CBCT fractal dimension changes at the apex of immediate implants placed using undersized drilling

Area of Science:

• Dental Implantology
• Oral Surgery
• Biomaterials Science

Background:

• Immediate implant placement in fresh extraction sockets is a common procedure.
• Achieving adequate primary stability is crucial for successful osseointegration.
• High insertion torque may influence peri-implant bone response.

Purpose of the Study:

• To assess bone quality changes around immediate implants placed with high insertion torque using an undersized drilling technique.
• To evaluate the fractal dimension of peri-implant bone using cone beam computed tomography (CBCT).

Main Methods:

• Three patients received single implants in the anterior maxilla with immediate provisionalization.
• Implants were placed using a 28.5% undersized osteotomy for high insertion torque.
• Bone quality was measured using CBCT fractal dimension at the apical 1.15 mm peri-implant bone at placement and 6 months.

Main Results:

• All implants were successful during an 18-month follow-up.
• A 3% increase in mean fractal dimension was observed at the implant apex after 6 months.

Conclusions:

• Undersized drilling and high insertion torque did not adversely affect radiographic bone quality at 6 months.
• Further studies with larger populations are required to optimize drilling undersizing for peri-implant bone remodeling.