Influence of different implant placement techniques to improve primary implant stability in low-density bone: A systematic review

AIM: The aim of this study is to assess the influence of different implant placement techniques to improve primary implant stability (PIS) in the low-density bone. MATERIALS AND METHODS: Citations published in English and those available in full text were searched from electronic databases (PubMed and Google Scholar) from the year 2000–2017 by which 75 manuscripts were revealed. After applying inclusion and exclusion criteria, seven were selected for the present review. The whole process was conducted by the following preferred reporting items for systematic reviews and meta-analyses guidelines. RESULTS: The measurement of primary stability showed significant correlations with different bone densities and with implant outcome; however, these two parameters have not been investigated at the same time frequently. Of the seven manuscripts, three discussed standard drilling protocol, two used undersized drilling, one used guided drilling, and one compared standard drilling with undersized drilling. Several intraoperative methods of jaw bone-density assessment were reported, and resonance frequency analysis, periotest, and insertion torque values were used to quantify PIS. CONCLUSION: The use of undersized drilling has proven advantageous for increasing initial implant stability in the low-density bone. Although the PIS may be lower, the secondary implant stability is found to be correlated to acceptable values.