Influence of different surgical techniques on primary implant stability in the posterior maxilla: a randomized controlled clinical trial

Background and objective Primary stability (PS) is remarkable for secondary stability and implant success. Surgical technique modifications seem to improve primary stability, especially in poor quality bone. The aim of this study was to compare the insertion torque (IT) and implant stability quotients (ISQ) of implants placed with underpreparation, expanders, and standard surgical instrumentation in different bone types. Material and methods This randomized controlled clinical trial enrolled 108 patients ( n =108 implants) distributed in three study groups: group 1 ( n =36) underpreparation technique, group 2 ( n =36) expander technique, and group 3 ( n =36) conventional drilling. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery. Results ISQ values were associated with the patient’s bone quality and were higher in bone quality type II (76.65) and type III (73.60) and lower in bone quality type IV (67.34), with statistically significant differences ( p