TY - JOUR
T1 - Osseodensification outperforms conventional implant subtractive instrumentation
T2 - A study in sheep
AU - Oliveira, Paula G.F.Pessôa de
AU - Bergamo, Edmara T.P.
AU - Neiva, Rodrigo
AU - Bonfante, Estevam A.
AU - Witek, Lukasz
AU - Tovar, Nick
AU - Coelho, Paulo G.
N1 - Funding Information:
To FAPESP grants # 2012/19078-7 , 2016/18818-8 , and to Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) grant # 304589/2017-9 .
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Osseodensification is a surgical instrumentation technique where bone is compacted into open marrow spaces during drilling, increasing implant insertion torque through densification of osteotomy site walls. This study investigated the effect of osseodensification instrumentation on the primary stability and osseointegration of as-machined and acid-etched implants in low-density bone. Six endosteal implants were inserted bilaterally in the ilium of five sheep totaling 60 implants (n = 30 acid-etched and n = 30 as-machined). Each animal received three implants of each surface. The osteotomy sites were prepared as follows: (i) subtractive conventional-drilling (R): 2 mm pilot, 3.2 mm and 3.8 mm twist drills; (ii) osseodensification clockwise-drilling (CW), and (iii) osseodensification counterclockwise-drilling (CCW) with Densah Burs (Versah, Jackson, MI, USA) 2.0 mm pilot, 2.8 mm, and 3.8 mm multi-fluted tapered burs. Insertion torque, bone-to-implant contact (BIC) and bone-area-fraction occupancy (BAFO) were evaluated. Drilling techniques had significantly different insertion torque values (CCW > CW > R), regardless of implant surface. While BIC was not different as a function of time, BAFO significantly increased at 6-weeks. A significantly higher BIC was observed for acid-etched compared to as-machined surface. As-machined R-drilling presented lower BIC and BAFO than acid-etched R, CW, and CCW. New bone formation was depicted at 3-weeks. At 6-weeks, bone remodeling was observed around all devices. Bone chips within implant threads were present in both osseodensification groups. Regardless of implant surface, insertion torque significantly increased when osseodensification-drilling was used in low-density bone. Osseodensification instrumentation improved the osseointegration of as-machined implants to levels comparable to acid-etched implants inserted by conventional subtractive-drilling.
AB - Osseodensification is a surgical instrumentation technique where bone is compacted into open marrow spaces during drilling, increasing implant insertion torque through densification of osteotomy site walls. This study investigated the effect of osseodensification instrumentation on the primary stability and osseointegration of as-machined and acid-etched implants in low-density bone. Six endosteal implants were inserted bilaterally in the ilium of five sheep totaling 60 implants (n = 30 acid-etched and n = 30 as-machined). Each animal received three implants of each surface. The osteotomy sites were prepared as follows: (i) subtractive conventional-drilling (R): 2 mm pilot, 3.2 mm and 3.8 mm twist drills; (ii) osseodensification clockwise-drilling (CW), and (iii) osseodensification counterclockwise-drilling (CCW) with Densah Burs (Versah, Jackson, MI, USA) 2.0 mm pilot, 2.8 mm, and 3.8 mm multi-fluted tapered burs. Insertion torque, bone-to-implant contact (BIC) and bone-area-fraction occupancy (BAFO) were evaluated. Drilling techniques had significantly different insertion torque values (CCW > CW > R), regardless of implant surface. While BIC was not different as a function of time, BAFO significantly increased at 6-weeks. A significantly higher BIC was observed for acid-etched compared to as-machined surface. As-machined R-drilling presented lower BIC and BAFO than acid-etched R, CW, and CCW. New bone formation was depicted at 3-weeks. At 6-weeks, bone remodeling was observed around all devices. Bone chips within implant threads were present in both osseodensification groups. Regardless of implant surface, insertion torque significantly increased when osseodensification-drilling was used in low-density bone. Osseodensification instrumentation improved the osseointegration of as-machined implants to levels comparable to acid-etched implants inserted by conventional subtractive-drilling.
KW - Bone
KW - Dental implants
KW - Histomorphometric
KW - In vivo
KW - Osseodensification
KW - Primary stability
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U2 - 10.1016/j.msec.2018.04.051
DO - 10.1016/j.msec.2018.04.051
M3 - Article
C2 - 29853095
AN - SCOPUS:85046147241
SN - 0928-4931
VL - 90
SP - 300
EP - 307
JO - Materials Science and Engineering C
JF - Materials Science and Engineering C
ER -