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Alveolar Ridge Expansion

Comparison of Osseodensification and Conventional Osteotome Techniques

Tian, Jimmy H.*,†; Neiva, Rodrigo, DDS, MS; Coelho, Paulo G., DDS, PhD†,§; Witek, Lukasz, BME, PhD; Tovar, Nick M., BME; Lo, Ivan C.*,†; Gil, Luiz F., DDS, PhD||; Torroni, Andrea, MD, PhD§

doi: 10.1097/SCS.0000000000004956
Scientific Foundations

Objective: The aim of this in vivo study is to compare the osseointegration of endosteal implants placed in atrophic mandibular alveolar ridges with alveolar ridge expansion surgical protocol via an experimental osseodensification drilling versus conventional osteotome technique.

Methods: Twelve endosteal implants, 4 mm × 13 mm, were placed in porcine models in horizontally atrophic mandibular ridges subsequent to prior extraction of premolars. Implants were placed with osseodensification drilling technique as the experimental group (n = 6) and osteotome site preparation as the control group (n = 6). After 4 weeks of healing, samples were retrieved and stained with Stevenel's Blue and Van Gieson's Picro Fuschin for histologic evaluation. Quantitative analysis via bone-to-implant contact (BIC%) and bone area fraction occupancy (BAFO%) were obtained as mean values with corresponding 95% confidence interval. A significant omnibus test, post-hoc comparison of the 2 drilling techniques’ mean values was accomplished using a pooled estimate of the standard error with P-value set at 0.05.

Results: The mean BIC% value was approximately 62.5% in the osseodensification group, and 31.4% in the regular instrumentation group. Statistical analysis showed a significant effect of the drilling technique (P = 0.018). There was no statistical difference in BAFO as a function of drilling technique (P = 0.198).

Conclusion: The combined osseodensification drilling-alveolar ridge expansion technique showed increased evidence of osseointegration and implant primary stability from a histologic and biomechanical standpoint, respectively. Future studies will focus on expanding the sample size as well as the timeline of the study to allow investigation of long-term prognosis of this novel technique.

*New York University College of Dentistry

Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY

Department of Periodontology, College of Dentistry, University of Florida College of Dentistry, Gainesville, FL

§Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, NY

||Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.

Address correspondence and reprint requests to Andrea Torroni, MD, PhD, Hansjörg Wyss Department of Plastic Surgery, New York University, Bellevue Hospital Center, 462 1st Ave, Room 5S19A, New York City, NY 10016; E-mail:

Received 8 February, 2018

Accepted 17 July, 2018

This work was partially funded by BRR Tech, MI, USA.

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.