Effect of Osseodensification on Bone Density and Crestal Bone Levels: A Split-mouth Study

Dental implants have become a popular alternative in the oral and maxillofacial rehabilitation after the introduction of the concept of osseointegration. A poor density bone can negatively influence the bone to implant contact (BIC) and delay osseointegration. Various osteotomy techniques and drilling procedures have been used to increase stability in low-density bone. But they have been associated with limitations such as trauma to the surrounding bone and difficulty in controlling the technique. Osseodensification has recently been developed. Densifying burs are specifically designed burs which help in preserving the bone by condensing the bone by rotating in the noncutting direction.

Split-mouth study was conducted on a total of 10 patients wherein implants were placed in the same patient bilaterally in maxillary posterior region where the left maxillary posterior region received implants through sequential osteotomy technique and the right maxillary posterior region received implants through a series of new multifluted tapered burs (Densah™). A cone-beam computed tomography (CBCT) was taken preoperatively, immediately after implant placement, and 3 and 6 months after implant placement. The bone density and crestal bone levels were measured. Results were analyzed by student's paired "t" test and Man-Whitney U test.

There is no statistical difference between the levels of the crestal bone between an osseodensified site as compared to a conventional osteotomy site. The width of the residual bone increases after osseodensification and remains in the increased dimension for 3 months and continues at 6 months. Thus, it can be concluded that osseodensification leads to bone expansion.

The radiographic bone density adjacent to the implant is significantly increased after ossedensification and the bone there remains relatively dense over a period of 6 months aiding in a primary stability and eventual good osseointegration.