A Novel Osseodensification Technique for Dental Implant Placement in Osteoporotic Patients (A Clinical Prospective Study)

Background: Implant placement in osteoporotic patients is not a forgiving choice, and always threatened by a high tendency
of failure. Female patients are more prone to osteoporosis, and posterior maxilla is known to have low bone density than both
anterior maxilla and mandible. The recently introduced osseodesification kits aimed to improve the predictability of these
cases. The aim of this study is to evaluate the effect of osseodensification technique by reversing the direction of rotation during
implant drilling on implants placed in osteoporotic female patients.
Materials and Methods: Twenty-four female patients with edentulous posterior maxilla were recruited and divided equally
into two groups, the first group (osteoporosis group) received dental implants while preparing the implant osteotomies with an
opposite drilling direction while the second group (control group) received dental implants with a conventional forward drilling
direction. Implant stability quotient was measured by the Ostell device both immediately and six months later. On the same time
intervals, a CBCT was requested to determine the change in bone density.
Results: A total of 44 implants were placed, 24 were placed in group one, while the remaining 20 were placed in the control
group. All of them successfully showed bone osseointegration and were then loaded six months later. For group 1, the mean
Ostell reading was 50.62 + 15.88, after 6 months follow up interval the mean was 65.96 + 15.02. While for group 2 ostell
reading was 61.70 + 4.78, after 6 months follow up interval the mean was (71.33 + 2.02). There was a significant increase in
the ostell reading in both groups. Regarding the mean calculated bone density, it was 371.92 + 200.82 HU in the immediate
postoperative CBCT for group 1, while 446.91 + 185.26 HU for group 2. It increased non-significantly to 499.85 + 251.78 HU
and 572.47 + 184.72 HU respectively, with no statistical significance in both groups.
Conclusion: The osseodensification technique using the reverse drilling direction is a reliable and successful technique, which
allows implant placement in osteoporotic patients.