Osseodensification versus piezoelectric surgery for implant site preparation

Osseodensification is a non-subtractive drilling technique that preserves and compacts bone. This procedure attempts to increase bone density, insertion torque and implant stability. The technique is suitable for horizontal augmentation in narrow alveolar ridges, as well as for vertical height gain via crestal sinus lift.

Osseodensification vs piezoelectric surgery

Stacchi et al (2023) conducted a multicentre randomised controlled trial to measure changes in implant stability over the first 90 days of healing after implant site preparation with osseodensification burs (OD; Densah, Versah) or piezoelectric implant site preparation (PISP; Implant Crestal Set, W&H). Twenty-seven patients received two identical implants each in the posterior maxilla, one site prepared with OD and the other with PISP. Implant stability was measured by resonance frequency analysis (SmartPeg #A3, Osstell Beacon, Osstell) immediately after implant placement and at specified intervals up to 90 days after. The insertion torques of the two techniques were also compared and documented directly with the W&H Implantmed.

At the time of implantation, there were no significant differences between the two groups in terms of primary/mechanical stability. During the 90-day healing period, there were no significant differences in ISQ values between the two groups. At one year, 53 of the 54 implants were successfully osseointegrated and functional.

Overall, the results suggest that there are no significant differences in primary/mechanical or secondary/biological stability or in implant survival rate after one year of loading between implants placed with OD or PISP. However, the authors stated that further studies are needed to better understand the bone healing process following osseodensification procedures and potential benefits of this approach for dental implant placement in low-density bone.

This study indicates that both concepts represent a successful method of implant site preparation. As an individual solution provider, W&H therefore enables both approaches, on the one hand the W&H Implantmed with integrated CCW-Torque indicator function and on the other hand the modular combination of W&H Implantmed and Piezomed module with instrument sets tailored to the application. Therefore, it is up to the oral surgeon to choose which approach fits the most for their dental implant therapy.

Reference

1. Almutairi AS, Walid MA, Alkhodary MA. The effect of osseodensification and different thread designs on the dental implant primary stability. F1000Res 2018; 7: 1898.
2. Bhalla N, Dym H. Update on Maxillary Sinus Augmentation. Dent Clin North Am 2021; 65: 197-210.
3. Yu X, Chang C, Guo W, Wu Y, Zhou W, Yu D. Primary implant stability based on alternative site preparation techniques: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24: 580-590.
4. Stacchi C, Troiano G, Montaruli G, et al. Changes in implant stability using different site preparation techniques: Osseodensification drills versus piezoelectric surgery. A multi-center prospective randomized controlled clinical trial. Clin Implant Dent Relat Res. 2023;25(1):133-140.