Primary and secondary stability in implants placed in low-density bone using conventional vs. osseodensification technique: a systematic review and meta-analysis.

ABSTRACT:

Background

One of the most important clinical challenges in implant dentistry is achieving stability in low-density bone. Identifying a method that maximizes implant stability in bones of low quantity and quality is crucial. Osseodensification (OD) has been suggested as an alternative to conventional drilling (CD) to improve implant stability. This study compared the primary and secondary stability of two commonly used techniques for implant placement in low-density bone: CD and OD.

Methods

Search was conducted in PubMed, Scopus, Web of Science, EMBASE, and Google Scholar up to January 2024. Studies that evaluated dental implant placement in low-density bone using the OD technique and compared it with CD were included in this study. These studies assessed primary and secondary stability using the Implant Stability Quotient (ISQ). Additionally, other outcomes such as marginal bone loss (MBL), crestal bone level (CBL), probing depth (PD), and plaque index (PI) were analyzed. The meta-analysis was conducted using a random-effects model and presented as overall mean differences along with 95% confidence intervals (CIs) and p-values for each outcome. Subgroup analyses were also performed for a few outcomes, primarily by follow-up time or anatomical site of intervention. The Comprehensive Meta-Analysis software, version 2, was used for all analyses.

Results

Seven studies met the inclusion criteria. The follow-up periods varied across studies and included 4, 6, 8, and 12 months. There are no statistically significant differences between OD and CD groups in primary stability (MD = 4.13, P = 0.13) or secondary stability (MD = 1.78, P = 0.11). No significant differences were found in MBL and PI. However, for PD, the OD group showed a significantly lower PD at 12 months. In the CBL outcome, a significant difference in favor of OD was observed only at the palatal site.

Conclusion

There is not enough strong evidence to say that OD is better than CD in the long term. More randomized clinical trials (RCTs) with standardized protocols and longer follow-up periods are recommended. Additional long-term, well-designed comparative human studies are needed to declare the advantages and disadvantages of the OD technique vs. the CD technique. There was some heterogeneity across sites, gender, duration of follow-up, implant system, and operator, but not affect the comparability and generalizability of this meta-analysis.

SUBMITTER: Mohammadi M 

PROVIDER: S-EPMC12659130 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature