Comparison of the effect of conventional drilling, undersized bone drilling and osseodensification techniques on primary stability, in insertion of standard dental implants into d4 bone with insertion torque, removal torque and resonance frequency analysis

Ekiz, ÖF. (2023). Comparison of the Effect of Conventional Drilling, Undersized Bone Drilling and Osseodensification Techniques on Primary Stability, in Insertion of Standard Dental Implants into D4 Bone with Insertion Torque, Removal Torque and Resonance Frequency Analysis. Yeditepe University, Institute of Health Sciences, Department of Oral and Maxillofacial Surgery, PhD Thesis. Istanbul Endosseous dental implants have been shown to be amongst the most successful restorative options for restoring teeth. Success is determined by the osseointegration method, where it helps to maintain long-term longevity. The purpose of this thesis was to compare of the effect of conventional (CD), osseodensification (OD), and undersized bone drilling (UD) techniques on primer stability, in insertion of standard dental implants into low-density bone (D4) with insertion torque (IT), removal torque (RT) and stability quotient (ISQ). Study compared the insertion torque values, removal torque values and ISQ values of the dental implants inserted on polyurethane blocks (#1522-23, #1522-03: Sawbones, Malmö, Sweden) that mimic D4 (PCF05) bone structures. A total of 66 implants (IMPLANCE; Turkey) with size of (4.3x10mm) were split into three groups, according to osteotomy techniques (conventional technique (n=22), underdrilling technique (n=22) and osseodensification technique (n=22). All the implants were placed on bone blocks at speed of 40 rpm with using a physio-dispenser. The resonance frequency analysis of the dental implants was performed via a smartpeg. Mann-Whitney U test was employed to compare the two groups. The significance thresholds were set at p<0.05. Comparing osseodensification with conventional drilling and undersized drilling, OD group had highest insertion torque. Additionally, the difference between CD and OD was statistically significant however the difference between OD and UD was not statistically significant. In terms of removal torque value, undersized drilling had the highest value when compared to the OD and CD. In terms of ISQ, statistically significance was observed between OD and CD and UD. CD and UD groups had significantly lower ISQ values than OD group. Large-scale clinical studies are needed to support the results. Key words: Primary Implant Stability, Osseodensification, Posterior Maxilla, Insertion Torque, Removal Torque, Resonance Frequency Analysis