Effect of different osteotome surgical protocols on primary implant stability in poor quality bone: an ex vivo study

To compare the effect of three types of surgical site preparation protocols on the primary stability of dental implants installed in poor quality bone. Pig tibia blocks were analyzed using X-ray microtomography to identify regions of poor bone quality like bone type IV, in which thirty osteotomies were performed using one of three techniques: conventional implant bed preparation (n = 10), undersized osteotomies (n = 10), and osteotomies prepared with expander-osteotomes (n = 10). The primary stability of the implants was evaluated using the final insertion torque and the implant stability quotient (ISQ). Statistical analysis included the Shapiro-Wilk test, One-way ANOVA, with Tukey's post-hoc and Pearson's correlation coefficient with a significance level of 5%. The undersized surgical technique obtained higher final insertion torque values (p < 0.05) and better results in terms of resonance frequency analysis values (p < 0.05). Pearson's correlation test showed a strong correlation between the variables (p < 0.05). According to the methodology used, the undersized surgical technique proved to be more advantageous in regions of low bone quality.