Biomechanical, Biologic, and Clinical Outcomes of Undersized Implant Surgical Preparation : A Systematic Review

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Biomechanical, Biologic, and Clinical Outcomes of Undersized Implant Surgical Preparation : A Systematic Review

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Publication Article, review peer-reviewed scientific
Title Biomechanical, Biologic, and Clinical Outcomes of Undersized Implant Surgical Preparation : A Systematic Review
Author Stocchero, Michele ; Toia, Marco ; Cecchinato, Denis ; Becktor, Jonas P ; Coelho, Paulo G ; Jimbo, Ryo
Date 2016
English abstract
PURPOSE: To compile the current evidence on biomechanical, biologic, and clinical outcomes of undersized surgical preparation protocols in dental implant surgery. MATERIALS AND METHODS: An electronic search using three different databases (PubMed, Web of Science, and Cochrane Library) and a manual hand search were performed including in vitro, animal, and clinical studies published prior to October 2015. Studies in which an undersized drilling protocol was compared with a nonundersized drilling protocol were included. RESULTS: From an initial selection of 1,655 titles, 29 studies met the inclusion criteria, including 14 biomechanical, 7 biologic, 6 biologic and biomechanical, and 2 clinical. Due to methodologic variation, meta-analysis was not performed. Several studies showed that implants inserted with an undersized drilling approach reached a significantly higher insertion torque value than conventional drilling in low-density substrates, while this effect is less evident if a thick cortical layer is present. Similar results in terms of boneto-implant contact (BIC) were achieved in the longer term between implants inserted with undersized and nonundersized protocols. Results in the short term were inconclusive. Clinical studies did not show negative outcomes for undersized drilling, although clinical evidence was sparse. No data are available on marginal bone loss. CONCLUSION: From the biomechanical standpoint, an undersized drilling protocol is effective in increasing insertion torque in low-density bone. Biologic response in long-term healing after undersized implant placement is comparable to that in the nonundersized surgical drilling protocol. Clinical studies indicate that performing an undersized drilling protocol on low-density bone is a safe procedure; however, more extensive studies are needed to confirm these data.
DOI https://doi.org/10.11607/jomi.5340 (link to publisher's fulltext.)
Publisher Quintessence
Host/Issue The International journal of oral & maxillofacial implants;6
Volume 31
ISSN 0882-2786
Language eng (iso)
Subject dental implant
primary stability
secondary stability
surgical protocol
systematic review
undersized osteotomy
Medicine
Medicine
Animals
Dental Implantation, Endosseous
Dental Implants
Dental Models
Dental Prosthesis Design
Humans
Surface Properties
Torque
Research Subject Categories::ODONTOLOGY
Handle http://hdl.handle.net/2043/23844 Permalink to this page
Link to publication in DiVA Find this research publication in DiVA (n/a for student publ.)
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