***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE The objective of the present investigation was to longitudinally monitor stability changes of  implants inserted using traditional rotary instruments or piezoelectric inserts , and to follow their variations during the first 90 days of healing . MATERIAL S AND METHODS A r and omized , controlled trial was conducted on 20 patients . Each patient received two identical , adjacent implants in the upper premolar area : the test site was prepared with piezosurgery , and the control site was prepared using twist drills .  Resonance frequency analysis measurements were taken by a blinded operator on the day of surgery and after 7 , 14 , 21 , 28 , 42 , 56 , and 90 days . RESULTS At 90 days , 39 out of 40 implants were osseointegrated ( one failure in the control group ) . Both groups showed an initial decrease in mean implant stability quotient ( ISQ ) values : a shift in implant stability to increasing ISQ values occurred after 14 days in the test group and after 21 days in the control group . The lowest mean ISQ value was recorded at 14 days for test implants ( 97.3 % of the primary stability ) and at 21 days for the control implants ( 90.8 % of the primary stability ) . ISQ variations with respect to primary stability differed significantly between the two groups during the entire period of observation : from day 14 to day 42 , in particular , the differences were extremely significant ( p < .0001 ) . All 39 implants were in function successfully at the visit scheduled 1 year after insertion . CONCLUSIONS The findings from this study suggest that ultrasonic implant site preparation results in a limited decrease of ISQ values and in an earlier shifting from a decreasing to an increasing stability pattern , when compared with the traditional drilling technique . From a clinical point of view , implants inserted with the piezoelectric technique demonstrated a short-term clinical success similar to those inserted using twist drills To overcome the limitations of implant placement in knife-edge ridges , Summer introduced the osteotome technique in 1994 . It has been cl aim ed that using bone condensing to prepare the implant site in soft maxillary bone avoids the risk of heat generation , and implants can be placed precisely with increased primary stability . The purpose of this clinical study was to evaluate the crestal bone loss exhibited by the bone around early nonfunctionally loaded implants placed with conventional implant placement technique and with Summer 's osteotome technique and to evaluate whether the bone-compression technique provides better primary stability than the conventional technique . A total of 10 Uniti implants were placed in the maxillary anterior region of 5 patients . One implant site was prepared using the conventional technique with drills ( control group A ) , and second site was prepared using the osteotome technique ( experimental group B ) and an MIS bone compression kit . Resonance frequency measurements ( RFMs ) were made on each implant at the time of fixture placement and on the 180th day after implant fixture placement . The peri-implant alveolar bone loss was evaluated radiographically . Differences between the alveolar crest and the implant shoulder in radiographs were obtained immediately after implant insertion and on the 180th day after implant placement . The RFMs demonstrated a significantly higher stability of implants in control group A than in experimental group B on the day of surgery ( P = .026 ) . However , no statistically significant difference in stability was found between both groups on 180th day after implant placement ( P = .076 ) . A significant difference was found in the crestal bone levels after 180 days of surgery between two groups ( P = 0 ) with less crestal bone loss with group A. Within the limitations of this study we concluded that the osteotome technique is good for the purpose for which it was introduced , that is , for knife-edge ridges , and it should not be considered a substitute for conventional procedures for implant placement Objectives : Implant primary stability is one of the important factors in achieving implant success . The osteotome technique may improve primary stability in patients with poor bone quality . The aim of this study was to compare implant stability using two different techniques namely osteotome versus conventional drilling in the posterior maxilla . Material s and Methods : In this controlled r and omized clinical trial , 54 dental implants were placed in 32 patients ; 29 implants were placed in the osteotome group and 25 in the conventional drilling group .  