Implant Stability Quotients of Osteotome Bone Expansion and Conventional Drilling Technique for 4.1 mm Diameter Implant at Posterior Mandible.
BACKGROUND
Clinical conclusions in studying the stability and osseointegration of mandibular implants positioned using the bone expansion techniques are conflicting and limited.


OBJECTIVE
The objective was to examine the implant stability quotient (ISQ) values of mandibular posterior dental implants with 4.1 mm diameter that inserted with osteotome bone expansion technique versus conventional drilling technique during a 12-week observation period.


METHODS
Twenty-four implants with 4.1mm diameter in 18 patients were included. Twelve implants in 10 patients were positioned using osteotome bone expansion technique, and 12 fixtures in 9 patients were installed using the conventional drilling technique. The ISQ values of a 3.3 mm diameter implant was measured at recipient sites (ISQb) before final drilling or expansion technique to standardize the increased ISQ value of 4.1 mm diameter implants. The ISQ values at Weeks 0, 1, 2, 3, 4, 6, 8, 10, and 12 post-surgery were recorded. Data were analyzed by Wilcoxon rank sum test, repeated measure ANOVA, and Fisher Lest Significant Difference test.


RESULTS
Calibrated according to a 3.3-mm-diameter implant, bone expansion technique was adopted for the sites with ISQ≦65 bone density, and the areas with ISQ >65 bone condition were treated with conventional drilling technique (p =.038). Both groups presented a similar healing pattern and a comparable ISQ reading from Week 0 to Week 12 (p > .05) for 4.1 mm diameter implants. However, bone expansion technique could enhance more stability when the ISQ values were calibrated by 3.3 mm diameter implant (p < .05).


CONCLUSIONS
Bone expansion technique substantially increased more ISQ values from primary stability and achieved comparable primary and secondary stabilities with the conventional technique. Both groups reached a stability plateaus at Week 10.
Associate professor, Attending, Department of Periodontology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taipei, Taiwan; and Department of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
Hsiang-Hsi
HH
Hong
California Northstate University, College of Medicine, Elk Grove, CA, USA.
Adrienne
A
Hong
Biostatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Lan-Yan
LY
Yang
Biostatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Wei-Yang
WY
Chang
Attending, Lecturer, Department of Prosthodontics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taipei, Taiwan.
Yi-Fang
YF
Huang
Attending, Department of Periodontology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan and College of Medicine, Chang Gung University, Taipei, Taiwan.
Yen-Ting
YT
Lin
D000328:Adult; D000368:Aged; D000539:Alveolar Process; D015519:Bone Density; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D006801:Humans; D007575:Jaw, Edentulous; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration; D010027:Osteotomy
D015921:Dental Implants
bone expansion; edentulous mandible; implant stability