Effect of surgical techniques on primary implant stability and peri-implant bone

Purpose: To evaluate the primary stability of dental implants placed with condensing-osteotome versus drilling-osteotome techniques and to explore peri-implant mircromorphologic consequences of lateral bone condensing. Materials and Methods: The experimental model designed for the study comprised bilateral iliac crests from 3 fresh frozen human cadavers. Two AstraTech dental implants (AstraTech AB, Molndal, Sweden) were consecutively placed with condensing- and drilling-osteotome techniques in bone with a 10-mm interimplant distance. Six experimental bone sites received a total of 12 implants. Installation torque values (ITVs) and implant stability quotients (ISQs) were measured to quantify primary implant stability. Bone specimens including implants were removed to quantify the peri-implant relative bone volume and bone microstructural parameters in the I-mm circular vicinity of implants using desktop computed tomography (microCT). The Mann-Whitney U test was used to evaluate the differences in primary implant stability values and microCT data for the surgical placement techniques. Results: ITVs and ISQs were similar for both surgical placement techniques without statistical significance (P > .05). Relative bone volumes around implants placed with the condensing-osteotome technique were significantly (P < .05) higher than those around implants placed with the drilling-osteotome technique. Microstructural parameters, such as trabecular thickness, separation, and number, differed significantly between the 2 osteotome techniques. Conclusions: managing implant sites with the condensing-osteotome technique results in notable changes in peri-implant bone architecture but might not be as promising in improving primary implant stability compared with the drilling-osteotome technique. (c) 2007 American Association of Oral and Maxillofacial Surgeons.