A comparative study of crestal bone loss and implant stability between osteotome and conventional implant insertion techniques: a randomized controlled clinical trial study.

PURPOSE: The aim of this prospective randomized controlled clinical study was to assess the crestal bone loss and the implant stability in implants that were placed by the osteotome technique compared with the conventional drilling technique.

MATERIALS AND METHODS: Forty-six screw type Straumann SLA® oral implants (Straumann AG, Waldenburg, Switzerland) were inserted in the anterior segment of maxilla of 30 patients. The implant site was prepared randomly using either osteotome technique (test group) or the conventional drilling technique (control group). Radio frequency analysis (RFA) values at implant placement and after 3 months were recorded. The crestal bone loss was measured using digital subtraction radiography technique after 3, 6, and 12 months.

RESULTS: RFA demonstrated a statistically significant higher primary stability for implants in the osteotome group than that of the conventional group (p=.026) at the time of implant insertion. However, there was no statistically significant difference between both groups 3 months after the surgery (p=.06). At month 3, the osteotome group caused significantly more crestal bone loss than the conventional group (p=.04). At months 6 and 12, both groups had comparable bone levels (p=.29).

CONCLUSION: Osteotome technique yielded higher primary stability than conventional drilling technique. However, this technique was not superior to conventional technique after 3 months.