Dental School, University of Western Australia, Perth, WA, Australia.
Department of Periodontology, Dental School, University of Western Australia, Perth, WA, Australia.
J Oral Implantol. 2023 Apr 1;49(2):179-186. doi: 10.1563/aaid-joi-D-21-00259.
Osseodensification is a novel technique based on nonsubtractive drilling to preserve and condense bone during osteotomy preparation. The aim of this ex vivo study was to compare osseodensification and conventional extraction drilling technique with regard to intraosseous temperatures, expansion of alveolar ridge width, and primary implant stability using different implant geometries: tapered and straight walled. A total of 45 implant sites were prepared in bovine ribs following osseodensification and conventional protocols. Changes in intraosseous temperatures were recorded at 3 depths using thermocouples, and ridge width was measured at 2 different depths before and after osseodensification preparations. The primary implant stability was measured using peak insertion torque and the implant stability quotient (ISQ) following placement of straight and tapered implants. A significant change in temperature was recorded during site preparation for all techniques tested but not at all depths. Osseodensification recorded higher mean temperatures (42.7°C) than conventional drilling, particularly at the midroot level. Statistically significant ridge expansion was observed at both the crestal and apical levels in the osseodensification group. The ISQ values were significantly higher only for tapered implants placed in osseodensification sites when compared with conventional drilling sites; however, there was no difference in the primary stability between tapered and straight implants within the osseodensification group. Within the limitations of the present pilot study, osseodensification was found to increase the primary stability of straight-walled implants without overheating the bone and significantly expanded the ridge width. However, further investigation is required to determine the clinical significance of the bone expansion created by this new technique.
骨密实化是一种基于非减损钻孔的新技术，旨在保存和浓缩骨组织，减少在骨切开准备过程中的骨损失。本体外研究的目的是比较骨密实化和传统的取栓钻孔技术在不同种植体几何形状（锥形和直壁）下的骨内温度、牙槽嵴宽度的扩展和初级种植体稳定性方面的差异。在牛肋骨上按照骨密实化和传统方案制备了总共 45 个种植体部位。使用热电偶在 3 个深度记录骨内温度的变化，并在骨密实化准备前后在 2 个不同的深度测量牙槽嵴宽度。使用直型和锥形种植体植入后的最大插入扭矩和种植体稳定性指数（ISQ）测量初级种植体稳定性。所有测试技术的骨内温度在手术准备过程中都有显著变化，但并非在所有深度都有变化。骨密实化比传统钻孔记录的平均温度（42.7°C）更高，尤其是在根尖水平。在骨密实化组中，牙槽嵴在牙槽嵴和根尖水平都有显著的扩张。当与传统钻孔部位相比时，只有在骨密实化部位植入的锥形种植体的 ISQ 值显著升高，但在骨密实化组中，锥形和直型种植体之间的初级稳定性没有差异。在本初步研究的限制范围内，发现骨密实化可以增加直壁种植体的初级稳定性，而不会使骨过热，并显著扩展牙槽嵴宽度。然而，需要进一步研究来确定这种新技术创造的骨扩张的临床意义。
