Effect of Rotating Osteotomes on Primary Implant Stability—An In Vitro Investigation
Achieving sufficient primary implant stability in poor-quality bone is difficult. Other than for conventional osteotomes, little is known about the effectiveness of screw-shaped spreaders in condensing bone and increasing primary stability. Therefore, implant stability quotient (ISQ) measurements of implants placed in bone surrogate models were conducted. Whereas bony microarchitecture had no effect on implant stability, initial bone density, presence of a cortical layer, and the use of screw-shaped spreaders significantly increased ISQ levels.

Figure 1. Set of burrs, counter sink, and tapping device used for conventional implant placement. Figure 2. (a) Sequence of twist drills used for to create an osteotomy before the use of rotating osteotomes. Figure 2. (b) Set of rotating osteotomes (Split-Control 15 mm, Hager & Meisinger GmbH, Neuss, Germany) used to create implant sockets corresponding to the implant system used.

Figure 3. Implants were placed in both conventional and osteotome-prepared sockets using a surgical handpiece and the implant manufacturer's adapter. Figure 4. SmartPeg abutment attached to the implant shoulder for resonance frequency measurements using the Osstell Mentor device (Osseointegration Diagnostics AB, Gothenburg, Sweden). Figure 5. Mean values and standard deviations of implant stability quotients for implants placed in different bone surrogate materials using conventional and bone-condensing techniques for implant bed preparation.
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