April 2022

Aim: Primary stability of dental implants is a prerequisite for osseointegration, and the osteotomy technique is one of the factors that may alter it. The aim of this study was to compare the primary stability of dental implants installed using osseodensification and bone expansion drilling systems. Materials and Methods: This split-mouth comparative clinical study included 12 patients. Each patient received one implant for each of the tested systems, totaling 24 implants. Implants were installed in edentulous areas with space for two adjacent implants or in two similar contralateral areas for the installation of a single implant. The areas had to present medullar bone interposed between vestibular and palatal/lingual cortical bone. The primary outcome was the insertion torque. Results: The average torque obtained with bone expansion was 37±14 N.cm, whereas the final torque equaled 46±10 N.cm with osseodensification (p=0.02). The average torque was also higher with osseodensification than bone expansion in cases of type IV bone, in the maxilla and in cases of narrow implants. Osseodensification reached 35N. cm or more in 91.7% of cases compared to 50% after bone expansion (p=0.02). Conclusion: Primary stability is affected by the osteotomy technique. Dental implants installed after osseodensification presented higher levels of insertion torque than after a bone expansion system.