Modified drilling technique in enhancing primary stability in low density bone-An Ex-vivo study
Mamatha Nanjappa Siddalingappa1, Madhumathi Singh1, Ramesh Chowdhary2
1Department of Oral and Maxillofacial Surgery, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India.
National Journal of Maxillofacial Surgery
|September 29, 2025
Summary
A new proposed drilling technique and osseodensification technique (OT) significantly improve primary implant stability in low-density bone compared to standard protocols. Both techniques offer comparable, enhanced stability for dental implants in challenging bone conditions.
Area of Science:
- Dental Implantology
- Biomaterials Science
- Surgical Techniques
Background:
- Primary implant stability is crucial for successful osseointegration.
- Low-density bone (D3, D4) presents significant challenges in achieving adequate primary stability.
- Existing drilling protocols may be insufficient for optimal implant fixation in compromised bone quality.
Purpose of the Study:
- To compare the primary stability of dental implants using a proposed drilling technique, standard drilling protocol, and osseodensification technique (OT).
- To evaluate the efficacy of these techniques in low-density bone conditions.
- To determine if the proposed technique offers comparable stability to established methods like OT.
Main Methods:
- An ex-vivo study was conducted using fresh, humid bovine bone.
- Sixty dental implants were placed, with 20 utilizing the standard drilling protocol, 20 the OT, and 20 the proposed drilling technique.
- Primary stability was assessed by measuring insertion torque value (N cm) and implant stability quotient (ISQ).
Main Results:
- The proposed drilling technique and OT yielded significantly higher insertion torque values (>40 N cm in 90% and 65% of implants, respectively) compared to the standard protocol (20-30 N cm in 80%).
- Mean ISQ values were comparable between the proposed technique (68.31 ± 3.22) and OT (68.06 ± 3.14), both higher than the standard protocol (65.51 ± 2.65).
- Statistical analysis confirmed significant differences in both insertion torque (P < 0.001) and ISQ (P = 0.008) between the techniques.
Conclusions:
- The proposed drilling technique achieves primary implant stability comparable to the osseodensification technique in low-density bone.
- Both the proposed technique and OT demonstrate superior performance over the standard drilling protocol.
- The proposed drilling technique shows potential for clinical application in improving dental implant success rates in low-density bone environments.
