Clockwise Osseodensification Technique For Primary Stability In Low-Density Bone.

The primary stability of dental implants plays a crucial role in early osseointegration, particularly in low-density bone (D3, D4). Conventional drilling techniques often struggle to achieve adequate stability in such conditions. This study compares the primary stability of implants placed using a clockwise osseodensification (OD) technique versus the standard drilling (SD) technique in low-density bone. Nine formalin-fixed cadaveric tibia bone samples were used. A total of 40 Osstem Taper TS III implants (Osstem®, Korea) were placed, with 20 sites assigned to the SD group and 20 to the OD group. All implant sites were prepared by a single surgeon using a standardized drilling sequence. Insertion torque (IT) was recorded using an implant motor (NSK™, Japan), and implant stability quotient (ISQ) values were measured immediately post-placement in four directions using Osstell® (W&H, Sweden). Cone-beam computed tomography (CBCT) was utilized to assess bone-implant contact in both groups. The OD group had a higher mean ISQ (67.54 ± 6.45) than the SD group (62.93 ± 9.29) (p = 0.077). Similarly, insertion torque was higher in the OD group (34.0 ± 6.6 Ncm) compared to the SD group (29.5 ± 7.59 Ncm) (p = 0.052) with no significant difference between groups (p<0.05). A moderate correlation (ρ = 0.414) was found between insertion torque and ISQ. While OD demonstrated a trend toward improved primary stability, differences were not statistically significant. Further research is needed to confirm its clinical benefits in low-density bone.