The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis

Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis—11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.

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In Vitro Comparison of Time and Accuracy of Implant Placement Using Trephine and Conventional Drilling Techniques Under Dynamic Navigation

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00125 ◽

2020 ◽

Author(s):

Janina Golob Deeb ◽

Anja Frantar ◽

George R. Deeb ◽

Caroline K. Carrico ◽

Ksenija Rener-Sitar

Keyword(s):

In Vitro Study ◽

Site Preparation ◽

Experimental Conditions ◽

Implant Placement ◽

Significant Difference ◽

Dynamic Navigation ◽

Drilling Technique ◽

Implant Site Preparation ◽

Conventional Drilling

The aim of this randomized in vitro study was to compare the time and accuracy of implant site preparation and implant placement using a trephine drill versus a conventional drilling technique under dynamic navigation. A total of 42 implants were placed in simulation jaw models with the two drilling techniques by two operators with previous experience with dynamic navigation. The timing of each implant placement was recorded, and horizontal, vertical, and angulation discrepancies between the planned and placed implants were compared. There was no significant difference in time or accuracy between the trephine and conventional drilling techniques. Implant site preparation with a single trephine drill using dynamic navigation was as accurate under in vitro experimental conditions as a conventional drilling sequence.

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Impact of Insertion Depth and Predrilling Diameter on Primary Stability of Orthodontic Mini-implants

The Angle Orthodontist ◽

10.2319/071708-373.1 ◽

2009 ◽

Vol 79 (4) ◽

pp. 609-614 ◽

Cited By ~ 46

Author(s):

Benedict Wilmes ◽

Dieter Drescher

Keyword(s):

Bone Quality ◽

Primary Stability ◽

Site Preparation ◽

Insertion Torque ◽

Insertion Depth ◽

Mini Implants ◽

Local Bone ◽

The Mean ◽

Implant Site Preparation ◽

The Impact

Abstract Objective: To test the hypothesis that the impact of the insertion depth and predrilling diameter have no effect on the primary stability of mini-implants. Materials and Methods: Twelve ilium bone segments of pigs were embedded in resin. After implant site preparation with different predrilling diameters (1.0, 1.1, 1.2, and 1.3 mm), Dual Top Screws 1.6 × 10 mm (Jeil, Korea) were inserted with three different insertion depths (7.5, 8.5, and 9.5 mm). The insertion torque was recorded to assess primary stability. In each bone, five Dual Top Screws were used as a reference to compensate for the differences of local bone quality. Results: Both insertion depth and predrilling diameter influenced the measured insertion torques distinctively: the mean insertion torque for the insertion depth of 7.5 mm was 51.62 Nmm (±25.22); for insertion depth of 8.5 mm, 65.53 Nmm (±29.99); and for the insertion depth of 9.5 mm, 94.38 Nmm (±27.61). The mean insertion torque employing the predrill 1.0 mm was 83.50 Nmm (±33.56); for predrill 1.1 mm, 77.50 Nmm (±27.54); for the predrill 1.2 mm, 61.70 Nmm (±28.46); and for the predrill 1.3 mm, 53.10 (±32.18). All differences were highly statistically significant (P < .001). Conclusions: The hypothesis is rejected. Higher insertion depths result in higher insertion torques and thus primary stability. Larger predrilling diameters result in lower insertion torques.

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Observational Study on the Preparation of the Implant Site with Piezosurgery vs. Drill: Comparison between the Two Methods in terms of Postoperative Pain, Surgical Times, and Operational Advantages

BioMed Research International ◽

10.1155/2019/8483658 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Michele Maglione ◽

Lorenzo Bevilacqua ◽

Federica Dotto ◽

Fulvia Costantinides ◽

Felice Lorusso ◽

...

Keyword(s):

