The effect of osseodensification drilling for endosteal implants with different surface treatments: A study in sheep

Bradley Lahens, Christopher D. Lopez, Rodrigo F. Neiva, Michelle M. Bowers, Ryo Jimbo, Estevam A. Bonfante, Jonathan Morcos, Lukasz Witek, Nick Tovar, Paulo G. Coelho

Research output: Contribution to journalArticlepeer-review


This study investigated the effects of osseodensification drilling on the stability and osseointegration of machine-cut and acid-etched endosteal implants in low-density bone. Twelve sheep received six implants inserted into the ilium, bilaterally (n = 36 acid-etched, and n = 36 as-machined). Individual animals received three implants of each surface, placed via different surgical techniques: (1) subtractive regular-drilling (R): 2.0 mm pilot, 3.2 and 3.8 mm twist drills); (2) osseodensification clockwise-drilling (CW): Densah Bur (Versah, Jackson, MI) 2.0 mm pilot, 2.8, and 3.8 mm multifluted tapered burs; and (3) osseodensification counterclockwise-drilling (CCW) Densah Bur 2.0 mm pilot, 2.8 mm, and 3.8 mm multifluted tapered burs. Insertion torque was higher in the CCW and CW-drilling compared to the R-drilling (p < 0.001). Bone-to-implant contact (BIC) was significantly higher for CW (p = 0.024) and CCW-drilling (p = 0.006) compared to the R-drilling technique. For CCW-osseodensification-drilling, no statistical difference between the acid-etched and machine-cut implants at both time points was observed for BIC and BAFO (bone-area-fraction-occupancy). Resorbed bone and bone forming precursors, preosteoblasts, were observed at 3-weeks. At 12-weeks, new bone formation was observed in all groups extending to the trabecular region. In low-density bone, endosteal implants inserted via osseodensification-drilling presented higher stability and no osseointegration impairments compared to subtractive regular-drilling technique, regardless of evaluation time or implant surface.

Original languageEnglish (US)
Pages (from-to)615-623
Number of pages9
JournalJournal of Biomedical Materials Research - Part B Applied Biomaterials
Issue number3
StatePublished - Apr 2019


  • bone
  • histologic
  • implant
  • insertion torque
  • osseodensification

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering


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