Osseodensification in different-dimension dental implants: a split-mouth clinical study

Abstract Purpose. To compare the insertion torque (IT) and temporal implant-stability-quotients (ISQ) of different-dimension dental implants placed using subtractive drilling (SD) or osseodensification instrumentation (OD). Methods. Twenty-three patients with edentulous spaces received at least two implants. Narrow or regular-diameter implants, as well as short or regular-length implants, were placed in the anterior or posterior maxilla. A split-mouth model was used, with 105 implants placed. After osteotomies were performed following the manufacturer's recommendation, IT was recorded with a torque indicator, and ISQ with resonance-frequency-analysis was immediately performed after surgery and then weekly up to 6 weeks and at 10 weeks. IT data were analyzed using linear mixed models, while ISQ data were analyzed using repeated measures ANOVA and Tukey tests. Multivariate regression models were used to assess correlations between changes in IT, ISQ, and covariates. Results The study included 11 females and 12 males (mean age 60.5±14 years). Within the studied cohort, OD was associated with higher IT values than SD across the evaluated implant dimensions and sites. ISQ values were also higher in the OD group during the first 2 weeks. In multivariate regression, increased IT was correlated with implants placed in the anterior maxilla, regular diameter, and use of OD drilling. While the investigated factors did not affect the baseline ISQ value, an increased ISQ during the early healing process was correlated with implants placed in the anterior maxilla and the use of an OD bur. Conclusion. Within the limitations of this study, OD demonstrated higher IT and early ISQ values compared to SD, independent of implant dimension or surgical site. These findings suggest a potential impact of drilling technique on early implant stability within the study's parameters. Additional studies with larger and more diverse samples are needed to explore clinical relevance.