Postoperative Pain ◽

Operative Time ◽

Oral Surgery ◽

Study Groups ◽

Site Preparation ◽

Medical Sciences ◽

Operative Duration ◽

Significant Difference ◽

Surgery Department ◽

Implant Site Preparation

Purpose. Recent advances show that ultrasonic implant site osteotomy is related to a decreased trauma and a better postoperative healing of the surgical site when compared to traditional drilling techniques. The micrometric bone cutting control and the operative advantages related to the piezoelectric approach are also characterized by a learning curve for the clinician in surgical practice and an increased operative duration of the procedure. The aim of this investigation is to compare the operative time, the postoperative pain, and the amount of painkillers taken by the patient during the healing period. Methods. A total of 65 patients were treated at the Unit of Oral Surgery (Department of Medical Sciences, Surgery and Health, University of Trieste, Italy) using a split mouth model: 75 drill-inserted implants (G1) and 75 piezoelectric device-inserted implants (G2) were placed. The Visual Analogue Scale (VAS) was performed to evaluate the postoperative pain at 15 days from surgery. The operative time and frequency of intake of painkillers were measured. Results. The G1 and G2 groups showed a significant difference with a higher use of painkillers observed for G1. The G2 patients showed a lower level of pain (VAS) at all experimental times between 8 hours to 7 days (p<0.01) postsurgery. At 15 days, the pain levels were similar for both groups. No differences were found in site preparation duration between the study groups. Conclusions. The evidence supports the application of the piezoelectric approach compared to the drill’s osteotomy as a useful technique for implant site preparation. This trial is registered with NCT03978923.

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Biomolecular, Histological, Clinical, and Radiological Analyses of Dental Implant Bone Sites Prepared Using Magnetic Mallet Technology: A Pilot Study in Animals

Materials ◽

10.3390/ma14226945 ◽

2021 ◽

Vol 14 (22) ◽

pp. 6945

Author(s):

Gianmario Schierano ◽

Domenico Baldi ◽

Bruno Peirone ◽

Mitzy Mauthe von Degerfeld ◽

Roberto Navone ◽

...

Keyword(s):

Computed Tomography ◽

Fibrous Tissue ◽

Primary Stability ◽

Site Preparation ◽

Positive Trend ◽

X Rays ◽

Implant Positioning ◽

Significant Difference ◽

New Instrumentation ◽

Implant Site Preparation

Background. A new instrumentation exploiting magneto-dynamic technology (mallet) proposed for implant site preparation was investigated. Methods. In the tibias of three minipigs, two sites were prepared by mallet and two by drill technique. Primary stability (ISQ) was detected after implant positioning (T0) and at 14 days (T14). X-rays and computed tomography were performed. At T14, bone samples were utilized for histological and biomolecular analyses. Results. In mallet sites, histological evaluations evidenced a significant increase in the newly formed bone, osteoblast number, and a smaller quantity of fibrous tissue. These results agree with the significant BMP-4 augmentation and the positive trend in other osteogenic factors (biological and radiological investigations). Major, albeit IL-10-controlled, inflammation was present. For both techniques, at T14 a significant ISQ increase was evidenced, but no significant difference was observed at T0 and T14 between the mallet and drill techniques. In mallet sites, lateral bone condensation was observed on computed tomography. Conclusions. Using biological, histological, clinical, and radiological analyses, this study first shows that the mallet technique is effective for implant site preparation. Based on its ability to cause osseocondensation and improve newly formed bone, mallet technology should be chosen in all clinical cases of poor bone quality.

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The influence of diabetes mellitus on rotator cuff repair: A systematic review and meta-analysis

Combinatorial Chemistry & High Throughput Screening ◽

10.2174/1386207323666201020114034 ◽

2020 ◽

Vol 23 ◽

Author(s):

Xiaomin Lu ◽

He Sun ◽

YiSheng Xu ◽

Xuewei Cao

Keyword(s):

