Modified drilling technique in enhancing primary stability in low density bone-An Ex-vivo study.

Introduction: The primary stability of the implant plays a pivotal role in its success of the implant. This depends largely on the bone quality, drilling protocol, and shape of the fixture. In low-density bone (D3, D4 bone), achieving primary implant stability is extremely challenging. The aim of this study was to compare and evaluate the primary stability of the implants with the proposed drilling technique, the standard drilling protocol, and the osseodensification technique (OT) in low-density bone through the ex-vivo study.

Material and method: A total of 60 dental implants, with 20 dental implants in standard drilling protocol, OT, and proposed drilling technique, were placed on a fresh, humid bovine bone. The insertion torque value and implant stability quotient value were measured to evaluate the primary stability of the implant.

Results: The insertion torque value in the standard drilling technique was in the range of 20-30 N cm in 80% of the dental implants placed, whereas it was greater than 40 N cm in 65% of implants with the OT and 90% with the proposed drilling technique. The mean implant stability quotient in the standard drilling protocol was 65.51 ± 2.65, the OT was 68.06 ± 3.14, and the proposed drilling technique was 68.31 ± 3.22. This difference in the insertion torque value (P < 0.001) and mean implant stability quotient (P = 0.008) between three techniques was statistically significant. The OT and the proposed drilling technique produced similar results.

Conclusion: The study found proposed drilling protocol produced results in the range similar to the OT. The proposed drilling technique has a possible clinical application in low-density bone.