INFLUENCE OF DIFFERENT BONE GRAFTING TECHNIQUES ON PRIMARY STABILITY

Abstract

Objective: To critically review the available evidence on the influence of different bone grafting techniques and implant site preparation methods on the primary stability of dental implants. Methods: Narrative review based on randomized clinical trials, prospective and retrospective studies, systematic reviews, and meta-analyses published between 2015 and 2025 in PubMed, Scopus, Web of Science, and SciELO. Included studies evaluated autogenous bone grafts, substitute biomaterials, osseodensification, piezosurgery, and short implants, focusing on insertion torque, implant stability quotient (ISQ), and implant survival rates. Results: Autogenous grafts remain the gold standard due to their biological properties, but with significant donor site morbidity. Substitute biomaterials demonstrated comparable results in stability and survival, particularly in sinus floor elevation. Osseodensification showed improvements in torque and ISQ in type III–IV bone, although recent studies highlight controversies and protocol dependence. Short implants achieved survival rates similar to longer implants with bone augmentation, reducing morbidity and costs. Biological adjuncts such as PRF and platelet concentrates demonstrated coadjuvant benefits but do not replace conventional biomaterials.Conclusion: Primary stability is influenced by multiple variables, and technique selection should be individualized. Current evidence suggests that substitute biomaterials, osseodensification, and short implants are predictable alternatives to autogenous grafts in specific scenarios. This review emphasizes the need for individualized and integrated approaches to optimize clinical predictability in modern implant dentistry.

DOI: https://doi.org/10.56238/sevened2025.031-042