Primary stability is a key determinant of dental implant success, particularly in low-density bone. Osseodensification (OD) is a non-subtractive drilling technique designed to preserve and compact bone during osteotomy preparation, potentially improving implant stability while maintaining patient comfort. However, clinical evidence regarding its influence on postoperative pain and dental anxiety remains limited.

Primary stability is a key determinant of dental implant success, particularly in low-density bone. Osseodensification (OD) is a non-subtractive drilling technique designed to preserve and compact bone during osteotomy preparation, potentially improving implant stability while maintaining patient comfort. However, clinical evidence regarding its influence on postoperative pain and dental anxiety remains limited.

In this prospective randomized clinical trial, 72 patients receiving 337 dental implants were assigned to conventional drilling or osseodensification groups. Postoperative pain was assessed using a Visual Analog Scale (VAS) at immediate, 24-hour, 72-hour, and 10-day intervals. Dental anxiety was evaluated using the Modified Dental Anxiety Scale (MDAS). Implant stability was measured using insertion torque and implant stability quotient (ISQ) values at placement and after 3 months.

Inclusion Criteria:

• at least 18 years old,
• requiring implant-supported tooth restorations,
• with adequate alveolar bone volume,
• with bone density classified as D1-D4 according to Lekholm and Zarb classification,
• who provided written informed consent to participate in the study.

Exclusion Criteria:

• uncontrolled systemic disease,
• smoking more than 10 cigarettes per day,
• parafunctional habits (e.g., bruxism),
• bisphosphonate use,
• previous grafting at the implant site.