Conclusions

Within the limitations of this study, osseodensification significantly improved peri-implant bone density in both D3 and D4 bone of the posterior maxilla. The technique also produced measurable alveolar ridge expansion, with greater dimensional gain at the mid-apical and apical levels than at the crestal level. D3 bone showed higher baseline and postoperative density values than D4 bone, but the difference between the groups reduced by the four-month postoperative interval. Age and gender did not significantly influence the measured outcomes. Osseodensification appears to be a useful implant osteotomy technique for low-density posterior maxillary bone because it preserves bone, enhances peri-implant density, and promotes controlled ridge expansion. Larger controlled clinical studies with longer follow-up are required before broad clinical recommendations can be made.