Effect of Osseodensification with and without iPRF on implant stability quotient and crestal bone level: A randomized controlled clinical trial

Dental implants have become a cornerstone in modern restorative dentistry, offering reliable solutions for replacing missing teeth. Achieving optimal implant stability and successful osseointegration are critical for the long-term success of implant therapy. Conventionally, implant placement involves subtractive drilling techniques to create osteotomies, which may compromise bone density and volume, particularly in areas with low-quality or thin cortical bone. While this approach is widely accepted, the challenges associated with bone remodeling and the time required for osseointegration remain areas of ongoing research and innovation.

In 2013, Huwais and Meyer presented an innovative approach for preparing implant sites that addresses bone defects by forming a densified osteotomy with reduced heat generation and a technique that does not cut bone, which is known as the osseodensification technique utilizing Densahâ„¢ Burs that promote bone densification throughout the osteotomy process.

Unlike conventional drilling, this new technique proposes the method of bone compaction through the application of controlled deformation due to rolling and sliding contact along the inner surface of the osteotomy with the rotating lands of the densifying bur. Growth factors, such as bone morphogenic proteins and platelet-derived growth factor (PRF), have been used in numerous trials to promote bone development in the affected areas. In the treatment of the perimplant bony defect, PRF has shown osteoinductive qualities and speeds up bone recovery.

A biomaterial made from human blood called platelet rich fibrin (PRF) is a part of a platelet concentrate that is produced by centrifugation. It is frequently used in dentistry and medicine for tissue regeneration, post-operative recuperation, and rehabilitation. The hemostatic, adhesion, and healing qualities of fibrin plasma have benefited neurological, ophthalmic, reconstructive, dental, cardiovascular, and thoracic procedures.

Platelet-rich fibrin (PRF), which was originally developed by Choukroun et al in 2001, is a 2nd-generation platelet concentrate that represents the development of the therapeutic use of a platelet gel that aims to collect platelets, leukocytes, and related cytokines in a fibrin clot. Whitman et al concluded that wound healing is improved by using platelet concentrates instead of fibrin glue. A specific quantity of progenitor cells is drawn from the bloodstream via injectable PRF, which offers the advantages of advanced PRF in the form of a liquid. It has demonstrated exceptional efficacy in regenerative medicine and oral surgery.

The PRF application likely increases implant stability as proved by a higher implant stability quotient (ISQ). Thus, the application of PRF favors rapid osseointegration.Therefore, this randomized control clinical trial study the effect of Osseodensification with iPRF on implant stability quotient and crestal bone level.