Diabetes Mellitus ◽

Rotator Cuff ◽

Clinical Outcomes ◽

Clinical Studies ◽

Rotator Cuff Repair ◽

Meta Analysis ◽

Japanese Orthopaedic Association ◽

Cochrane Library ◽

Significant Difference ◽

Cuff Repair

Background: : Clinical outcomes after rotator cuff repair associated with diabetes mellitus(DM) are generally favorable, but no study has attempted to establish the influence of DM on outcomes after rotator cuff repair. Purpose: To conduct a meta-analysis of clinical studies evaluating patient outcomes between people with DM and people without DM after rotator cuff repair. Study Design: Meta-analysis. Methods: A literature search of the Embase, PubMed, and Cochrane Library databases was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Cohort studies and case-control studies about clinical outcomes after rotator cuff repair comparing people with DM and people without DM were included. Statistical analysis was performed with RevMan (v 5.3.3). Results: Nine clinical studies that met the inclusion criteria were identified and included a total of 314 patients treated with DM and 1092 patients without DM. The failure rate was significantly higher in the DM group than in Non-DM group (23.97% compared with 16.60%, OR: 2.39; 95% CI, 1.69–3.37; p < 0.001). The postoperative retear rate and showed a significant difference between the two groups (24.5% and 13.7%; OR: 2.41; 95% CI, 1.57–3.71; p<0.001). The DM group showed a higher rate of postoperative unhealed cuff than the Non-DM group(41.81% and 25.23%; OR: 2.14; 95% CI, 1.69–3.37; p=0.01).Postoperative Range of motion(ROM) at 12 months after surgery show a significant difference in the range of external rotation between two groups (WMD: -6.02; 95% CI, -7.54 to -4.50; p<0.001).The preoperative Japanese Orthopaedic Association (JOA) score, the comparison of pre- and post-operative JOA scores showed a significant difference in the DM and Non-DM group(p<0.001). The postoperative JOA score, the pre- and post-operative muscle strength, the pre- and postoperative visual analog scale (VAS) show significant difference between the the DM and Non-DM group(p<0.001). The postoperative infection rates, the rates of postoperative shoulder stiffness, the preoperative ROM, the postoperative ROM at 6 months, the postoperative ROM at 12 months of forward flexion and abduction, the American Shoulder and Elbow Surgeons score, the University of California, Los Angeles scores, and the preoperative Constant-Murley scores show no significant difference between the two groups. Conclusion: This meta-analysis indicates that DM may be relative to a higher rate of shoulder retear and cuff unhealing. However, patients with DM can achieve great clinical outcomes after cuff repair, compared to patients without DM.

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Comparison of the Use of Titanium–Zirconium Alloy and Titanium Alloy in Dental Implants: A Systematic Review and Meta-Analysis

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-17-00233 ◽

2018 ◽

Vol 44 (4) ◽

pp. 305-312 ◽

Cited By ~ 1

Author(s):

Ronaldo Silva Cruz ◽

Cleidiel Aparecido Araujo Lemos ◽

Hiskell Francine Fernandes Oliveira ◽

Victor Eduardo de Souza Batista ◽

Eduardo Piza Pellizzer ◽

...

Keyword(s):

Dental Implants ◽

Animal Studies ◽

Meta Analysis ◽

In Vivo Studies ◽

Cochrane Library ◽

Eligibility Criteria ◽

Ti Alloys ◽

Significant Difference ◽

Titanium Zirconium

The aim of this study was to compare the values of bone-implant contact (BIC) and removal torque (RTQ) reported in different animal studies for titanium–zirconium (TiZr) and titanium (Ti) dental implants. This review has been registered at PROSPERO under number CRD42016047745. We undertook an electronic search for data published up until November 2017 using the PubMed/Medline, Embase, and The Cochrane Library databases. Eligibility criteria included in vivo studies, comparisons between Ti and TiZr implants in the same study, and studies published in English that evaluated BIC and RTQ. After inclusion criteria, 8 studies were assessed for eligibility. Of the 8 studies, 7 analyzed BIC outcome and 3 analyzed RTQ outcome. Among such studies, 6 studies were considered for meta-analysis of quantitative for BIC and 2 studies for RTQ. There was no significant difference for BIC analysis (P = .89; random ration [RR]: −0.21; 95% confidence interval [CI]: −3.14 to 2.72). The heterogeneity of the primary outcome studies was considered low (7.19; P = .21; I2: 30%). However, the RTQ analysis showed different results favoring the TiZr dental implants (P = .001; RR: 23.62; 95%CI: 9.15 to 38.10). Low heterogeneity was observed for RTQ (χ2: 1.25; P = .26; I2: 20%). Within the limitations of this study, there was no difference between TiZr and Ti alloys implants in terms of BIC. However, TiZr implants had higher RTQ than Ti alloys.

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Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique

Applied Sciences ◽

10.3390/app10238623 ◽

2020 ◽

Vol 10 (23) ◽

pp. 8623

Author(s):

Alessandro Antonelli ◽

Francesco Bennardo ◽

Ylenia Brancaccio ◽

Selene Barone ◽

Felice Femiano ◽

...

