ArticleMedicina oral, patologia oral y cirugia bucal2026
Primary stability of dental implants placed in low-density polyurethane blocks: Undersized osteotomy versus osseodensification, an in vitro comparative study.
Article in Medicina oral, patologia oral y cirugia bucal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrimary stability is a determinant of early implant success and becomes critical in low-density bone, where reduced trabecular support may increase micromotion risk. Undersized osteotomy and osseodensification are two commonly discussed site-preparation strategies aimed at improving initial stability through different biomechanical mechanisms. MATERIALS AND
methodsAn analytical experimental in vitro study was performed using 76 cylindrical implants (4.0×10mm) (n=38 per group) placed in type IV polyurethane blocks with a dense cortical shell. Group OS underwent an undersized osteotomy drilling sequence, while Group OD underwent osseodensification using Densah® burs operated in counterclockwise rotation. In Group OD, the final osteotomy diameter was intentionally overprepared by 0.3mm (4.3mm) relative to the implant diameter. Maximum insertion torque (Ncm) was recorded during placement. Primary stability was measured as implant stability quotient (ISQ) using the Penguin® resonance frequency analysis device (two perpendicular readings per implant; mean value used). Between-group comparisons were performed using Student's t-test for independent samples (α=0.05).
resultsGroup OS showed higher mean insertion torque than Group OD (30.66±1.71 vs 26.58±2.63 Ncm; p<0.0001). Group OD showed higher mean ISQ than Group OS (56.80±2.90 vs 52.92±3.57; p=0.00000227).
conclusionsUndersized osteotomy increased insertion torque, consistent with higher rotational resistance during insertion, whereas osseodensification increased ISQ, suggesting higher construct stiffness. Both protocols may be clinically useful in low-density bone depending on the primary objective (torque-driven mechanical engagement vs RFA-derived stiffness).
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