To Drill or to Densify? Clinical Indications for the Use of Osseodensification

As highlighted in part 1 of this two-part article, primary mechanical stability in implant dentistry is considered a prerequisite for successful osseointegration. While many surgical techniques have been conceptualized with the goal of improving implant stability, osseodensification (OD) represents a novel method utilizing the accumulation of autogenous bone within the implant site via the compaction of cancellous bone, which has good viscoelastic and plastic deformation characteristics. The philosophy of this technique runs counter to that of conventional bone drilling in that healthy bone is maintained within the implant osteotomy, especially in regions where bone density is already compromised. This article focuses on the clinical indications of OD. Three cases are presented and include a lateral sinus augmentation procedure, a crestal sinus augmentation in combination with use of a synthetic bone putty, and a socket-shield technique in the esthetic zone. The aim of this article is to provide clinicians a better understanding of OD and methods to optimize the technique. It also highlights favorable clinical outcomes in cases where initial bone density has been compromised.