JMIR Publications

ABSTRACT

Background:

Delayed placement of dental implants often leads to bone resorption, particularly in the posterior region, compromising the conditions required for successful implant placement. Osseodensification (OD), a technique using specialized rotary instruments to compact and densify bone, may improve bone quality by increasing the density and strength. This technique will be proposed to counteract bone resorption and enhance implant stability, osseointegration, and overall clinical outcomes. However, its effectiveness compared to conventional drilling methods has not been fully explored. This study determines whether OD can achieve superior clinical results, ultimately improving the success of dental implant placement.

Objective:

The objectives of this study are to assess how effectively the OD system works to increase bone volume and density at regions where implants are scheduled to be positioned later. Through clinical and radiographic analyses, the study also strives to evaluate the impact of the OD method on the main stability and osseointegration of dental implants. With an emphasis on bone healing, implant success rates, and the frequency of issues and it further seeks to compare the clinical and radiological results of implants positioned using the OD system.

Methods:

This will be a nine-month single-arm clinical and radiographic study in 10 systemically healthy patients with edentulous region/s in the anterior or posterior arch. Pre-operative full-mouth ultrasonic scaling, dental hygiene instructions, and pre-operative Cone Beam Computed Tomography (CBCT) imaging will be obtained to measure the bone density at the coronal (mesial and distal), apical regions of the extraction socket in Hounsfield Units (HU). Following local anaesthesia and implant surgery, OD method will be applied to increase the density of the bone during osteotomy site preparation that eventually will help to improve the insertion torque. Simultaneously, improvement in primary stability will be evaluated immediately after implant placement using Ostell device for clinical implant mobility scale (CIMS). Postoperative care will include antibiotics, anti-inflammatory drugs, and follow-up visits. CBCT imaging will be done at baseline, 3 months, and 9months post-surgery to monitor changes in bone density.

Results:

Increases in HU measures at 3 and 9 months after surgery demonstrated that OD significantly improved bone density at the implant sites. Implant Stability Quotient (ISQ), a measure of primary implant stability, increased right after implantation and kept getting better over the course of the follow-up. There were no significant problems recorded, and clinical results, such as bleeding and plaque indices, were within acceptable bounds.

Conclusions:

In delayed implant placement, OD improves bone density and implant stability, especially in locations with D2 and D3 bone. The procedure seems to be a viable substitute for traditional drilling techniques because it increases bone-to-implant contact, promotes bone healing, and lowers the risk of implant failure. Clinical Trial: CTRI/2025/03/082513