Ridge dimensional changes and implant stability utilizing the osseodensification protocol: A randomized clinical trial

Background: There is limited evidence on the effect of osseodensification drilling (OD) on alveolar ridge dimension changes and implant stability compared to standard drilling (SD). The purpose of this study was to compare the effect of both drilling protocols on ridge dimensional changes and implant stability.

Methods: Fifteen patients were recruited for a total of 20 pairs of implants. Pre- and postdrilling ridge widths were measured at the crest and 5 and 10 mm apical to the crest, using a premarked surgical guide as a reference to standardize recordings. Following implant placement, insertion torque and implant stability quotients (ISQ) were recorded. ISQ were also recorded at 3, 6, and 12 weeks post-op. Six-month post-op changes in buccal bone thickness (BBT) were measured via pre-op and post-op cone beam computed tomography (CBCT) superimposition analysis.

Results: Greater ridge width changes were observed at the crest and 5 mm apical from the crest, favoring OD, with no difference at 10 mm. When comparing BBT 6 months post-op, OD maintained BBT better than SD. Additionally, greater insertion torque, ISQ, and high implant stability (HIS) were observed following OD compared to SD.

Conclusion: OD results in greater ridge dimensional changes compared to SD following osteotomy preparation, predictably maintains BBT and reduces the risk of buccal dehiscence and resorption, obtains superior torque at placement, higher ISQ values, and a greater number of implants achieving HIS, which is maintained throughout the entire healing period.