PurposeImplant beds with an insufficient amount of cortical bone or a loss of cortical bone can result in the initial instability of a dental implant. Thus, the objective of this study was to evaluate the effect of bone cement grafting on implant initial stability in areas with insufficient cortical bone.MethodsTwo different circumferential defect depths (2.5 mm and 5 mm) and a control (no defect) were prepared in six bovine rib bones. Fourteen implants of the same type and size (4 mm×10 mm) were placed in each group. The thickness of the cortical bone was measured for each defect. After the implant stability quotient (ISQ) values were measured three times in four different directions, bone cement was grafted to increase the primary stability of the otherwise unstable implant. After grafting, the ISQ values were measured again.ResultsAs defect depth increased, the ISQ value decreased. In the controls, the ISQ value was 85.45±3.36 (mean±standard deviation). In circumferential 2.5-mm and 5-mm defect groups, the ISQ values were 69.42±7.06 and 57.43±6.87, respectively, before grafting. These three values were significantly different (P<0.001). After grafting the bone cement, the ISQ values significantly increased to 73.72±8.00 and 67.88±10.09 in the 2.5-mm and 5.0-mm defect groups, respectively (P<0.05 and P<0.001). The ISQ value increased to more than double that before grafting in the circumferential 5-mm defect group. The ISQ values did not significantly differ when measured in any of the four directions.ConclusionsThe use of bone cement remarkably increased the stability of the implant that otherwise had an insufficient level of stability at placement, which was caused by insufficient cortical bone volume.Graphical Abstract

The aim of the present study was to compare bone-collecting capacity of bone harvesting device and minimally irrigated low-speed drilling using three implant systems. One bone harvesting device and three commercially available drill systems were compared using the osteotomies on bovine rib bones. The amount of the collected bone particle and particle size (<500 μm: small, 500–1000 μm: medium, and >1000 μm: large) were measured. Total wet (1.535 ± 0.232 mL) and dry volume (1.147 ± 0.425 mL) of the bone particles from bone harvesting device were significantly greater than three drill systems (wet volume: 1.225 ± 0.187–1.27 ± 0.29 mL and dry volume: 0.688 ± 0.163–0.74 ± 0.311 mL) (P < 0.05). In all groups, the amount of large sized particles in wet and dry state was the greatest compared to that of medium and small particles. The dry weight of the bone particles showed the same tendency to volumetric measurement. In conclusion, total bone particles and large sized particles (>1000 μm) were harvested significantly greater by bone harvesting device than minimally irrigated low-speed drilling. The composition of particle size in all harvesting methods was similar to each other.

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Schneiderian membrane perforation (SMP) is the most common complication during sinus floor elevation (SFE). Conventional methods to repair SMP, such as using a collagen barrier, may be clinically demanding. The aim of the present study was to compare the effects of collagenated bone substitute materials with and without a collagen barrier to repair SMP during SFE in terms of new bone formation and dimensional stability. In 12 rabbits, intentional SMP was made during bilateral SFE. The rabbits were randomly assigned under two groups: the control group, in which the sinus was repaired with a collagen barrier, and the test group, in which the sinus was repaired without a collagen barrier. Collagenated bone substitute material was grafted in both groups. Healing periods of 2 weeks and 4 weeks were provided in both groups. There were no adverse clinical events. Histology revealed that the Schneiderian membrane had atrophied with loss of cilia and serous glands in both groups at 4 weeks. Histomorphometry revealed that the newly formed bone (test: 0.42 ± 0.17 mm2, control: 0.36 ± 0.18 mm2 at 2 weeks; test: 1.21 ± 0.36 mm2, control: 1.23 ± 0.55 mm2 at 4 weeks) or total augmented area did not significantly differ between the two groups at either time points (p > 0.05). In conclusion, collagenated bone substitute material without a collagen barrier demonstrated similar new bone formation and dimensional stability as that with a collagen barrier in repairing SMP.