The increasing adoption of dental implants as a preferred modality for replacing missing teeth is underscored by the critical role of implant therapy success, which hinges on the stability of the primary implant to facilitate osseointegration [1, 2]. Osseointegration, as defined by Brånemark and colleagues in 1977, is a direct structural and functional connection between living bone and the surface of the implant [2]. This phenomenon is pivotal for the implant’s loading capacity and its long-term clinical success. The achievement of primary stability, influenced by variables such as surgical techniques, and the quantity and quality of bone, is deemed essential for optimal osseointegration [3,4,5].

The literature highlights the multifaceted aspects contributing to osseointegration, including the material, surface, and design of the implant, host factors, surgical techniques, and biomechanical preparation [4]. Central to the placement of dental implants, achieving primary stability is governed by bone density, surgical protocol, and the macro and micro-design of the implant, among others. The conventional approach to creating osteotomies involves bone-removal drills, with the final drill size being slightly smaller than the implant to ensure primary stability. This practice aims to preserve bone bulk, thereby enhancing the primary mechanical stability of bone-to-implant contact and, subsequently, the implant’s secondary stability [5,6,7,8].

Expanding on these findings, previous studies have further validated the impact of bone quality on implant stability, highlighting the benefits of adapted surgical techniques in areas of low bone density to improve implant survival rates [9, 10].

Earlier in implant dentistry the surgical technique used were undersized implant site preparation [10] and osteotome was used to condense the bone [11]. The use of the osteotome in poor density bone allows fracturing and condensing of bone trabeculae, but this technique does not improve peri-implant bone density and it may also cause bone fracture [12].

In contrast to traditional drilling techniques, which remove bone to create osteotomies, the advent of osseodensification, a technique developed by Huwais in 2013, presents a novel approach. This technique, characterized by the use of specially designed burs that compact and autograft bone along the osteotomy, not only preserves bone bulk but also enhances the bone density around dental implants, thereby improving their primary stability. Unlike conventional drilling, osseodensification does not excavate bone tissue. Rather, it preserves bone bulk, so bone tissue is simultaneously compacted and autografted in an outwardly expanding direction to form the osteotomy. The unexcavated bone mass increases the bone dentistry in both the mesial-distal and apical osteotomy site [1, 13, 14]. That increase in bone density is checked by the comparing the patient pre-operative and post-operative dentascan (CT) [15].

Osseodensification represents a modern biomechanical bone preparation process that facilitates the placement of dental implants by developing a densification layer around the osteotomy site [15,16,17,18,19]. This process, which involves compacting and autografting bone across the entire depth of the osteotomy, has been shown to increase bone density and expansion, thereby offering a promising alternative to traditional drilling techniques.

Subsequent research, has continued to explore the effects of bone density and surgical techniques on implant stability and success [20,21,22,23,24]. These investigations have contributed to a nuanced understanding of how modifications in surgical approach, such as osseodensification, can positively influence implant outcomes, especially in low-density bone environments.

The cumulative evidence from these studies underscores a critical evolution in dental implantology. By focusing on the interplay between bone density, surgical techniques, and implant design, the field has moved towards personalized, evidence-based strategies that enhance implant stability and success.

This study aims to elucidate the impact of pre-operative and post-operative increases in bone density around implant surfaces facilitated by osseodensification drills. By employing digital radiographic techniques such as dentascan (CT), this investigation seeks to delineate the efficacy of osseodensification drills in achieving enhanced primary stability and to document the variation in bone density pre and post-operatively.

Objectives 1.

To evaluate preoperative bone density: This objective involves the comprehensive assessment of the bone density at the intended site of implant placement prior to the surgical procedure. Such an evaluation is crucial for establishing a baseline against which postoperative outcomes can be compared, thereby enabling an understanding of the bone’s condition before any intervention.

2.

To evaluate postoperative bone density using osseodensification technique: Postoperative assessment of bone density is essential to ascertain the effectiveness of the osseodensification technique. By comparing the bone density after the implant placement with the preoperative levels, this objective seeks to quantify the impact of osseodensification on enhancing bone density around the implant site.

3.

To inter-compare bone density before and after placement using osseodensification technique: The core of the study revolves around a comparative analysis of bone density measurements taken before and after the application of the osseodensification technique. This comparative analysis aims to provide empirical evidence regarding the technique’s role in improving bone density, which is a critical factor in achieving primary stability and long-term success of dental implants.

The realization of these objectives will contribute significantly to the body of knowledge on dental implantology, specifically highlighting the benefits and implications of employing osseodensification as a technique for preparing the implant site. Through this study, dental professionals and researchers will gain valuable insights into advanced surgical techniques that could potentially enhance the success rates of dental implant procedures.