In the medical history, the 55 year-old patient states that he has no systemic disease and is not taking any medication. The patient’s lifestyle is similarly unremarkable. The patient has a few tooth restorations and two implants (2nd and 4th quadrants). On the basis of current findings, gingivitis is identified in an otherwise stable periodontal condition on the reduced periodontium (stage III, grade A).

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.

Long-term success in implant therapy is an aim that all clinicians strive for. Fundamental to this is proper implant placement, surgical site preparation, and good osseointegration after insertion. Although a torque value is a basic prerequisite for primary stability, it alone does not provide complete information for the clinician. Therefore, knowledge of ISQ values is fundamental to assess both primary implant stability (mechanical stability) and secondary implant stability (biological stability or osseointegration).

Snus is usually brought into contact with the oral mucosa via its placement beneath the upper lip, and in some cases under the lower lip, whereby the nicotine it contains can enter the bloodstream via the oral mucosa