Keyword(s):

Cancellous Bone ◽

Biological Response ◽

In Vivo Studies ◽

Insertion Torque ◽

Clinical Settings ◽

Implant Stability ◽

Primary Implant ◽

Significant Difference

Background: This study aims to analyze bone compaction and osseodensification techniques and to investigate how cancellous bone compaction could influence primary implant stability (PS). Methods: Two different surgical protocols (bone compactors—BC; osseodensification drills—OD) were compared by placing 20 implants into 20 fresh pig ribs for each procedure. Peak insertion torque (PIT) and peak removal torque (PRT) were investigated using an MGT-12 digital torque gauge, and implant stability quotient (ISQ) was analyzed using an Osstell® Beacon device. Results: Analysis of our data (T-test p < 0.05) evidenced no statistically significant difference between BC and OD in terms of PIT (p = 0.33) or ISQ (p = 0.97). The comparison of PRT values showed a statistically significant difference between BC and OD protocols (p = 0.009). Conclusions: Cancellous bone compaction seems to improve PS, preserving a significant amount of bone and evenly spreading trabeculae on the entire implant site. Although the PIT and ISQ values obtained are similar, the PRT values suggest a better biological response from the surrounding bone tissue. Nevertheless, a larger sample and further in vivo studies are necessary to validate the usefulness of this protocol in several clinical settings.

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Efficacy of Balneotherapy and Mud Therapy in Patients with Knee Osteoarthritis: A Systematic Literature Review

Aktuelle Rheumatologie ◽

10.1055/a-1157-8570 ◽

2020 ◽

Author(s):

Hafiz Muhammad Asim Raza ◽

Grazina Krutulyte ◽

Inesa Rimdeikiene ◽

Raimondas Savickas

Keyword(s):

Knee Osteoarthritis ◽

Pain Score ◽

Clinical Studies ◽

Meta Analysis ◽

Womac Pain ◽

Function Score ◽

Womac Pain Score ◽

Womac Function ◽

Significant Difference ◽

Mud Therapy

Abstract Objectives To identify literature reporting on thermal mineral water and mud therapy effectiveness on pain, stiffness and knee function in patients with knee osteoarthritis. Design Systematic evidence scan of MEDLINE and PubMed was performed to identify the randomized controlled trial studies published from 2004 to December 2018. Study selection Papers reporting the effect of balneotherapy and mud therapy for treating knee OA, a duration of ≥2 weeks and in which Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used as an outcome measure. Data extraction Not RCT, Studies not in English. Results A quantitative meta-analysis of ten studies (831 patients) was performed. Five clinical studies (407 patients) measured effectiveness of balneotherapy and there was significant difference between the groups in WOMAC pain score, WOMAC stiffness score and WOMAC function score, with the differences in favour of balneotherapy. Six clinical studies (500 patients) measured effectiveness of mud therapy and there was significant difference between the groups in WOMAC pain score, WOMAC stiffness score and WOMAC function score, with the differences in favour of mud therapy. Conclusion This meta-analysis indicates that balneotherapy and mud therapy were clinically effective in relieving pain, stiffness, and improving function, as assessed by WOMAC score.

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Conventional Drilling Versus Piezosurgery for Implant Site Preparation: A Meta-Analysis

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-17-00091 ◽

2018 ◽

Vol 44 (5) ◽

pp. 400-405 ◽

Cited By ~ 2

Author(s):

Daniel Isaac Sendyk ◽

Natacha Kalline de Oliveira ◽

Claudio Mendes Pannuti ◽

Maria da Graça Naclério-Homem ◽

Ann Wennerberg ◽

...

Keyword(s):

Clinical Trials ◽

Dental Implants ◽

Site Preparation ◽

Implant Stability ◽

Controlled Clinical Trials ◽

Randomized Controlled Clinical Trials ◽

Randomized Controlled ◽

Significant Difference ◽

Implant Site Preparation ◽

Conventional Drilling

The aim of this study was to evaluate if the stability of dental implants varies between dental implants placed by piezosurgery compared with those placed by conventional drilling. An electronic search in MEDLINE, SCOPUS, and the Cochrane Library was undertaken until August 2016 and was supplemented by manual searches and by unpublished studies at OpenGray. Only randomized controlled clinical trials that reported implant site preparation with piezosurgery and with conventional drilling were considered eligible for inclusion in this review. Meta-analyses were performed to evaluate the impact of piezosurgery on implant stability. Of 456 references electronically retrieved, 3 were included in the qualitative analysis and quantitative synthesis. The pooled estimates suggest that there is no significant difference between piezosurgery and conventional drilling at baseline (weighted mean differences [WMD]: 2.20; 95% confidence interval [CI]: −5.09, 9.49; P = .55). At 90 days, the pooled estimates revealed a statistically significant difference (WMD: 3.63; 95% CI: 0.58, 6.67, P = .02) favoring piezosurgery. Implant stability may be slightly improved when osteotomy is performed by a piezoelectric device. More randomized controlled clinical trials are needed to confirm these findings.

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