A stepwise under-prepared osteotomy technique improves primary stability in shallow-placed implants: a preliminary...

Area of Science:

• Dental Implantology
• Oral Surgery
• Biomaterials Science

Background:

• Simultaneous vertical ridge augmentation (VRA) offers efficiency but can compromise implant primary stability (PS), especially with shallow placement.
• Existing research on improving PS during simultaneous VRA is limited, posing risks to implant prognosis.

Purpose of the Study:

• To investigate if tapered implants using a stepwise under-prepared osteotomy enhance PS in a shallow-placed implant model during simultaneous VRA.
• To compare the primary stability of tapered (BLT) and hybrid (BL) implants under standard and stepwise under-prepared osteotomy protocols.

Main Methods:

• In vitro study using polyurethane foam blocks with 80 osteotomies of varying depths (4-10 mm).
• Tapered (BLT) and hybrid (BL) implants were inserted using standard (S) or stepwise under-prepared (U) osteotomy protocols.
• Primary stability assessed via maximum insertion torque (IT), implant stability quotient (ISQ), and removal torque (RT).

Main Results:

• No significant differences in IT, ISQ, or RT between BLT-S and BL-S, or BLT-U and BL-U at 6 and 8 mm depths.
• The stepwise under-prepared osteotomy protocol (BLT-U) resulted in significantly greater IT compared to the standard protocol (BLT-S) across all depths.
• BLT-U demonstrated improved initial stability for tapered implants in a shallow-placed model.

Conclusions:

• A stepwise under-prepared osteotomy protocol effectively improves the initial stability of tapered implants, particularly in shallow placement scenarios.
• The BLT-U protocol presents a potentially valuable technique for enhancing implant prognosis in simultaneous VRA procedures.