الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Posterior maxilla often presented as challenging region for implant placement since the majority of posterior areas composed of more or less dense trabecular bone surrounded by a thin layer of cortical bone (D 4). In this situation it is often difficult to achieve good primary stability. Several techniques had been approved to enhance the primary stability and osseointegration of implants. Osseodensification using Densah bur was introduced as innovative technique to increase bone density during the drilling process and enhancing the primary stability. The primary objective of this study was to evaluate and compare clinically and radiographically by cone beam computed tomography the efficacy of osseodensification as a new bone drilling concept in low density bone and to compare the effect of osseodensification versus conventional drilling on the initial stability and osseointegration of implant. Seven female subjects with bilateral posterior edentulous maxilla were selected from outpatient clinic of the Department of Oral Medicine, Periodontology, Oral Diagnosis, and Radiology, Faculty of Dentistry, Tanta University to participate in the present study. Their ages ranged from 40 to 59 years with a mean age of 49.5 years. Fourteen implants were placed with two different surgical techniques in a split mouth design. In Osseodensification group one implant was placed on the left side of each patient after the usage of Densah bur while in the conventional group one implant was placed on each patient after the usage of implant system drills in the right side. Ratio plant implant system was used in both groups The patients were evaluated clinically for implant stability using ostell. There was no reliable difference observed between the two groups or between primary and secondary stability. This was validated to other previous studies. Also, regarding the clinical parametric data like plaque index, bleeding on probing &pocket depth no merit difference existed between the two groups. This could be due to the commitment of both groups to adequate implant supportive periodontal treatment. The subjects were evaluated radiographically for showing marginal bone loss (MBL) and estimation of bone density (BD) by CBCT immediately after surgery, 7 months &12 months post operatively. No significant difference in MBL of the two groups. However the intragroup comparison of osseodenfication group revealed that MBL kept maintained after load application .this may be attributed to different architecture of the marginal bone which affects the stress distribution around implant and bone loss. Analysis of the BD results revealed statistically significant difference in bone density in favor of osseodensification group immediately after surgery. BD increased significantly after load application in the osseodensification group than conventional group. This could reflect rapid healing, bone growth and remodeling in osseodensification group than conventional group. Based on the limitation of the results of the present study, it was concluded that:- 1) Osseodensification showed enhancement of bone density by the novel Densah bur that work safely in low density bone and decrease the possibility of creating bone dehiscence. 2) CBCT advantageous preoperatively for determining the bone density also postoperatively can adequately measure the bone architecture and density around implants. 3) Based on advantageous present study results, osseodensification technique is reliable method to enhance the rapid healing and maintain the marginal bone integrity after load.