The effect of osseodensification drilling for endosteal implants with different surface treatments: A study in sheep

Abstract

This study investigated the effects of osseodensification drilling on the stability and osseointegration of machine‐cut and acid‐etched endosteal implants in low‐density bone. Twelve sheep received six implants inserted into the ilium, bilaterally (n = 36 acid‐etched, and n = 36 as‐machined). Individual animals received three implants of each surface, placed via different surgical techniques: (1) subtractive regular‐drilling (R): 2.0 mm pilot, 3.2 and 3.8 mm twist drills); (2) osseodensification clockwise‐drilling (CW): Densah Bur (Versah, Jackson, MI) 2.0 mm pilot, 2.8, and 3.8 mm multifluted tapered burs; and (3) osseodensification counterclockwise‐drilling (CCW) Densah Bur 2.0 mm pilot, 2.8 mm, and 3.8 mm multifluted tapered burs. Insertion torque was higher in the CCW and CW‐drilling compared to the R‐drilling (p < 0.001). Bone‐to‐implant contact (BIC) was significantly higher for CW (p = 0.024) and CCW‐drilling (p = 0.006) compared to the R‐drilling technique. For CCW‐osseodensification‐drilling, no statistical difference between the acid‐etched and machine‐cut implants at both time points was observed for BIC and BAFO (bone‐area‐fraction‐occupancy). Resorbed bone and bone forming precursors, preosteoblasts, were observed at 3‐weeks. At 12‐weeks, new bone formation was observed in all groups extending to the trabecular region. In low‐density bone, endosteal implants inserted via osseodensification‐drilling presented higher stability and no osseointegration impairments compared to subtractive regular‐drilling technique, regardless of evaluation time or implant surface. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 615–623, 2019.

Osseodensification effect on implants primary and secondary stability: Multicenter controlled clinical trial

“…Rather than removing bone particles in the more conventional SD techniques, it has been proposed that an OD drilling sequence will maintain bone by compacting the particles into the osteotomy wall 13,14 . Biomechanical and preclinical studies have indicated significantly higher biomechanical and histomorphometric parameters for OD relative to conventional SD in temporal investigations 14,17–21 . This clinical trial investigated the influence of both surgical instrumentation techniques, SD and OD, on IT and ISQ during the first 6 weeks of healing of implants with different diameters and lengths placed in the anterior and posterior regions of the maxilla and in the mandible.…”

“…Achieving high levels of biomechanical stability have been increasingly required in clinical practice to accommodate the current tendency toward early loading protocols, even for bone types with low density 31,32 . Therefore, the OD instrumentation has demonstrated to improve bone quality as osteotomy size is expanded and guarantee greater levels of physical interlocking at the implant interface, especially in such challenging scenarios 14,17–21 . Histomorphometric analyses of OD in preclinical animal models have exhibited an increased bone mineral density zone of approximately 1 mm circumferentially and apically to the osteotomy wall produced by compacted autograft particles that act as new bone formation nucleating sites, hastening osseointegration 14,17–21 .…”

Osseodensification Drilling vs. Standard Protocol of Implant Site Preparation: An In Vitro Study on Polyurethane Foam Sheets

“…The polyurethane sheet simulation provides a highly standardized design model for dental implant and drilling preparation techniques. In fact, several bone substrates have been proposed for in vitro implant studies such as bovine ribs, sheep mandible, pig tibiae and human cadaveric bones; however, local anatomical and density variability, environmental and sample temperature and humidity, as well as biological sample conservation represent potential limitations and determinant factors [5,27,[33][34][35][36][37][38][39][40][41].…”

Does the Osseodensification Technique Allow for the use of a Healing Chamber with Primary Stability in Low-Density Bone? An in Vivo Study

“…Therefore, the present study was designed to verify if the OD technique could be a viable approach for standardization of the healing chamber in low-density bone when using dental implants with a biomimetic surface. The ilium of a sheep was used as the animal model because this region is considered as a low-density bone 18,27,32 , and it was already used in other histomorphometric studies involving dental implants without the need to euthanize the animals 30 . The implants used in this study have a bioactive surface with nanostructured hydroxyapatite and the only difference between the groups was the instrumentation technique of the implantation bed.…”