Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review

Table 1

(a)

Author and year	Geographical location	Sample	Implant dimensions (mm) and surface	Number of implants	Implant and manufacturer
Padmanabhan and Gupta 2010 [48]	India	Number: 5; Gender: 2 ♀ with a mean age of 29, 3 ♂ with a mean age of 23	Length: 13; Diameter: 3.7; Surface: microgrip 1–5 𝜇m roughness	10	Uniti (Equinox Medical Technologies)
Shayesteh et al. 2013 [49]	Iran	Number: 30; Gender: 18 ♀, 12 ♂; Mean age: 40.5	length: 10, 12; Diameter: 4.1; Surface: sandblasted, large grit, and acid etched	46	SLA oral implants (Straumann AG)
Marković et al. 2013 [50]	Belgrade	Number: 53; Gender: 25 ♀, 28 ♂; Mean age: 43.9	Length: 10; Diameter: 4 mm; Surface: BlueSky Bredent-sandbasted and etched osseo connect; Straumann-2–4 𝜇m roughness sandblasted and acid etched	102	51 self-tapping BlueSky (Bredent),; 51 non-self-tapping Standard Plus; SLActive; (Straumann)
Turkyilmaz et al. 2008 [51]	Turkey	Number: 22; Gender: 10 ♀, 12 ♂; Mean age: 49	Lengths: 10, 11.5; Diameters: 3.75, 4; Surface: layer of titanium oxide	60	TiUnite Mk III (Nobel Biocare)
Alghamdi et al. 2011 [52]	Saudi Arabia	Number: 29; Gender: 12 ♀, 17 ♂; Mean age: 47 ± 8	Length: 12; Diameter: 4.1; Surface: 2–4 𝜇m roughness sandblasted and acid etched	52	Standard Plus; SLActive; (Straumann)
Stacchi et al. 2013 [11]	Italy	Number: 20; Gender: 12 ♂, 8 ♀; Mean age: 59.7 ± 13.6	Length: 10 mm; Diameter: 4.0; Surface: nanotite surface	40	NanoTite Parallel Walled Certain (Biomet 3i)
Katsoulis et al. 2012 [32]	Switzerland	Number: 40; Gender: 16 ♀, 24 ♂; Mean age: 61 ± 9	Length: 10, 13; Diameter: 3.5, 4.3; Surface: anodized surface	195	Replace Select Tapered (Nobel Biocare)
García-Morales et al. 2012 [53]	Brazil	Number: 8; Gender: 2 ♂, 6 ♀; Mean age: 36	Diameter: 3.8; Length: 11; Surface: sandblasted and acid etched	30	XiVE-S (Dentsply Friadent)

(b)

