Ex Vivo Analysis of Ability of Osseodensification to Improve Dental Implant Primary Stability Using Xenograft Bone Walls

Abstract

Osseodensification is a technique that involves compressing bone using specialized drilling instruments to increase bone–implant contact. The present study aimed to evaluate the structure of a xenograft bone (XB) wall created within an implantation site and how it affects the initial stability of dental implants. Six segments of pig ribs, representing low-density bone, were used in the experiment. Four different drilling conditions were created for each section using a tapered bur system associated with bovine xenograft bone: clockwise (cutting mode—CW) or counterclockwise (densification mode—CCW). The bone samples were then placed individually in microtomography equipment to define a volume of interest (VOI) 50% larger than the osteotomy. Mathematical calculations of bone volume, trabecular thickness and separation, and total porosity were performed. An implant with a diameter of 4.0 mm and a length of 11.5 mm was then inserted into each osteotomy. The final insertion torque (IT) and resonance frequency analysis/implant stability quotient (ISQ) values were recorded. The groups were compared using ANOVA and Tukey’s post hoc test. The results show that the use of xenograft bone produced densification at the apex region, with higher bone volume and trabecular thickness, and reduced trabecular separation compared with the CW group (p < 0.05). The CW + XB group demonstrated a similar porosity to the CCW group and similar values of IT and ISQ (p > 0.05). Compared with the other groups, CCW + XB exhibited the lowest percentual porosity and the highest values of IT and ISQ (p < 0.05). We concluded that the use of a xenograft bone wall before implant placement can improve the primary stability of dental implants.