Implant primary stability with an osteocondensation drilling protocol in different density polyurethane blocks

Fanali, S; Tumedei, Margherita; Pignatelli, Pamela; Inchingolo, Francesco; Pennacchietti, Paolo; Pace, Gianluca; Piattelli, Adriano

doi:10.1080/10255842.2020.1806251

Cited by 37 publications

(43 citation statements)

References 29 publications

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“…The osseodensification drill (OD) technique uses universal tapered drills (OD) that can operate in a clockwise or counterclockwise direction, cutting or expanding the trabecular bone. These drills used in a counterclockwise direction can produce an osseous densification all along the implant site, causing plastic bone compaction [3,16]. Recently, a manual osteotomy protocol was introduced by B&B dental implant (San Benedetto, BO, Italy), which uses customized manual bone compactors (BC) to improve bone density.…”

Section: Introductionmentioning

confidence: 99%

Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique

et al. 2020

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Background: This study aims to analyze bone compaction and osseodensification techniques and to investigate how cancellous bone compaction could influence primary implant stability (PS). Methods: Two different surgical protocols (bone compactors—BC; osseodensification drills—OD) were compared by placing 20 implants into 20 fresh pig ribs for each procedure. Peak insertion torque (PIT) and peak removal torque (PRT) were investigated using an MGT-12 digital torque gauge, and implant stability quotient (ISQ) was analyzed using an Osstell® Beacon device. Results: Analysis of our data (T-test p < 0.05) evidenced no statistically significant difference between BC and OD in terms of PIT (p = 0.33) or ISQ (p = 0.97). The comparison of PRT values showed a statistically significant difference between BC and OD protocols (p = 0.009). Conclusions: Cancellous bone compaction seems to improve PS, preserving a significant amount of bone and evenly spreading trabeculae on the entire implant site. Although the PIT and ISQ values obtained are similar, the PRT values suggest a better biological response from the surrounding bone tissue. Nevertheless, a larger sample and further in vivo studies are necessary to validate the usefulness of this protocol in several clinical settings.

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Section: Introductionmentioning

confidence: 99%

Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique

et al. 2020

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“…Nevertheless, this analysis has given us a global vision of the results obtained by the osseodensification technique and its possible use. In the literature, we can find sporadic case reports about osseodensification [ 77 , 78 , 79 ], and also in these cases, there is evidence about the efficacy of this technique [ 77 ]; instead, positive results have been observed in studies that compare the preparation technique for osseodensification and the conventional technique of implant preparation in blocks of polyurethane in several densities in which the innovating technique has been shown advantages especially in areas where the obtaining of good primary stability would have been harder [ 11 ]. Several alveolar preparation techniques have been described to increase the interface of the implant with surrounding bone [ 80 ] in order to improve the primary stability and the osseointegration outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…In this paper, we analyzed the osseodensification technique operating in the opposite rotatory direction than the conventional drills due to the use of different drills with an exclusive and patented design. Because of this technique, it is possible the bone condensing toward the osteotomy walls within the same surgery moment of the implant site preparation [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…The ISQ has no relation with the micromovements suffered by the implants [ 50 ], representing another factor to consider fromnthe beginning of the post-operation step because if it is higher than 50–100 µ, it may influence negatively the militainment of the implant stability [ 51 , 52 ]. Moreover, the insertion torque (IT) represents one of the most common clinical predictors for dental implant primary stability [ 11 , 14 , 15 , 53 , 54 ]. This value is correlated to the mechanical frictional relationships between the implant fixture and the surrounding bone during the device positioning.…”

Section: Introductionmentioning

confidence: 99%

“…This value is correlated to the mechanical frictional relationships between the implant fixture and the surrounding bone during the device positioning. The disadvantage of IT is represented by the non-repeatability of this measurement during the operative practice [ 11 , 53 ].…”

Section: Introductionmentioning

confidence: 99%

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The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis

Inchingolo

Bordea

et al. 2021

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Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis—11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.

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Evaluation of instrumentation and pedicle screw design for posterior lumbar fixation: A pre‐clinical in vivo/ex vivo ovine model

et al. 2023

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Background Stabilization procedures of the lumbar spine are routinely performed for various conditions, such as spondylolisthesis and scoliosis. Spine surgery has become even more common, with the incidence rates increasing ~30% between 2004 and 2015. Various solutions to increase the success of lumbar stabilization procedures have been proposed, ranging from the device's geometrical configuration to bone quality enhancement via grafting and, recently, through modified drilling instrumentation. Conventional (manual) instrumentation renders the excavated bony fragments ineffective, whereas the “additive” osseodensification rotary drilling compacts the bone fragments into the osteotomy walls, creating nucleating sites for regeneration. Methods This study aimed to compare both manual versus rotary Osseodensification (OD) instrumentation as well as two different pedicle screw thread designs in a controlled split animal model in posterior lumbar stabilization to determine the feasibility and potential advantages of each variable with respect to mechanical stability and histomorphology. A total of 164 single thread (82 per thread configuration), pedicle screws (4.5 × 35 mm) were used for the study. Each animal received eight pedicles (four per thread design) screws, which were placed in the lumbar spine of 21 adult sheep. One side of the lumbar spine underwent rotary osseodensification instrumentation, while the contralateral underwent conventional, hand, instrumentation. The animals were euthanized after 6‐ and 24‐weeks of healing, and the vertebrae were removed for biomechanical and histomorphometric analyses. Pullout strength and histologic analysis were performed on all harvested samples. Results The rotary instrumentation yielded statistically (p = 0.026) greater pullout strength (1060.6 N ± 181) relative to hand instrumentation (769.3 N ± 181) at the 24‐week healing time point. Histomorphometric analysis exhibited significantly higher degrees of bone to implant contact for the rotary instrumentation only at the early healing time point (6 weeks), whereas bone area fraction occupancy was statistically higher for rotary instrumentation at both healing times. The levels of soft tissue infiltration were lower for pedicle screws placed in osteotomies prepared using OD instrumentation relative to hand instrumentation, independent of healing time. Conclusion The rotary instrumentation yielded enhanced mechanical and histologic results relative to the conventional hand instrumentation in this lumbar spine stabilization model.

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Implant primary stability with an osteocondensation drilling protocol in different density polyurethane blocks

Cited by 37 publications

References 29 publications

Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique

Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique

The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis

Evaluation of instrumentation and pedicle screw design for posterior lumbar fixation: A pre‐clinical in vivo/ex vivo ovine model

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