Combined effect of undersized surgical technique and axial compression on the primary implant stability and host bone architecture

AimThe aim of this study was to investigate the combined effect of the lateral-compression of host-bone (undersized-osteotomy-preparation) and axial-compression of host-bone (not drilling the full length of the implant) on the primary-implant-stability and the host-bone-architecture.Materials and MethodsIn this experimental-study, 44 dental implants (diameter-4.2 mm; length-10 mm; Dyna®) were installed in the femoral-condyles of four cadaver-goats using four different surgical approaches (11 implant/surgical approach; n = 11). Approach-1: Standard preparation according to the manufacturer's guidelines. The bone-cavity was prepared up to 10 mm in depth and 4 mm in diameter. Approach-2: Preparation up to 8 mm in depth and 4 mm in diameter. Approach-3: Preparation up to 10 mm in depth. Approach-4: The bone-cavity was prepared up to 8 mm in depth and 3.6 mm in diameter. Insertion torque (n = 11), removal torque (n = 7) and % bone-implant contact (n = 4) measurements were recorded. Bone architecture was assessed by micro-computer tomography and histological analysis (n = 4).ResultsFor approaches 2, 3, and 4 (P < .05), insertion-torque values were significantly higher as compared to approach 1. Regarding the bone-implant-contact percentage (%BIC), approach 3 and 4 were significantly higher compared to approach 1 and 2 (P<.05). For approach 2, the %bone volume (%BV) was significantly higher as compared to approach 1 (P<.05) for the most the inner zone of host bone in proximity of the implant.ConclusionLateral and axial compression improved the primary-implant-stability and therefore this new surgical-technique should be considered as an alternative approach especially for placing implants in low-density bone. Nevertheless, additional in vivo studies should be performed.