Comparative Assessment of Osseodensification and Conventional Drilling on Implant Stability, Peri-Implant Bone Response, and Inflammatory Cytokines: A Randomized Controlled Trial.

Abstract

Purpose: To evaluate and compare the influence of osseodensification (OD) and conventional drilling (CD) techniques on primary and secondary implant stability. The study also compares the effect of these techniques on peri-implant bone density, crestal bone level, alveolar ridge width, and concentration of TNF-α and IL-1β.

Materials & methods: A total of 24 single or multiple edentulous sites were randomly and evenly allocated into two groups of 12, such that osteotomy preparation for implant placement was carried out using the OD technique in Group A and the CD technique in Group B. Follow-up evaluations were performed at 1, 4, and 6 months after implant placement. Intergroup and intragroup comparisons were performed with independent t-tests and paired t-tests respectively. Repeated measures ANOVA was applied to compare bone density across different time points. A p-value ≤ 0.05 was set as statistically significant.

Results: Of 24 sites, only 20 (6 males, 5 females) were evaluated in the final analysis, as 3 subjects (1 male, 2 females) missed their follow-up visits. Group A showed significantly higher ISQ values immediately after implant placement (p ≤ 0.001), but not after 4 months (p = 0.053). No significant intergroup differences were found for bone density, crestal bone levels, ridge width, or TNF-α/IL-1β levels at all time points. Nevertheless, Group A exhibited significant postoperative increases in bone density (p = 0.003) and ridge width (p ≤ 0.001) relative to preoperative measurements.

Conclusion: OD offers a conservative and biologically favorable approach to implant osteotomy preparation, particularly beneficial in sites with compromised bone conditions by simultaneously enhancing primary stability, bone density, and ridge width without inducing adverse peri-implant tissue responses.