Journal of Oral Implantology May 2013 - (Page 241)

RESEARCH Use of Osteotomes for Implant Bed Preparation— Effect on Material Properties of Bone and Primary Implant Stability Tim Krafft, PD Dr Dr Friedrich Graef, Dr Werner Winter, Dr-Ing Manfred Wichmann, Prof Dr Matthias Karl, PD Dr* The aim of this study was to evaluate the efficacy of osteotomes in enhancing bone quality as compared to conventional implant bed preparation using burrs. Polyurethane foam blocks differing in density (10 pcf, 20 pcf) and structure (cellular, solid) were used. Ten implant sockets were prepared in each of the materials by means of drilling and by using osteotomes. Bone quality was assessed by measuring implant insertion torque and primary implant stability (resonance frequency analysis). Additionally, a newly designed device (BoneProbe) for bone quality testing during dental implant surgery based on intraoperative compressive tests was applied. Multivariate analysis of variance with Pillai’s trace was used as test statistic (level of significance: a ¼ 0.05) and Pearson correlation coefficients were calculated for all combinations of parameters. Whereas a significant influence of bone type on all measurement results (P ¼ 0) could be found, the factor preparation technique only showed a significant effect on BoneProbe measurements in the cortical area (P ¼ 0) and on implant insertion torque (P ¼ 0). The interaction of bone type and preparation technique showed a significant effect on BoneProbe measurements in the trabecular area (P ¼ .002) and on implant insertion torque (P ¼ 0). Significant correlations between all parameters were found. The application of osteotomes leads to higher values for compressive testing of bone in the apical part of an osteotomy depending on the initial density of the bone. Intraoperative compressive testing appears to be sensitive enough for quantifying localized changes in bone quality. Key Words: bone density, bone quality, implant stability, mechanical testing, osteotome INTRODUCTION L ocal alveolar bone quality and quantity, geometry of the implant as well as the placement technique used have been shown to affect primary implant stability.1,2 As this purely mechanical phenom- University of Erlangen-Nuremberg, Germany * Corresponding author, email: Matthias.Karl@uk-erlangen.de DOI: 10.1563/AAID-JOI-D-10-00187 enon of primary stability is difficult to achieve in low quality bone, modifications of the regular surgical protocol for implant placement such as undersized drilling,3 the use of tapered implants,2 and the use of osteotomes4–6 have been suggested. For nonablative implant bed preparation by means of osteotomes, it has been claimed that bone would be condensed and relocated both laterally and apically, thereby enhancing local bone density and consequently primary implant stability.4,7 Journal of Oral Implantology 241

Table of Contents for the Digital Edition of Journal of Oral Implantology May 2013

Implantology: Inter-Dependent Worldwide Relationships
Use of Osteotomes for Implant Bed Preparation-Effect on Material Properties of Bone and Primary Implant Stability
The Effects of a Static Magnetic Field on Bone Formation Around a Sandblasted, Large-Grit, Acid-Etched-Treated Titanium Implant
Effect of Platelet-Rich Plasma on the Outcome of Early Loaded Dental Implants: A 3-Year Follow-up Study
Flapless Dental Implant Surgery for Patients on Oral Anticoagulants-The "WarLess Procedure": A Report of 2 Cases
Radiographic Evaluation of Narrow-Diameter Implants After 5 Years of Clinical Function: A Retrospective Study
Histomorphometry of 2 Immediately Loaded Mini Implants Retrieved From Human Mantible After 3 Months: A Light and Scanning Electron Microscopy Report
Splinted Zirconia Fixed Partial Denture Supported by Small Diameter (Mini Implants) in the Posterior Mandible: A Case Letter

Journal of Oral Implantology May 2013