A Comparison of Different Implant Site Preparation Techniques in Low-Density Bone: An Ex-Vivo Study

Osseointegration is considered a prerequisite for the long-term success of dental implants, and many researchers have considered the stability of the implant when placed in the bone. Many techniques include undersized drilling, densifying burs, magnetic mallets, and expanders. These methods have led to higher initial insertion torque values. The present study aims to evaluate the effectiveness of expanders, densifying burs, and magnetic mallet methods for preparing the implant site in low-density bone and compare them in terms of achieving good initial implant stability.

The present study was conducted in an ex vivo animal model using bovine rib bones. This study was performed on 20 bovine ribs; each rib had four implant site preparations divided into four groups according to the drilling method: a control group of the conventional technique (n=20), the expanders group (n=20), the densification burs group (n=20), and the magnetic mallet group (n=20). The measured values were Primary Insertion Torque and Implant Stability Quotient (ISQ).

The highest average insertion torque was in the magnetic Mallet group, where the average was 43.75 N/cm², followed by the burs group, where the average was 43.00 N/cm², then the expanders group with an average of 32.80 N/cm², then the conventional preparation group with 19.30 N/cm² as the lowest average among the study groups. The highest ISQ mean was in the burs group, where the mean was 80.30, followed by the magnetic Mallet group, where the mean was 80.20, then the expanders group with a mean of 68.90, then the conventional preparation group with 50.10 as the lowest mean among the study groups.

Within the limitation of this study, we conclude that all methods used were better than conventional preparation in both ISQ and insertion torque, with the magnetic mallet group outperforming the insertion torque and the Densah burs outperforming the ISQ.