Numerical trends suggest that osseodensification may offer marginally better primary stability and Summers’ osteotome technique showed slightly lower initial values, which should be interpreted cautiously given the small sample size and relatively short follow-up period.
Abstract
The aim of this clinical trial was to compare the implant stability in terms of primary and secondary stability with three different osteotomy techniques, to establish a protocol that can consistently help achieve increased implant stability in the maxillary posterior region. A total of 30 patients (19 males, 11 females; mean age 46.3 ± 8.7 years) requiring single implant placement in the maxillary posterior region were divided into three groups. Endosseous implants (Straumann Bone Level Tapered, SLActive surface, 4 mm × 10 mm) were placed in Group I using conventional osteotomy, Group II with Summers’ osteotome technique, and Group III with the osseodensification technique. All implants were placed with an emerged (non-submerged) technique and immediately restored with provisional prostheses adjusted to eliminate centric and eccentric contacts (immediate restoration without functional loading). The stability was assessed at the time of implant placement, at three months and at six months using resonance frequency analysis (Osstell). One-way ANOVA and Tukey post-hoc test were used to compare the ISQ values between groups, and repeated measures ANOVA for intragroup comparisons. No statistically significant differences were observed in the ISQ values at the time of placement, three months, and six months after implant placement between Group I (Conventional osteotomy), Group II (Summers’ osteotome technique), and Group III (Osseodensification). However, numerical trends indicated slightly lower initial primary stability in Group II and slightly higher values in Group III throughout the observation period. All implants achieved 100% survival at six months. Within the limitations of this exploratory study, all three osteotomy techniques achieved adequate primary stability for immediate restoration in the maxillary posterior region. While no statistically significant differences were detected between techniques, numerical trends suggest that osseodensification may offer marginally better primary stability and Summers’ osteotome technique showed slightly lower initial values. These findings should be interpreted cautiously given the small sample size and relatively short follow-up period. Further large-scale, adequately powered studies are needed to definitively establish clinical superiority of any technique. CLINICAL TRIAL REGISTRY OF INDIA (CTRIICMR) REGISTRATION NO. CTRI/2021/09/036513. Registered retrospectively on 15/09/2021 (enrollment began September 2020). Available at https://www.ctri.nic.in.
Neither the choice of drilling technique nor the implant macrogeometry significantly influences insertion torque or stability levels in regions of low bone density in this randomized controlled clinical study.
Worood A Akram, S. Bede· The Journal of craniofacial...· 0 citations
AIM
To compare the clinical outcomes of digitally assisted immediate implant placement in the posterior mandible using immediate (Type A) and delayed (Type C) loading protocols.
METHODS
Eighty-two patients requiring five-unit fixed partial dentures supported by three implants were consecutively enrolled. All cases were planned using a fully digital workflow integrating CBCT, intraoral scanning, and static computer-guided surgery. Only implants achieving adequate primary stability (insertion torque ≥25 Ncm and/or ISQ ≥60) were included. Patients were assigned to either immediate or delayed loading protocols. Implant survival, marginal bone loss (MBL), plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were evaluated over variable follow-up periods according to the timing of patient enrollment and treatment completion.
RESULTS
A total of 246 implants were placed, yielding an overall survival rate of 97.5% with no significant differences between loading protocols. Mean MBL was 0.7 mm and remained comparable between groups. Peri-implant parameters, including PI, BOP, and PD, were stable throughout follow-up. Regression analysis identified restorative angles >30° as the only significant predictor of increased MBL.
CONCLUSION
Digitally guided immediate implant placement in the posterior mandible demonstrated high survival rates and favorable peri-implant outcomes with both Type A and Type C loading protocols.
CLINICAL SIGNIFICANCE
Type A loading may provide a predictable and time-efficient alternative to conventional delayed loading without compromising clinical outcomes.
Mohammed A. Elsawy, Mohammed T. Khater, Islam Kandil et al.· E -journal of dentistry· 0 citations
Immediate implant placement (IIP) and loading protocols have emerged as predictable treatment strategies in contemporary dentistry, particularly in the esthetic zone. These approaches offer advantages such as reduced treatment time, preservation of peri-implant soft tissue architecture, and improved patient satisfaction. However, biological and prosthetic prerequisites, including adequate bone and soft tissue support and primary stability, must be fulfilled to ensure long-term success. This case report presents the management of an 18-year-old female patient with high esthetic demands who underwent IIP, grafting, and provisionalization in the maxillary anterior region. Following atraumatic extraction and implant placement with sufficient stability, grafting was performed and a screw-retained provisional restoration was delivered within 24 h. After a 3-month healing period, definitive zirconia implant-supported restorations were fabricated and cemented. Over a 10-month follow-up, no complications were observed, and satisfactory esthetic and functional outcomes were achieved. The results indicate that, with proper case selection, sufficient primary stability, and careful prosthetic planning, immediate implant loading can provide reliable and predictable outcomes.
M. N. Ürün, M. Toprak, Serdar Polat· Akdeniz Diş Hekimliği Dergis...· 0 citations
The clinically meaningful esthetic advantages of IIP support its preferential use in the anterior zone when anatomical conditions permit and when combined with guided protocols and customized healing abutments, IIP and EIP yield comparable 12-month marginal bone outcomes.
Sara N. El Touliani, Ahmed M. Abdel-Hamid, Nada M. H. Fahmy et al.· Frontiers in Dental Medicine· 0 citations
The clinical outcome supports current evidence indicating that osseodensification may enhance initial stability and predictability of immediate implants placed in posterior mandibular regions.
Márcio de Carvalho Formiga, Jucielly Santos Lesnik de Souza, Gustavo Dos Santos Coura et al.· Reports· 0 citations
Objectives: The primary objective of this retrospective pilot study was to evaluate the long-term radiographic stability of peri-implant marginal bone levels (MBLs) at a five-year follow-up, comparing two different socket preservation protocols against spontaneous healing. Materials and Methods: A total of 24 patients who underwent tooth extraction followed by delayed implant placement were divided into three groups of 8 subjects each. Test Group 1 was treated with a heterologous cortico-cancellous bone graft covered by a slow-resorbing bovine pericardium membrane. Test Group 2 received the same bone graft but covered by a rapidly resorbing native porcine collagen membrane. The Control Group was left to heal spontaneously. Marginal bone loss (MBL) was calculated radiographically by measuring the difference in bone levels between the time of osseointegration (T0) and the 5-year follow-up (T1). For each implant, mesial and distal MBL values were averaged to obtain a single mean per-implant MBL value for group-level analysis. Results: The 5-year implant survival rate was 100% across all analyzed groups. Test Group 1 demonstrated the highest peri-implant bone stability, recording a mean MBL of 0.17±0.20 mm. In contrast, Test Group 2 and the Control Group exhibited greater resorption, with mean MBL values of 0.46±0.12 mm and 0.45±0.27 mm, respectively. Descriptive analysis indicated a trend toward improved peri-implant bone preservation in the group treated with biomaterial and a slow-resorbing pericardium membrane compared to both the short-resorbing collagen membrane group and the spontaneous healing control group. Conclusions: Within the limitations of this pilot study, the results suggest that the choice of barrier membrane in socket preservation procedures could affect 5-year marginal bone stability. The application of a slow-resorbing membrane provided a prolonged barrier action and showed a descriptive trend of lower mean marginal bone loss. However, the extremely small sample size precludes establishing clinical superiority over standard collagen membranes or spontaneous healing. Further randomized clinical trials with larger cohorts are necessary to confirm these long-term findings.
E. Colombo, E. Giammarinaro, M. Menini et al.· Dental journal· 0 citations
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