The Effect of Osteotomy Preparation Techniques and Implant Diameter on Primary Stability and the Bone-Implant Interface of Short Implants (6 mm)

Purpose: To evaluate the effect of osteotomy preparation techniques and implant diameter on primary stability and the bone-implant interface of short implants (6 mm) when placed in bone with a high degree of cancellous content. Materials and Methods: Overall, 90 short dental implants (6 mm; Astra Tech Implant System EV, Dentsply Sirona) were divided into nine groups based on width (narrow implants [N]: 4.2 mm; regular implants [R]: 4.8 mm; or wide implants [W]: 5.4 mm), and the type of osteotomy preparation used (standard [ST], osteotome [OT], or osseodensification [OD]) to be placed in porcine tibia plateau bone samples. The following groups were created: group N-ST, group N-OT, group N-OD, group R-ST, group R-OT, group R-OD, group W-ST, group W-OT, and group W-OD. The insertion torque and implant stability quotient (ISQ) were measured. Additionally, four implants from groups N-ST, N-OT, and N-OD were evaluated histomorphometrically. Results: The insertion torque was significantly higher for implants in group W-OD compared to group W-ST (50.00 ± 14.14 Ncm vs 28.00 ± 10.85 Ncm; P = .005). Similarly, the insertion torque was significantly higher for implants in group W-OT compared to group W-ST (46.87 ± 17.10 Ncm and 28.00 ± 10.85 Ncm, respectively; P = .026). The insertion torque was also significantly higher for implants in group W-OD compared to group N-OD (50.00 ± 14.14 Ncm and 31.5 ± 15.82 Ncm, respectively; P = .04). No significant differences were observed for the percentage of bone marrow space and connective tissue in contact with the implant surface between studied groups. Conclusions: Osteotomy preparation technique in sites with a high degree of cancellous content was found to influence the implant insertion torque for short and wide implants (5.4 × 6 mm). Implant width was found to influence the insertion torque of short implants placed with the OD technique.