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Abstract Rehabilitation of single edentulous maxillary arches with screw-retained prostheses is considered an optimal treatment choice. However, atrophy in the maxilla may result in deficient bone volume for implants. The ―All-on-4‖ concept offers favorable clinical results for immediate rehabilitation. Primary stability is essential for efficient and predictable immediate loading. Different osteotomy procedures were proposed for preparation of the implant site. Osseodensification is used to improve quality of bone and initial stability specially in the resorbed maxillae. Aim of the study: To compare and evaluate the effect of osseodensification versus self-tapping technique on immediately loaded maxillary fixed-detachable restorations retained by implants inserted according to the all-on-four concept. Materials and methods: Twelve patients with maxillary posterior atrophy, received screw-retained restorations retained by implants placed following the all–on-four concept. Split mouth design was conducted whereas each patient received two implants inserted following the osseodensification technique and two utilizing the self-tapping technique followed by immediate loading. Clinical and radiographical parameters were evaluated immediately after surgery, prosthesis delivery and up to 12 months. Results: Clinical parameters, Implant stability measures and bone level changes showed more favorable mean values in the osseodensified side over the self-tapping, revealing a statistical significance in most of the groups (p ≤ 0.05) Conclusion: Osseodensification provides better implant stability, less amount of bone loss and promising periodontal parameters in maxillary arches improving the chances for immediate loading. Key words: Implants, immediate loading, All-on-four, osseodensification, fixed detachable restorations. |