The effects of different implantation procedures on primarystability in low density bone

Additional approaches are required for dental implant therapy in the maxillary posterior region with low bone density and insufficient alveolar bone height. In recent years, different implant treatments have emerged as an alternative to invasive surgical procedures. The purpose of our study is to examine the effects of different implant applications on primary stability in bone with low density on an ex-vivo model. 108 short (6mm) and standard (10mm) length implants with a diameter of 4.1 mm were placed in fresh sheep iliac bones. There are six study groups; Group I: standard length / axial position, Group II: standard length / 30 ° angular position, Group III: standard length/undersized implant cavity preparation, Group IV: bicortical application with osteotome , Group V: short/ axial position, Group VI: short/ undersized cavity preparation. The highest insertion torque values (ITVs) during the placement of the implants and the implant stability quotient (ISQ) values immediately after insertion were recorded. The insertion torque values (ITVs) of standard length implants placed in undersized cavity were higher than those of short implants (p = 0.008). Standard length implants have higher ISQ values than short implants regardless of the insertion methods. (Group V- I, II, III, IV: p= 0,000, Group VI- I, II, III: p= 0,000, Group IV-VI: p= 0,003). Standard implants placed at an angle of 30 ° have higher ITVs and ISQ values than those of short implants placed in axial position ( ITV: Group II- V: p= 0,000, ISQ Group II- V, II- VI: p= 0,000 ). The results of our study have shown that standard length implants are more advantageous than short implants, and the angled placement of implants is more advantageous than the use of short implants and bicortical implant applications in providing primary stability. There was no statistically significant difference between the ISQ values of the standard length (10 mm) implant groups.(p 0,005) When short implants (6 mm) were considered, it was found that,the preparation of undersized cavity resulted in statistically significant difference in ISQ values compared to standard cavity preparation.(Grup V- VI: p= 0,024) The comparison of ISQ values of short and standard length implants revealed that, the mean ISQ values of the standard length implants were statistically significantly higher than those of short implants (Group I, II, III, IV - V: p= 0,000; Group I, II, III - VI: p= 0,000; Group IV- VI: p= 0,003). The implants placed with bicortical approach using osteotome showed statistically significantly lower ITVs compared to the angled implants and implants placed in a undersized cavity (Group II- IV: p= 0,034, Group III- IV: p =0,000). The ITVs of short implants placed in an undersized cavity were significantly higher than those of short implants placed using standard surgical procedures. (Group V-VI: p= 0,011) When the mean ITVs of the short and standard length implant groups were compared, 6 mm implants placed in undersized cavity showed statistically significantly lower values than those of 10 mm implants placed with the same preparation method.( Group III- VI: p= 0,008) Within the limits of this study, it has been observed that undersized cavity preparation is important for primary stability in the short dental implant applications in regions with low bone density. It may be considered that angled implants may be a better alternative to transcrestal approach in providing primary stability. Keywords: Insertion Torque Value, Implant Stability Quotient, Low Bone Density, Short Implant, Angled Implant.