Comparision of two different drilling systems in various implant surgical procedures: A retrospective study

Introduction and Aim: Dental implants are currently the most popular method for the treatment of edentulism. For the success of implants, it is essential to achieve complete and healthy integration with the bone tissue. Implant stability values are of great importance in achieving this integration. The osseodensification method is among the techniques used today to increase stability. The aim of this study is to evaluate the effectiveness of this method by comparing it with conventional techniques. Materials and Methods: This study is designed as a retrospective analysis of dental implant applications performed in the Department of Periodontology, Faculty of Dentistry at Ordu University between 30.07.2021 and 01.01.2023. A total of 449 implants placed in 80 patients who met the necessary criteria were included in the study. The implants were categorized according to surgical procedures, with 47 implants placed via closed sinus lift and 402 implants via immediate placement. Data (torque, ISQ, bone density, and bone gain) were obtained from patient records and radiographic images. These values were divided into two groups based on osseodensification and conventional drilling systems. In the immediate implant and closed sinus lift groups, torque values were measured during the surgery, and ISQ values were measured during surgery and at the time of healing abutment placement (3-4 months). Radiographic images taken before and after closed sinus lift (3-4 months) were used for the evaluation of bone gain and density. Results: According to the evaluations, no significant difference was found between the Osseodensification (OD) and conventional drilling systems in terms of torque values in either surgical method. When ISQ values were compared, the OD group demonstrated higher values in the closed sinus lift group. In immediate implantation, the OD group showed higher ISQ values in the maxillary anterior, maxillary posterior, and mandibular posterior regions, whereas no significant difference was observed in the mandibular anterior region. In terms of bone gain in closed sinus lift procedures, no difference was observed between the two systems, but the Osseodensification group had higher bone density values around the implants. Conclusion: The OD method appears to be a good option for increasing stability in low-density bones. In closed sinus lift procedures, it showed results as successful as traditional methods in terms of bone elevation and more successful in terms of stability. In procedures like immediate implantation, where achieving sufficient primary stability is challenging, the OD method positively contributed to implant stability. Keywords: Dental Implant, Osseodensification, Primary Stability, Bone Gain