Comparison of Crestal Bone Loss and Implant Stability Among the Implants Placed With Conventional Procedure and Using Osteotome Technique: A Clinical Study

Abstract

To overcome the limitations of implant placement in knife-edge ridges, Summer introduced the osteotome technique in 1994. It has been claimed that using bone condensing to prepare the implant site in soft maxillary bone avoids the risk of heat generation, and implants can be placed precisely with increased primary stability. The purpose of this clinical study was to evaluate the crestal bone loss exhibited by the bone around early nonfunctionally loaded implants placed with conventional implant placement technique and with Summer's osteotome technique and to evaluate whether the bone-compression technique provides better primary stability than the conventional technique. A total of 10 Uniti implants were placed in the maxillary anterior region of 5 patients. One implant site was prepared using the conventional technique with drills (control group A), and second site was prepared using the osteotome technique (experimental group B) and an MIS bone compression kit. Resonance frequency measurements (RFMs) were made on each implant at the time of fixture placement and on the 180th day after implant fixture placement. The peri-implant alveolar bone loss was evaluated radiographically. Differences between the alveolar crest and the implant shoulder in radiographs were obtained immediately after implant insertion and on the 180th day after implant placement. The RFMs demonstrated a significantly higher stability of implants in control group A than in experimental group B on the day of surgery (P = .026). However, no statistically significant difference in stability was found between both groups on 180th day after implant placement (P = .076). A significant difference was found in the crestal bone levels after 180 days of surgery between two groups (P = 0) with less crestal bone loss with group A. Within the limitations of this study we concluded that the osteotome technique is good for the purpose for which it was introduced, that is, for knife-edge ridges, and it should not be considered a substitute for conventional procedures for implant placement.

Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review

“…They demonstrated a statistically significant higher primary stability for implants placed with osteotome technique than those placed with the conventional drilling technique in the maxillary anterior [49] and maxillary posterior regions [35], based on ISQ values ( P < 0.05). In contrast, Padmanabhan and Gupta [48], based on ISQ values, demonstrated a statistically significant higher primary stability for implants placed with conventional drilling technique than those placed with osteotome in the maxillary anterior region ( P < 0.05).…”

“…After screening the titles and abstracts (when available) independently by at least two review authors, 14 articles appeared to meet the inclusion criteria [11, 32, 37, 48–53, 55–59]. …”

“…Thus, a total of 9 clinical studies [11, 32, 48–53, 55] that met the inclusion criteria underwent quality assessment and data extraction.…”

“…A clinical observational study [48] compared conventional implant placement with osteotome technique to place 10 implants in maxillary anterior region. The implants were placed in the first quadrant using the conventional method (group A) and in the second quadrant using the osteotome technique (group B).…”

“…When evaluating what the impact of using the osteotome in implant bed preparation on primary and/or secondary implant stability is, only one RCT [49] and two clinical observational studies [48, 50] were selected. Shayesteh et al [49] and Marković et al [50] found positive association between using the osteotome technique and the primary implant stability.…”