Background and Clinical Significance: Immediate implant placement in mandibular molars represents a clinical challenge due to lower trabecular bone density and anatomical limitations of the interradicular septum. Osseodensification has been proposed as an alternative to improve primary stability in sites with low bone quality. Case Presentation: This report describes the case of a 54-year-old female patient with a mesial root fracture in the lower right first molar, treated by atraumatic extraction followed by immediate implant placement using a densifying drilling protocol. After careful root removal, the interradicular septum was expanded using Versah burs at 1200 rpm, allowing placement of a 4.0 × 7 mm Implacil Duecone implant with a final insertion torque of 25 Ncm. The residual gap was filled with a xenogeneic bone substitute and covered with a dense polytetrafluorethylene membrane for alveolar preservation. Healing progressed uneventfully and, after four months, adequate bone formation was observed, enabling prosthetic rehabilitation with a single ceramic crown. After 4 postoperative years we could find peri-implant tissue stability. Conclusions: 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
Purpose Primary implant stability is a key factor for successful osseointegration and may be influenced by osteotomy preparation techniques, particularly in low‐density bone. Thus, this study compared undersized drilling (UD), UD combined with osseodensification, and sequential osseodensification protocols with varying degrees of undersizing in simulated bone types III and IV with respect to implant stability. Additionally, the relationships between insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ) were analyzed. Materials and Methods Eighty implants (4.0 × 11 mm) were placed in polyurethane blocks simulating type III and IV bone with a cortical layer. Four osteotomy protocols were tested: UD, UD plus osseodensification (OD1), and sequential osseodensification with −0.5 mm (OD2) and −0.7 mm (OD3) undersizing. Primary stability was assessed using IT, RT, and ISQ measurements. Data were analyzed using two‐way ANOVA, Pearson correlation, and multiple regression analysis (α = 0.05). Results OD2 and OD3 produced higher IT values in both bone types compared with UD and OD1. In type III bone, OD3 showed the highest RT values, while in type IV bone, OD2 and OD3 were significantly higher than UD and OD1. ISQ values were higher for osseodensification protocols in type III bone, whereas no significant differences were observed in type IV bone. A strong correlation was found between IT and RT (r = 0.746), whereas ISQ showed weaker associations with torque. Conclusion The use of sequential osseodensification protocols yielded superior mechanical stability parameters, specifically in IT and RT, in synthetic (polyurethane) bone models. However, improvements in ISQ were predominantly noted in the denser type III model. Importantly, because the tested protocols involved different drill designs and underpreparation dimensions, these enhancements reflect the success of the overall surgical strategy rather than the isolated effect of osseous densification.
Silvio Yoshiaki Okagawa, Alex Sandro de Souza, Paulo Sérgio Perri de Carvalho et al.· International Journal of Den...· 0 citations