This study confirmed the hypothesis that the osseous densification technique would increase primary stability, bone mineral density, and the percentage of bone at the implant surface compared with drilling. By preserving bulk bone, it is hypothesized that the healing process will be accelerated due to the bone matrix, cells, and biochemicals that are maintained in situ and autografted along the surface of the osteotomy site. The healing response requires further study in vivo.

To evaluate the effectiveness and predictability of a novel biomechanical, minimally invasive bone instrumentation technique that enhances bone density through compaction grafting, called osseous densification, and allows for transcrestal sinus membrane elevation and augmentation with simultaneous implant placement. Materials and Methods: Patients who were consecutively treated with the bone densification and transcrestal sinus augmentation technique and were followed up in three treatment centers between May 2012 and September 2017 were included in this retrospective study. The summary statistics are presented as means for continuous variables and percentages for categorical variables. Results: In total, 222 patients with 261 implants were included in the final clinical analysis. The included follow-up period ranged from 6 to 64 months with a mean of 35 months. The subsinus residual bone height at baseline was 5.4 mm (SD: 1.9). Following the sinus augmentation, a significant vertical increase of 7 mm (SD: 2.49) was observed. No sinus membrane perforations and no late implant failures were observed from 6 up to 64 months follow-up, yielding a cumulative implant survival rate of 97%. Conclusion: This osseous densification technique for maxillary implant site preparation with transcrestal sinus augmentation and simultaneous implant placement led to favorable clinical outcomes with up to 64 months of follow-up.

Background Osseodensification (OD) has shown to improve implant stability; however, the influences of implant design, dimensions, and surgical site characteristics are unknown. Purpose To compare the insertion torque (IT) and temporal implant stability quotients (ISQ) of implants placed via OD or subtractive drilling (SD). Materials and Methods This multicenter controlled clinical trial enrolled 56 patients, whom were in need of at least 2 implants (n = 150 implants). Patients were treated with narrow, regular, or wide implants and short, regular, or long implants in the anterior or posterior region of the maxilla or in the posterior region of the mandible. Osteotomies were performed following manufacturers recommendation. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery, 3 and 6 weeks. Results Data complied as a function of osteotomy indicated significantly higher IT for OD relative to SD. OD outperformed conventional SD for all pairwise comparisons of arches (maxilla and mandible) and areas operated (anterior and posterior), diameters and lengths of the implants, except for short implants. Overall, ISQ data also demonstrated significantly higher values for OD compared to SD regardless of the healing period. Relative to immediate readings, ISQ values significantly decreased at 3 weeks, returning to immediate levels at 6 weeks; however, ISQ values strictly remained above 68 throughout healing time for OD. Data as a function of arch operated and osteotomy, area operated and osteotomy, implant dimensions and osteotomy, also exhibited higher ISQ values for OD relative to SD on pairwise comparisons, except for short implants. Conclusions OD demonstrated higher IT and temporal ISQ values relative to SD, irrespective of arch and area operated as well as implant design and dimension, with an exception for short implants. Future studies should focus on biomechanical parameters and bone level change evaluation after loading.

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