Osseodensification outperforms conventional implant subtractive instrumentation: A study in sheep

Author(s)

de Oliveira, Paula G. F. Pessoa ^[1] ; Bergamo, Edmara T. P. ^[1] ; Neiva, Rodrigo ^[2] ; Bonfante, Estevam A. ^[3] ; Witek, Lukasz ^[1] ; Tovar, Nick ^[1] ; Coelho, Paulo G. ^{[1, 4, 5]}

Affiliation

^[1] NYU, Dept Biomat & Biomimet, 433 1st Ave, New York, NY 10010 - USA

^[2] Univ Florida, Dept Periodontol, 1395 Ctr Dr, D1-11, Gainesville, FL 32610 - USA

^[3] Univ Sao Paulo, Dept Prosthodont & Periodontol, Bauru Sch Dent, Al Otavio Pinheiro Brisola 9-75, BR-17012901 Bauru, SP - Brazil

^[4] NYU, Langone Med Ctr, Hansjorg Wyss Dept Plast Surg, 550 First Ave, New York, NY 10016 - USA

^[5] NYU, Mech & Aerosp Engn, Tandon Sch Engn, 6 MetroTech Ctr, New York, NY 11201 - USA

• Document type: Journal article
• Source: Materials Science & Engineering C-Materials for Biological Applications; v. 90, p. 300-307, SEP 1 2018.
• Web of Science Citations: 2

Abstract

Osseodensification is a surgical instrumentation technique where bone is compacted into open marrow spaces during drilling, increasing implant insertion torque through densification of osteotomy site walls. This study investigated the effect of osseodensification instrumentation on the primary stability and osseointegration of as-machined and acid-etched implants in low-density bone. Six endosteal implants were inserted bilaterally in the ilium of five sheep totaling 60 implants (n = 30 acid-etched and n = 30 as-machined). Each animal received three implants of each surface. The osteotomy sites were prepared as follows: (i) subtractive conventional-drilling (R): 2 mm pilot, 3.2 mm and 3.8 mm twist drills; (ii) osseodensification clockwise-drilling (CW), and (iii) osseodensification counterclockwise-drilling (CCW) with Densah Burs (Versah, Jackson, MI, USA) 2.0 mm pilot, 2.8 mm, and 3.8 mm multi-fluted tapered burs. Insertion torque, bone-to-implant contact (BIC) and bone-area-fraction occupancy (BAFO) were evaluated. Drilling techniques had significantly different insertion torque values (CCW > CW > R), regardless of implant surface. While BIC was not different as a function of time, BAFO significantly increased at 6-weeks. A significantly higher BIC was observed for acid-etched compared to as-machined surface. As-machined R-drilling presented lower BIC and BAFO than acid-etched R, CW, and CCW. New bone formation was depicted at 3-weeks. At 6-weeks, bone remodeling was observed around all devices. Bone chips within implant threads were present in both osseodensification groups. Regardless of implant surface, insertion torque significantly increased when osseodensification-drilling was used in low-density bone. Osseodensification instrumentation improved the osseointegration of as-machined implants to levels comparable to acid-etched implants inserted by conventional subtractive-drilling. (AU)

• FAPESP's process: 16/18818-8 - Multi-User Equipment approved in grant 2012/19078-7: ElectroPuls E3000 Linear-Torsion All-Electric dynamic test instrument package
• Grantee: Estevam Augusto Bonfante
• Support Opportunities: Multi-user Equipment Program
• FAPESP's process: 12/19078-7 - Development and processing of Al2O3-ZrO2 translucent composite for CAD/CAM monolithic prostheses: the effect of aging on biaxial flexural strength
• Grantee: Estevam Augusto Bonfante
• Support Opportunities: Research Grants - Young Investigators Grants