Author and year	Regions of implant insertion	Surgical technique	Primary stability: ISQ, PTV and/or IT (N cm) mean (SD)	Confounders included in analysis	Association between Primary stability and surgical technique	Secondary stability: ISQ, PTV and/or IT (N cm) mean (SD)	Association between Secondary stability and surgical technique
Padmanabhan and Gupta; 2010 [48]	Maxillary anterior region	Osteotome technique versus conventional drilling	ISQ: drilling 64.77; osteotome 59.60	No confounders cited	ISQ drilling > ISQ osteotome significantly (𝑃=0.026)	ISQ 6 months: drilling 55.40; osteotome 61.50	No significant difference between ISQ drilling and ISQ; osteotome 6 months after surgery (𝑃=0.076)
Shayesteh et al. 2013 [49]	Maxillary anterior region	Osteotome technique versus conventional drilling	ISQ: drilling 64.70; osteotome 70.9	Implant length: cited, but not included in analysis	ISQ osteotome > ISQ drilling significantly (𝑃=0.026)	ISQ 3 months: drilling 71.37; osteotome 72.71	No significant difference between ISQ drilling and ISQ; osteotome 3 months after surgery (𝑃=0.06)
Marković et al. 2013 [50]	Maxillary posterior region	Osteotome technique versus conventional drilling	ISQ: drilling and non-self-tapping; 61.20 ± 1.63; osteotome and non-self-tapping; 74.03 ± 3.53; drilling and self-tapping; 65.10 ± 3.03; osteotome and self-tapping; 74.34 ± 4.09	Implant macrodesign (self-tapping versus non-self-tapping) influenced the stability during the entire follow-up period after bone drilling and only between the 2nd and 12th postoperative weeks, following bone condensation (𝑃<0.05)	ISQ osteotome > ISQ drilling significantly for self-tapping and non-self-tapping implants (𝑃<0.05)	ISQ 12th weeks: drilling and non-self-tapping; 67.10 ± 0.32; osteotome and non-self-tapping; 71.88 ± 1.10; drilling and; self-tapping; 68.20 ± 1.81; osteotome and self-tapping; 73.54 ± 2.58	ISQ osteotome > ISQ; drilling significantly for self-tapping and non-self-tapping implants during the entire 12-week observation period (𝑃<0.05)
Turkyilmaz; et al. 2008 [51]	Maxillary posterior region	Undersized drilling versus press-fit drilling	IT for 4×10 implants: standard drilling: 35.9 ± 6; undersized drilling; 37.2 ± 7; IT for 4×11.5 implants: standard drilling: 38.5 ± 7; Undersized drilling 41.1 ± 6	Implant diameter influenced the stability; bone density correlated with stability	For 4×10 and 4×11.5 implants: no significant differences between both (ISQ and IT); standard drilling and both (ISQ and IT) undersized drilling (𝑃>0.05)	Not evaluated	Not evaluated
Alghamdi et al. 2011 [52]	Posterior maxilla and mandible	Undersized drilling versus press-fit drilling	ISQ: standard drilling; 66.69 ± 5.41; undersized drilling; 68.58 ± 4.81; Maxilla; 66.96 ± 5.58; mandible; 66.52 ± 5.25; ♀ 64.39 ± 5.15; ♂ 68.27 ± 4.85; IT: standard drilling; 34.62 ± 5.82; undersized drilling; 35.19 ± 4.79; maxilla; 34.07 ± 4.81; mandible; 34.20 ± 4.93; ♀ 33.48 (±4.63); ♂ 36.38 (±5.96)	Bone density and jaw position (maxilla versus mandible): cited but not included in analysis and were not accounted for to remove their confounding influence on surgical techniques between groups	No significant differences between both (ISQ and IT); standard drilling and (ISQ and IT) undersized drilling (𝑃>0.05); ISQ ♂ > ISQ ♀ significantly (𝑃<0.001); No significant difference for IT values between women and men (𝑃>0.05)	Not evaluated	Not evaluated
Stacchi et al. 2013 [11]	Maxillary premolar area	Piezosurgery versus conventional drilling	ISQ: drills; 72.2 ± 5.8; piezoelectric; 70.5 ± 5.8	No confounders cited	No significant difference between ISQ drills and ISQ piezoelectric (𝑃=0.3215)	ISQ 3 months: drills; 69.2 ± 5.5; piezoelectric; 71.0 ± 2.9	ISQ piezoelectric > ISQ drills significantly during the entire period of observation (90 days): from day 14 to day 42, in particular, the difference was extremely significant (𝑃<0.0001)
Katsoulis et al. 2012 [32]	Complete edentulous maxilla	Flapless versus flap procedure	ISQ: flap 57.7 (±1.8); flapless 62.1 (±1.8); ♀ 56.5 (±2.0); ♂ 61.4 (±1.4); 10 mm length: 60.5 (±3.0); 13 mm length: 58.7 (±1.3); 3.5 mm diameter: 58.0 (±2.0); 4.3 mm diameter: 59.1 (±1.5)	Implant diameter and length did not influence stability; Bone density not evaluated	ISQ standard > ISQ; flapless significantly (𝑃<0.001); ISQ ♂ > ISQ ♀ significantly (𝑃=0.01)	ISQ 3 months: Flap 56.0 (±2.0); flapless 65.4 (±1.7); ♀ 55.9 (2.4); ♂ 62.0 (2.0); 10 mm length: 59.5 (4.1); 13 mm length: 59.6 (1.9); 3.5 mm diameter: 60.2 (2.7); 4.3 mm diameter: 59.0 (2.2)	ISQ flap > ISQ flapless significantly at 3 months (𝑃<0.001); ISQ ♂ > ISQ ♀ significantly at 3 months (𝑃<0.001)
García-Morales et al. 2012 [53]	Mandibular posterior region	Low-level laser stimulation versus placebo	ISQ: conventional; 75.7 (5.6); laser; 77.4 (3.4)	No confounders cited	No significant difference between ISQ conventional and ISQ laser (𝑃<0.05)	ISQ 12 weeks: conventional; 78.4 (3.0); laser; 76.3 (4.1)	No significant difference between ISQ conventional and ISQ laser at 12 weeks (𝑃>0.05)