Assessing the initial Primary Stability of Dental Implants via various Osteotomy Preparation Techniques: An Ex Vivo Comparative Study Utilizing Two Distinct Non-invasive Methods

Abstract

Background and aim: Stable connection between dental implants and bone is crucial in implant dentistry. Osteotomy preparation methods, such as Conventional drilling (C), Piezoelectric Bone Surgery (P), and Osseodensification (Densah bur) (D), play a major role in this process. The primary stability of implants, which influences prognosis and loading protocols, is affected by several factors, including cortical bone thickness. . Two innovative noninvasive devices like Periotest® (Siemens AG, Bensheim, Germany) and resonance frequency analysis (RFA) (Osstell Mentor) (Integration Diagnostics AB, Göteborg, Sweden) have been introduced to measure implant primary stability. The aim of this study is to assess and compare the primary stability of dental implants inserted through (C), (P), and (D), utilizing Resonance Frequency Analysis and Periotest, and to explore the effect of cortical bone thickness on the primary stability. Methods: Ten porcine ribs were utilized, with three osteotomies per rib employing (C), (P), and (D) techniques. Each technique involved ten implant preparation sites for 4.1 x 10 mm implants. Primary stability was assessed using Periotest and RFA. Bone thickness was measured using a calibrated dental ruler after bone sectioning at osteotomy sites. Statistical analysis involved one-way repeated measures ANOVA and multiple comparison tests, with significance set at p < 0.05 for the first objective. The second objective utilized the Pearson Correlation Coefficient (r) test. v Results: The mean ISQ for RFA was reported as 69.85, 68.25, and 73.05 for (C), (P), and (D), respectively. The PTV (Periotest Value) was recorded as -5.2300, -3.2250, and -3.5000 for (C), (P), and (D), respectively. The (D) technique exhibited a higher mean RFA score compared to (C) and (P) techniques, while Periotest scores were lower for (C) than (P) and (O). Interestingly, there was no consistent ranking between the RFA and Periotest results. Furthermore, no significant correlation was found between cortical bone thickness and either RFA or Periotest scores. Conclusions: While statistically significant differences were observed, all three techniques demonstrated results falling within the range of good clinical primary stability. The study suggests that there is no significant clinical distinction between (RFA) and Periotest. Additionally, cortical bone thickness did not show a significant correlation with either RFA or Periotest results.