Optimizing Osseodensification Drilling for Dental Implant Placement: An In Vitro Study

Area of Science:

• Biomaterials Science
• Dental Implantology
• Surgical Drilling Techniques

Background:

• Low-density bone presents challenges for achieving primary dental implant stability.
• Conventional drilling (CD) can lead to iatrogenic damage and compromise implant stability.
• Osseodensification drilling (OD) is a novel technique proposed to improve bone-to-implant contact.

Purpose of the Study:

• To optimize osseodensification drilling (OD) parameters for enhanced primary dental implant stability in simulated low-density bone (Type IV bone).
• To compare the effects of OD versus conventional drilling (CD) on implant site characteristics and primary stability.

Main Methods:

• Polyurethane foam blocks (0.160 g/cm³) simulated Type IV bone.
• Drilling was performed using bone level tapered drills (CD) and Densah drills (OD) on a DMU machine.
• Variables included spin speed, feed per tooth, and irrigation; parameters measured were thrust force, temperature, insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ).

Main Results:

• OD exhibited higher thrust force than CD (2.99 ± 0.22 N vs. 2.77 ± 0.17 N at 300 rpm).
• OD resulted in lower temperature elevation under irrigation (3.35°C vs. 4.67°C).
• OD achieved significantly higher IT (11.73 ± 0.45 N·m vs. 7.77 ± 0.21 N·m) and RT (9.28 ± 0.45 N·m vs. 6.65 ± 0.19 N·m) with fewer site defects compared to CD.

Conclusions:

• Osseodensification drilling (OD) enhances primary implant stability and bone density in Type IV bone, outperforming conventional drilling (CD).
• Optimal OD parameters for Type IV bone are 1500 rpm and 0.04 mm/z with irrigation to prevent thermal damage.
• OD minimizes iatrogenic damage to the implant site morphology, crucial for successful osseointegration.