Osseodensification of Dental Implants in Natural Bone and Artificial Material

Objectives: Implant placement in soft bone is associated with potential risk of failures. Therefore, improvement of bone quality and increase of implant stability may be fundamental for implant treatment success. Objective: The aim of this study was to evaluate in-vitro the effect of osseodensification (OD) technique using natural bone specimens and artificial bone simulant.
Methods: 60 implants (13mm/4.5mm, TSV, Zimmer- Biomet) were placed in porcine tibia head specimens (group A) and new artificial bone simulant (group B). Two methods of implant placement were used. The conventional technique (control) using the protocol recommended by the manufacturer and the Versah OD kit (test) with sequence of a pilot and 3 tapered drills (non-cutting mode) under copious saline irrigation. Implant stability was evaluated using the insertion torque (IT) and removal torque (RT) with a calibrated torque wrench and resonance frequency analysis with ISQ values using the Osstell device. Statistical comparison between A and B groups for test and control implants was performed using Friedman non-parametric-test with Dunn's multiple-comparison.
Results: The study presented a homogenous and consistent data for both group A and B osteotomies. The IT and RT values were higher in the test group than in the control group for group A (p<0.001) and group B (p<0.05) implants. No difference (p>0.05) in terms of IT, RT and ISQ values was found for both tested materials for all groups of implants. However, the ISQ values were higher in the test group than in the control group for group A (p<0.01) but not for the group B (p>0.05) implants.
Conclusions: The method of OD is a reliable technique for improvement of bone density at the bone-implant interface. Due to the elasticity and plasticity of the bone, the OD method increased significantly the implant stability. The new tested artificial bone simulant represented similarities to the natural bone.