Histomorphometric assessment in human cadavers of the peri-implant bone density in maxillary tuberosity following implant placement using osteotome and conventional techniques

Objective: To evaluate and compare peri-implant bone condensation in the maxillary tuberosity of human cadavers following the osteotome and standard drilling techniques, and to determine whether peri-implant bone condensation following the osteotome technique is localized or homogeneous. Material and methods: Twenty-four cylinder-threaded titanium implants (12 on each side) were placed in the left (standard technique) and right (osteotome technique with tapered osteotomes for bone condensation, Straumann (R)) maxillary tuberosities of 12 edentulous posterior maxillae of deceased people who had bequeathed their bodies to the University of Santiago de Compostela for medical-scientific research. After surgery, the implants were removed with the surrounding bone, prepared using sawing and grinding technique and examined histomorphometrically. The bone density (bone area/analyzed area) of the entire, periapical (fifth apical) and pericylinder peri-implant areas was calculated, statistically analyzed and compared with the bone density of the host cancellous maxillary bone. Results: The bone density of the entire peri-implant area was statistically found to be greater with the osteotome technique (39.38 +/- 9.67) than with conventional drilling technique (31.06 +/- 5.9). This difference was greatest for the periapical zone (53.32 +/- 12.26 vs. 34.18 +/- 6.34). Nonetheless, in the pericylinder area no significant difference was found between the two techniques (32.30 +/- 8.74 vs. 30.34 +/- 7.2). Conclusion: Peri-implant bone condensation following the osteotome technique is not homogeneously observed through the entire peri-implant area. A greater bone density was achieved only in the fifth apical peri-implant area.