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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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Bettach R, Boukhris G, De Aza PN, da Costa EM, Scarano A, Fernandes GVO, Gehrke SA. New strategy for osseodensification during osteotomy in low-density bone: an in vitro experimental study. Sci Rep 2023; 13:11924. [PMID: 37488216 PMCID: PMC10366104 DOI: 10.1038/s41598-023-39144-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/20/2023] [Indexed: 07/26/2023] Open
Abstract
The goal of this in vitro study was to evaluate and propose a new strategy for osseodensification technique using a drill counterclockwise to densification of bone of low density. Synthetic bone blocks of two different low densities (type III and IV) were used for the tests. The conventional drilling group (CD group) used Turbo-drill in a clockwise direction, and the osseodensification group (OD group) applied Turbo-drill in a counterclockwise direction. The applied tests were: (i) measurement of the temperature variation (ΔT) and (ii) measurement of the torque during the osteotomies, comparing the new strategy with the conventional drilling. Both groups were tested without (condition c1) and with (condition c2) irrigation, generating four subgroups: CDc1, CDc2, ODc1, and ODc2. Twenty osteotomies were made for each subgroup with a thermocouple positioned intra-bone (1 mm distant from the osteotomy) to measure the temperature produced. Other 20 samples/group were used to measure the torque value during each osteotomy in both synthetic bone density blocks. The mean of the ΔT during the osteotomies in type III bone was: 6.8 ± 1.26 °C for the CDc1 group, 9.5 ± 1.84 °C for the ODc1, 1.5 ± 1.35 °C for the CDc2, and 4.5 ± 1.43 °C for ODc2. Whereas, in the type IV bone, the ΔT was: 5.2 ± 1.30 °C for the CDc1 group, 7.0 ± 1.99 °C for the ODc1, 0.9 ± 1.05 °C for the CDc2, and 2.7 ± 1.30 °C for ODc2. The maximum torque during the osteotomies was: 8.8 ± 0.97 Ncm for CD samples and 11.6 ± 1.08 Ncm for OD samples in the type III bone; and 5.9 ± 0.99 Ncm for CD samples and 9.6 ± 1.29 Ncm for OD samples in the type IV bone. Statistical differences between the groups were detected in tests and conditions analyzed (p < 0.05). Using the drill counterclockwise for osseodensification in low-density bone generated a significantly greater torque of a drill than in CD and temperature variation during osteotomies. However, the temperature range displayed by the OD group was below critical levels that can cause damage to bone tissue.
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Affiliation(s)
- Raphael Bettach
- Associate Professor et Department of Cariology and Comprehensive Care, New York University, New York, NY, 10010, USA
| | | | - Piedad N De Aza
- Instituto de Bioingenieria, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Eleani Maria da Costa
- Department of Materials Engineering, Pontificial Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100, Chieti, Italy
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, 11100, Montevideo, Uruguay
| | | | - Sergio Alexandre Gehrke
- , Paris, France.
- Department of Materials Engineering, Pontificial Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, 11100, Montevideo, Uruguay.
- Department of Biotechnology, Universidad Católica de Murcia (UCAM), Murcia, Spain.
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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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Yu X, Chang C, Guo W, Wu Y, Zhou W, Yu D. Primary implant stability based on alternative site preparation techniques: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:580-590. [PMID: 35950637 DOI: 10.1111/cid.13127] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the effect of special implant site preparation methods in improving primary implant stability in low-density bone. MATERIAL AND METHODS This meta-analysis included studies published in English and Mandarin Chinese up to March 31, 2022 from MEDLINE/PubMed, Embase, Scopus, and Wanfang databases. The primary stability of five site preparation methods were measured using implant stability quotient. The random-effects model was chosen for data analysis. Grading of recommendations assessment, development, and evaluation assessment was adopted as a collective grading of the overall body of evidence. RESULTS 12 of the 17 studies included in the meta-analysis were randomized control trials. Three studies investigated osseodensification drilling (OD), eight studies examined osteotome technique (OT), five studies explored piezosurgery (PS), and four studies were conducted on under-drilling (UD). Meta-analysis showed a statistically significant increase in primary stability for the OD (mean difference [MD], 10.25; 95% CI: 4.97-15.52; p < 0.001), OT (MD, 6.34; 95% CI: 2.26-10.42; p = 0.002), and UD (MD, 11.43; 95% CI: 5.17-17.68; p < 0.001) groups when compared to the conventional drilling group, while the PS group did not (MD, 1.50; 95% CI: -2.54-5.54; p = 0.47). CONCLUSION Significantly higher primary implant stability was shown in the OD, UD, and OT groups compared to the conventional drilling group. PS displayed the least favorable primary stability and when compared to conventional drilling, was not statistically significant.
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Affiliation(s)
- Xinbo Yu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Cheng Chang
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wennan Guo
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiqun Wu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Wenjie Zhou
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Dedong Yu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China.,Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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