The effect of osseodensification versus conventional implant site preparation on implant stability for tapered and cylindrical dental implants.

Dental implant stability is a key factor influencing the success of osseointegration and the long-term prognosis of implant-supported restorations. The stability of an implant can be divided into two phases: primary stability, which depends on the mechanical engagement between the implant and the surrounding bone at the time of placement, and secondary stability, which develops through biological bone remodeling and osseointegration over time.

Traditional (conventional) drilling techniques used for implant site preparation are subtractive in nature, meaning they remove bone to create space for the implant. However, this process may reduce bone density at the osteotomy walls, particularly in low-density bone, potentially compromising initial stability.

Osseodensification (OD) is a relatively new, non-subtractive drilling technique introduced by Huwais and colleagues. Instead of removing bone, OD uses specially designed, counterclockwise rotating burs (Densah burs) that laterally compact and densify bone along the walls of the osteotomy.

mplant macrodesign-particularly whether the implant is tapered or cylindrical-also influences stability outcomes.

Tapered implants typically provide higher primary stability due to their wedging effect and better adaptation in underprepared osteotomies, especially in soft bone.

Cylindrical implants, while providing more uniform stress distribution, may rely more heavily on bone density and precise site preparation for achieving optimal stability.

Inclusion Criteria:

• 1-Patients who are willing to comply with the study and give their consent. 2-Ability to tolerate conventional surgical and restorative procedure. 3- Healthy patients over 18 years of either gender, having single or multiple missing teeth in the maxilla and/or mandible

Exclusion Criteria:

1. Active infection or inflammation in implant area or neighboring zone.
2. Systemic conditions (medically compromised patient) such as uncontrolled diabetes, coagulation disorders, immune compromised patient, patient treated with bisphosphate drugs, psychiatric problems or unrealistic expectations, pregnant women, any medical condition that affect bone healing.
3. Clinical evidence of parafunctional habits.
4. Active periodontitis.
5. Heavy smokers (≥20 cigarettes a day).
6. Advanced and complicated cases.
7. Patients who not able to follow the treatment protocol or lost during the study period.
8. Patient with history of radiotherapy to the head and neck -