Early implant stability in reconstructed alveolar bone supported by iliac crest grafts using bone-enhancing drills: a retrospective clinical study

Abstract

Autogenous iliac crest grafts are widely used for reconstruction of extensive alveolar defects because of their osteogenic potential and ability to support implant placement. However, limited evidence exists regarding early implant stability patterns in reconstructed alveolar bone. This study evaluated short-term stability changes of implants placed in mature iliac crest grafts using bone-enhancing drills. This retrospective clinical study included 32 implants placed in healed iliac crest–grafted sites in eight healthy patients (19–26 years). Implants were equally distributed among maxillary anterior, maxillary posterior, mandibular anterior, and mandibular posterior regions. Osteotomies were prepared using osseodensification burs to preserve and compact bone tissue. Implant stability was assessed by resonance frequency analysis (RFA) immediately after placement and at the 2nd and 3rd postoperative months using ISQ measurements in two perpendicular directions. ISQ values were compared over time and between anatomical regions. ISQ values showed a statistically significant increase between implant placement and the follow-up examinations performed at 2 and 3 months ( p < 0.001). No decrease in ISQ values was observed between the recorded measurement time points. Stability progression patterns were similar among all anatomical regions, with no significant regional differences detected ( p > 0.05). By the third month, 15 of 32 implants (46.9%) reached ISQ values considered suitable for early loading. Implants placed in mature iliac crest grafts demonstrated stable and progressive osseointegration. The findings suggest that reconstructed alveolar bone can provide a predictable environment for implant healing. However, the specific contribution of osseodensification burs to implant stability requires further investigation in controlled studies.