Comparison of heat production and bone architecture changes in the implant site preparation with compressive osteotomes, osseodensification technique, piezoelectric devices, and standard drills: an ex vivo study on porcine ribs

This study aimed at investigating differences in heat generation and bone architecture following four different implant site preparation techniques: compressive osteotomes, conventional drills, osseodensification (OD mode with osseodensification drills), and piezoelectric systems. Porcine rib bones were used as a model for implant surgery. Thermocouples were employed to measure temperature changes, and micro-CT to assess the bone architecture. The primary stability and insertion torque values of the implants placed in the differently prepared sites were assessed. The temperature changes were higher with Piezo. The average primary stability using the ISQ scale was the greatest for drills (76.17 +/- 0.90) and the lowest for osteotomes (71.50 +/- 11.09). Insertion torque was significantly higher with the osseodensification method (71.67 +/- 7.99 Ncm) in comparison to drills, osteotomes, and piezo. Osteotomes showed the highest bone to implant contact percentage (39.83 +/- 3.14%) and average trabecular number (2.02 +/- 0.21 per mm), while drills exhibited the lowest (30.73 +/- 1.65%; 1.37 +/- 0.34 per mm). Total implant site bone volume was the highest with osseodensification (37.26 +/- 4.13mm(3)) and the lowest for osteotomes (33.84 +/- 3.84mm(3)). Statistical analysis showed a high primary stability and decrease in temperature during implant site preparation with osseodensification technique. The results support the use of osseodensification technique for implant site preparation.