Recent Advances in Enhancing Dental Implant Stability in Low-Density Bone: A Systematic Review and Meta-Analysis of Clinical and Biomechanical Outcomes
European Journal of Prosthodontics and Restorative Dentistry (2026) 34(2s), 44–52
Keywordsdental implants, osseodensification, implant stability, low-density bone, meta-analysis
AuthorsAbstractBackground: Achieving good implant stability in low-density bone in the posterior maxilla remains challenging due to insufficient bone density, which undermines primary fixation and osseointegration. Several surgical and implant-based approaches have been suggested to enhance the results, and osseodensification is receiving more and more clinical interest. Aim: To systematically evaluate and quantitatively synthesize the evidence on techniques used to enhance dental implant stability in low-density bone. Methodology: A meta-analysis and systematic review were performed according to the PRISMA guidelines. The search of electronic databases (PubMed, Scopus, Web of Science, Embase and Cochrane Library) was conducted between January 2010 and December 2025. Comparative clinical studies reporting implant stability outcomes were included. Results on the implant stability quotient (ISQ), insertion torque and radiographic measurements were obtained. The risk of bias was assessed using the Newcastle-Ottawa Scale. The mean difference (MD) with 95% confidence intervals (CI) was calculated using a random-effects meta-analysis. Results: Twelve studies were included. Immediate implant stability was significantly higher in the experimental groups (MD = 8.21 ISQ units; 95% CI: 4.90–11.52; I² = 68.4%). Secondary stability at 6 months also favored the intervention groups (MD = 5.43 ISQ units; 95% CI: 2.71–8.15; I² = 52.0%). Insertion torque was generally increased, although heterogeneity was high. Radiographic findings indicated improved bone density and bone gain. Conclusion: Improvements in implant stability are achieved by using osseodensification and other related methods, whereas implant design also plays a role in early mechanical engagement. 1. Introduction Dental implants have been a globally acclaimed, predictable and dependable treatment modality in the replacement of missing teeth, not only in terms of functional restoration but also better appearance [1]. Innovations in the art of implants, their surface, and surgical procedures have led to high success rates in the last few decades [2]. Osseointegration can be described as a direct structural and functional relationship between the surface of the implant and the bone surrounding it, and this is the biological principle of implant success [3]. The field of implant dentistry has changed significantly over time, incorporating both the biological and mechanical concepts to improve the long-term results [4]. Primary stability is regarded as one of the determinants of implant success among other aspects, which affects the early healing and the long-term performance of implants [5]. It is attained by mechanical interaction between the implant and the host bone during the •••••••••••••••••••••••••••••••• ejprd.org- Published by Riset Publishing Services LLC.
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