Use of osteotomes for implant bed preparation - Effect on material properties of bone and primary implant stability

Abstract

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: α = 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=0) could be found, the factor preparation technique only showed a significant effect on BoneProbe measurements in the cortical area (P = 0) and on implant insertion torque (P = 0). The interaction of bone type and preparation technique showed a significant effect on BoneProbe measurements in the trabecular area (P = .002) and on implant insertion torque (P = 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.