ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Bone Condensing Technique is a Good Alternative to Bone Drilling Technique to Achieve Primary and Secondary Stability of Implants in the Posterior Maxilla
Clinical Question Is bone condensing a better technique compared to bone drilling to achieve primary and secondary stability of implants in Type IV bone in posterior maxilla?
Clinical Bottom Line Bone condensing provides higher primary and secondary stability of implants than drilling in type IV bone in posterior maxilla, and therefore is a good alternative to the traditional bone drilling technique.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21330161 Markovic/201148 implants placed in 8 patientsSplit Mouth Study
Key resultsThis study was conducted at the University of Belgrade, Serbia. 48 implants were placed in 8 healthy, non-smoking patients. From the original group of 10 patients, 2 patients were excluded from the study: one, due to a fracture of the buccal lamella during preparation in the condensing group. On the other patient, adequate stability was not achieved in one of the implants in the control group. On each of the remaining 8 patients, 3 implants were placed on each side of the maxilla utilizing bone-condensing technique on one side, and bone drilling technique on the other side. The stability of implants was evaluated by Resonance Frequency Analysis. Mean primary stability was significantly higher using bone condensation (74.03±3.53) compared to drilling (61.20±1.63) with P=000. The stability in the bone-condensing group remained considerably higher than the bone-drilling group at each point in time during the entire six weeks.
Evidence Search Implant[Title] AND stability[Title] AND posterior[Title] AND maxilla[Title] AND bone-condensing[Title]
Comments on
The Evidence
This study did not cover the full spectrum of patients, because it excluded the mandible by the study’s design. The criteria for the study’s conclusion were explicit and credible. The diagnostic work-up was comprehensive and consistently applied. The shortcomings of this study were that it was conduced on a relatively small number of patients and the follow up extended only 6 weeks. It does not appear that the statistical analysis made any adjustment for the clustering of implants within patients. With a small sample, it is hard to estimate the incidence of failure in terms of fracture or faulty implant stability. Further research is needed to evaluate long- term success, and to compare the stability of implants placed with both techniques over a longer period of time. Apparently, there was no conflicting interest of the author.
Applicability Bone condensing offers potential advantages over drilling as an alternative for oral surgeons, periodontists or general dentists in search of a way to improve the stability of implants in regions of the mouth with Type IV bone. Patients would benefit from a more conservative procedure that does not remove bone. An advantage of the condensing technique is that it generates a significantly smaller amount of heat than the drilling technique, which is favorable for osseointegration. The implant stability achieved by the condensing technique would potentially allow for immediate loading.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Implants, Stability, Posterior Maxilla, Bone Condensing
ID# 2599
Date of submission: 11/09/2013spacer
E-mail laura.ogas@ucdenver.edu
Author Laura N. Ogas
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ronald N. Brown, DDS
Faculty mentor/Co-author e-mail ronald.brown@ucdenver.edu
Basic Science Rationale
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