A Comparative Evaluation of Crestal Bone Loss around Implant Placed With Osseodensification versus Conventional Drilling: A Systematic Review

Abstract Introduction: Minimizing crestal bone loss is a critical factor for the long-term success and stability of dental implants. Conventional drilling techniques often result in bone removal, potentially compromising bone density around the implant site 1. In contrast, osseodensification—a novel technique using specially designed burs—aims to preserve and compact bone during osteotomy preparation. This systematic review was conducted to compare crestal bone loss around implants placed using osseodensification versus conventional drilling techniques. Methodology: A comprehensive literature search was performed in PubMed, Google Scholar, ScienceDirect, and Cochrane databases for studies published between January 2004 and May 2024. Additional manual searches were conducted in relevant journals and reference lists. Studies were selected based on predefined inclusion and exclusion criteria. Two independent reviewers screened the titles, abstracts, and full texts, and a third reviewer resolved any discrepancies. Data were extracted and analyzed qualitatively and quantitatively. Risk of bias was assessed using Cochrane ROB 2 for RCTs and Newcastle-Ottawa and Downs-Black tools for observational studies. Results: A total of 654 articles were initially identified. After removing duplicates and screening, 7 studies met the inclusion criteria and were included in the final review. Most studies reported reduced crestal bone loss in implants placed using osseodensification compared to conventional drilling, particularly during early healing and up to 12 months post-placement. Quantitative synthesis revealed a statistically significant reduction in mean crestal bone loss in the osseodensification group. Discussion: The findings suggest that osseodensification enhances primary stability and promotes bone preservation around the implant neck, likely due to bone compaction and improved bone-implant contact. However, variations in implant systems, follow-up periods, and measurement techniques among studies necessitate cautious interpretation. Despite some heterogeneity, the overall trend supports the clinical benefit of osseodensification in reducing crestal bone loss. Conclusion: Within the limitations of this systematic review, osseodensification appears to be a superior technique in minimizing crestal bone loss around dental implants when compared to conventional drilling. Further long-term, multicenter randomized controlled trials with standardized protocols are recommended to validate these findings.