Bone compaction

The bone compression ( ger .: Bone condensing ) is a special surgical method when placing dental implants. This procedure is intended to increase the stability of the dental implant . The bone compaction serves to improve the implant bed and is to be assigned to the area of jawbone augmentation. What is meant is not the more dense bone substance, which is referred to in the same way as in X-ray diagnostics .

Basics and areas of application

The basis for the successful healing of a dental implant is the primary stability after the implant has been inserted. Depending on the quality of the bone, the primary stability can turn out to be very different after using conventional preparation methods with rotating instruments (implant drills). The jawbone is structured very differently in its density depending on the region and anatomical structure. The ratio of dense and less dense bone structures determines the stability of the implants. Especially in the presence of a very wide-meshed bone (class 4 of the bone density classification), the use of the bone compaction method can contribute to significantly better primary stability of the dental implant. Since the upper jaw often falls into this category, the method of bone compression is almost exclusively used there. Especially in conjunction with sinus lift - operations found this method often your application.

method

The implant bed is usually prepared with rotating instruments. These cause the bone substance to be removed up to the respective diameter of the selected implant size. With the method of bone compaction, only the initial preparation for setting the position and direction is carried out with rotating instruments. The further preparation of the implant bed takes place with cylindrical or conical hand instruments made of titanium, which are driven into the bone with a surgical hammer . This procedure is carried out in increasing diameters until the desired implant diameter is reached. The use of hand instruments compresses the wide medullary canals. This increases the bone density and the screwed-in dental implant has significantly better primary stability. In the case of special implant systems, the geometry of the implant body is geared towards the highest possible primary stability. Here the preparation is also prepared with bone compaction. However, the diameter of the preparation is clearly underdimensioned, so that the bone is even more compacted when the dental implant is inserted.

advantages

The osseointegration process is positively influenced by the improved bone apposition and the reduction in micro-movements . The increased primary stability and the resulting improved healing process also often reduce the duration of the healing phase of the implant. In addition, implants stabilized in this way can be included in an immediate restoration. The method of bone compaction can sometimes achieve better clinical results. The healing phase is reduced and the spectrum of application areas in dental implantology is increasing.

disadvantage

If the bone compaction is carried out to an excessive extent, it can lead to micro-traumas or crushing of the bone tissue. The blood circulation may deteriorate. It can cause cracks in the jawbone.

Individual evidence

↑ ^a ^b C. E. Misch: Density of bone: effect on treatment plans, surgical approach, healing, and progressive boen loading. In: The International journal of oral implantology: implantologist. Volume 6, Number 2, 1990, pp. 23-31, ISSN 1048-1842 . PMID 2073394 .
↑ U. Lekholm U., GA Zarb: Patient selection and preparation. In: PI Brånemark, GA Zarb, T. Albrektsson: Tissue-integrated prostheses-Osseointegration in Clinical Dentistry. Quintessence Publishing, Chicago 1985, pp. 199-209.
↑ A. Markovi ?, D. Calasan et al. a .: Implant stability in posterior maxilla: bone-condensing versus bone-drilling: a clinical study. In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. Volume 112, Number 5, November 2011, pp. 557-563, ISSN 1528-395X . doi : 10.1016 / j.tripleo.2010.11.010 . PMID 21330161 .
↑ A. Scarano, M. Degidi et al. a .: Correlation between implant stability quotient and bone-implant contact: a retrospective histological and histomorphometrical study of seven titanium implants retrieved from humans. In: Clinical implant dentistry and related research. Volume 8, Number 4, 2006, pp. 218-222, ISSN 1523-0899 . doi : 10.1111 / j.1708-8208.2006.00022.x . PMID 17100747 .

[PMID2073394-1] C. E. Misch: Density of bone: effect on treatment plans, surgical approach, healing, and progressive boen loading. In: The International journal of oral implantology: implantologist. Volume 6, Number 2, 1990, pp. 23-31, ISSN 1048-1842 . PMID 2073394 .

[2] U. Lekholm U., GA Zarb: Patient selection and preparation. In: PI Brånemark, GA Zarb, T. Albrektsson: Tissue-integrated prostheses-Osseointegration in Clinical Dentistry. Quintessence Publishing, Chicago 1985, pp. 199-209.

[PMID21330161-3] A. Markovi ?, D. Calasan et al. a .: Implant stability in posterior maxilla: bone-condensing versus bone-drilling: a clinical study. In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. Volume 112, Number 5, November 2011, pp. 557-563, ISSN 1528-395X . doi : 10.1016 / j.tripleo.2010.11.010 . PMID 21330161 .

[PMID17100747-4] A. Scarano, M. Degidi et al. a .: Correlation between implant stability quotient and bone-implant contact: a retrospective histological and histomorphometrical study of seven titanium implants retrieved from humans. In: Clinical implant dentistry and related research. Volume 8, Number 4, 2006, pp. 218-222, ISSN 1523-0899 . doi : 10.1111 / j.1708-8208.2006.00022.x . PMID 17100747 .