Comparison of the effect of conventional and osseodensification drilling techniques on primary stability, in insertion of short dental implants into D4 bone with insertion / removal torques and resonance frequency analysis

Bone density is a determining factor in short dental implant treatments and the survival rates of short dental implants applied in the maxilla are lower. Implant losses were experienced in areas with low bone density due to peri-implant forcing and tensions. For this reason, short dental implants inserted in low-density D3-D4 bone types such as posterior maxilla by conventional drilling technique are less successful than high-density D1-D2 bone types such as mandible. The aim of this study is to compare the primary stability of 5 mm short dental implants placed in artificial bone blocks mimicking the structure of D4 posterior maxilla, using conventional and osseodensification (OD) drilling techniques with resonance frequency analysis (RFA), insertion and removal torque tests. A total of 42 short dental implants, 4.8 mm in diameter and 5 mm in length were applied to the same polyurethane bone block, which imitates the structure of D4 type posterior maxilla with different conventional and osseodensification osteotomy techniques. The result of this study showed that insertion torque values and removal torque values were statistically greater when the short dental implants were placed with the osseodensification drilling technique, (p<0.001). Similarly, Implant Stability Quotient (ISQ) values were statistically greater when the short dental implants were placed with the osseodensification drilling technique compared to the conventional drilling technique (p<0.001). As a result, the short dental implant placed with the osseodensification drilling technique in the low-density bone (D4) type is more successful than the implant placed with the conventional drilling technique. These findings are in line with the literature that is related to the standard implant diameters and length. Short dental implants placed with osseodensification drilling technique can be used as an alternative to augmentation techniques when dental implants are placed within D4 bone type. Further research is needed for different sizes for aggressive implant types.