32509230 PMCID: PMC7263779 DOI: 10.4317/jced.56727] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 02/24/2020] [Indexed: 01/08/2023] Open
Abstract
Background The aims of this study were to evaluate the effect of implant site preparation in low-density bone using osseodensification method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT.
Material and Methods This prospective observational clinical study included 24 patients who received 46 dental implants that were installed in low-density bone using the osseodensification method. CBCT was used to measure the bone density pre- and postoperatively and implant stability was measured using Periotest® immediately after implant insertion and then after 6 weeks and 12 weeks postoperatively. The data were analyzed using paired t-test and the probability value <0.05 was considered statistically significant.
Results Of the 46 implants, 43 were osseointegrated making the early survival of the implants 93.5%. There was a significant increase in bone density postoperatively; 337.6 ±182.9 compared to 265.3 ±173.9 Hounsfield units preoperatively. The primary implant stability was -2.7 ± 2.13 Periotest values (PTV), at the 6th week it decreased significantly (p<0.0001) to become 0.7 (± 4) PTV, and at the 12th week (secondary stability) it increased significantly (p<0.0001) to become -2.1 (± 2.8) PTV. The difference between primary and secondary stability was statistically non-significant (p=0.0814).
Conclusions Osseodensification resulted in high primary stability and increased peri-implant bone density but it did not prevent the implant stability drop during the first 6 weeks after insertion of implants. Key words:Osseodensification, implant stability, low-density bone.
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Affiliation(s)
- Aseel R Hindi
- B.D.S. Department of Oral and Maxillofacial surgery, College of Dentistry, University of Baghdad Bab- Almoadham, Medical City, Baghdad, Iraq
| | - Salwan Y Bede
- B.D.S., F.I.B.M.S. Professor. Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Bagh-dad Bab- Almoadham, Medical City, Baghdad, Iraq
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Primary Stability of Three Different Osteotomy Techniques in Medullary Bone: An in Vitro Study. Dent J (Basel) 2020; 8:dj8010021. [PMID: 32098046 PMCID: PMC7148503 DOI: 10.3390/dj8010021] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/13/2022] Open
Abstract
Background: The aim of this in vitro study was to analyse the primary stability of 20 implants placed with Twist drills (TD) versus 20 implants placed with Summers osteotomes (SO) and 20 implants placed with B&B bone compactors (BC) in medullary bone (quality type III and type IV). Methods: The implants were placed in 10 fresh pig ribs fixed on a bench vice in order to avoid micro-movements during surgical procedures and measure recording. Peak insertion torque (PIT) and Peak removal torque (PRT) were recorded with MGT-12 digital torque gauge and ISQ was recorded through OSSTELL ISQ™ device by an independent operator. Results: Comparing our data (Tukey test p = 0.05), it was evidenced a statistically significant difference in the PIT between TD and BC groups (p = 0.01). Analysing ISQ data, there was a statistically significant difference between the TD and BC groups (p = 0.0001) and between the SO and BC groups (p = 0.014). The analysis of PRT evidenced a statistically significant difference between the TD and BC groups (p = 0.038). Conclusions: This study evidenced that bone compactor preparation can positively influence primary implant stability (PS), however further in vivo studies and a larger sample are necessary to assess the usefulness in several clinical settings.
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Under-Drilling versus Hybrid Osseodensification Technique: Differences in Implant Primary Stability and Bone Density of the Implant Bed Walls. MATERIALS 2020; 13:ma13020390. [PMID: 31952138 PMCID: PMC7013970 DOI: 10.3390/ma13020390] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 01/11/2023]
Abstract
The goal of this study was to evaluate the effects of two implant bed preparation techniques on the implant primary stability (IPS) and the bone density of the implant site. We completed 40 implant bed osteotomies in pig ribs using two techniques: osseodensification (OD) plus under-drilling (UD) with universal osseodensification drills (Test A), and under-drilling alone with drills of the same implant system (Test B). Implants with a 4.1 mm diameter and 10 mm length were inserted, and the IPS was evaluated with three methods: (insertion torque (IT), periotest (PTV), and resonance frequency analysis (RFA). The bone density was evaluated using micro-computed tomography. ANOVA and Tukey’s post-hoc test were used for comparison of the IPS values, and Kruskal–Wallis was used to evaluate the bone density. Statistical significance was set at p < 0.05. The tested B technique (UD) achieved a higher IPS compared to the Test A technique (OD + UD) for all the evaluation methods (p < 0.05). Bone density was higher at the apical and middle region in Test A compared to Test B and control sites (p < 0.05). We concluded that although the bone density increased with the hybrid OD technique with universal drills, implant beds prepared with UD using drills with geometry similar to that of the implant are more efficient at increasing IPS values.
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Padhye NM, Padhye AM, Bhatavadekar NB. Osseodensification -- A systematic review and qualitative analysis of published literature. J Oral Biol Craniofac Res 2019; 10:375-380. [PMID: 31737477 DOI: 10.1016/j.jobcr.2019.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/29/2019] [Indexed: 11/24/2022] Open
Abstract
The recently introduced technique of osseodensification for dental implant involves the use of special drills (Densah) run in a counter-clockwise direction at the osteotomy site. It is claimed that this causes expansion of the osteotomy site, and increases density of the bone in immediate vicinity of the osteotomy. We reviewed published papers on the primary stability attained using this drilling technique. As a secondary finding, the bone to implant contact (BIC) and the bone area fraction occupancy (BAF) was also compared between the conventional drilling protocol and the osseodensification protocol, among these articles. A Systematic search was performed in PubMed-Medline, Embase and Google Scholar for clinical/animal studies up to November 2018. A total of 12 articles, from a database of 132 articles, consisting of 8 animal histologic studies, 2 human based clinical studies, 1 case series and 1 case report were assessed. 10/12 articles measured the insertion torque values, 7/12 articles measured the BIC and 6/12 articles estimated the BAF between the two techniques. Quality assessment of 8 studies performed using ARRIVE guidelines showed that 6/8 studies had a high score. An average increase in the insertion torque, BIC and BAF was noted in the osseodensification group as compared to the conventional drilling group. Since most of these studies are non-clinical, it can be inferred that osseodensification is an efficient way to enhance primary stability of implants in low density bone in an animal model. However, extrapolation to long term clinical success cannot be ascertained until further evidence becomes available.
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Affiliation(s)
| | - Ashvini Mukul Padhye
- Professor & Head of Department of Periodontics, Mahatma Gandhi Mission's Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Neel B Bhatavadekar
- Clarus Dental Specialties, Pune. Adjunct Faculty, University of North Carolina at Chapel Hill, USA
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