Implant stability was assessed at four time intervals namely at baseline , one , two and three months after implant placement using resonance frequency analysis ( RFA ) . Results : Primary stability based on implant stability quotient ( ISQ ) units was 71.4±7 for the osteotome group and 67.4±10 for the control group . There was no statistically significant difference between the two groups in implant stability at any of the measurement times . In each group , changes in implant stability from baseline to one month and also from two months to three months post-operatively were not significant but from one month to two months after implant placement , implant stability showed a significant increase in both groups . Conclusion : The results of this study revealed that in both techniques , good implant stability was achieved and osteotome technique did not have any advantage compared to conventional drilling in this regard OBJECTIVES To compare the effect of two surgical techniques , lateral condensation and bone drilling , on changes in temperature of the adjacent low-density bone during implant placement into posterior maxilla and to investigate the influence of the host factors - age , gender , region of implantation , bone density , and thickness of the cortical bone at the recipient sites . MATERIAL AND METHODS Local bone temperature was measured thermographically during implant placement into posterior maxilla following lateral bone condensing ( test group ) or bone drilling ( controls ) . The main study outcomes were baseline bone temperature prior to implantation and maximum bone temperature recorded during implantation . Early implant success was evaluated after 6 months of healing . RESULTS A total of 40 implants were r and omly allocated to test and control groups and placed into maxillary premolar and /or molar region of 18 participants of both genders and average age of 51.74 years . All recorded bone temperatures were below the threshold for thermal necrosis . Although both groups showed significant increase in bone temperature during implant placement procedure ( P ≤ 0.0005 ) , it was significantly higher for bone condensing compared with drilling ( P ≤ 0.0005 ; 3.79 ± 1.54 ° C ; 1.91 ± 0.70 ° C respectively ) . No host factor was singled out as a significant predictor of bone temperature changes , although trend of higher increase was observed in young patients , regardless of gender , during implant placement procedure into maxillary first premolar region with bone density type 3 and cortical layer thicker than 1 mm . Early implant success rate after 6 months follow-up was 100 % . CONCLUSION Although both surgical techniques , bone condensing and bone drilling , can be considered safe regarding their thermal effect on the bone of posterior maxilla , bone drilling is associated with fewer local bone heating during implantation . Host factors do not affect the bone thermal changes significantly OBJECTIVE Poor bone density in the posterior maxilla often presents challenges in achieving implant stability . Insertional torque ( IT ) and resonance frequency analysis ( RFA ) have been used to objective ly monitor the process of osseointegration . This study was design ed to quantitatively assess the primary and secondary stability of fixtures placed using the osteotome or conventional drilling technique  , in soft bone . The study also assessed if there was a correlation between IT and RFA measurements . METHOD AND MATERIAL S Sixteen implants of a st and ardized dimension were r and omly assigned to two groups : osteotome or conventional drilling .  IT was taken at the time of placement . RFA was recorded at baseline and 30 , 60 , and 90 days . RESULTS Average IT and RFA were 36 Ncm ( range 25 - 45 Ncm ) and 61.5 implant stability quotient ( ISQ ; range 44 - 72 ISQ ) , respectively . RFA in the osteotome group increased from day 0 to day 30 ( 63.5 to 68.0 ISQ ) whereas it decreased in the conventional drilling group ( 65.9 to 56.6 ISQ ) . At 90 days , both groups showed similar results . No statistically significant difference between IT and RFA was found across all time intervals . CONCLUSION IT and ISQ values were shown to fluctuate depending on various local anatomical factors such as density of the bone . Additional clinical and radiographic studies are needed in type 1 to 4 bone to determine the utilization of RFA and IT for routine implant surgery . Adequate stability measurements are critical for implant placement . Future guidelines and knowledge of stability and bone density values may help in establishing loading protocol s and improving success rate OBJECTIVES To date , there have been no studies on the outcome of osseointegration of alveolar bone  around dental implants inserted with piezoelectric osteotomy versus conventional osteotomy . The aim of this study was to compare the radiographic differences , through evaluation of peri-implant bone density , between implant insertion using traditional surgical technique and piezoelectric technique . METHOD AND MATERIAL S Forty patients were selected whose treatment consisted of a minimum of two implants placed in nonpathologic native bone . A single type of implant surface ( SLA ) was chosen . The implants were placed following the manufacturer protocol for traditional surgical technique and piezoelectric technique . Radiographs were taken following surgery and 30 , 60 , and 90 days after surgery . The bone density was studied with the densitometry application . RESULTS AND CONCLUSION All patients completed the study period with success . Despite a limited number of treated patients , the results of this pilot study demonstrated that ( 1 ) piezoelectric implant site preparation promotes better bone density and osteogenesis , and ( 2 ) the piezoelectric technique is predictable , with a 100 % success rate in this study AIM To evaluate the effect of piezoelectric surgery ( PS ) implant osteotomy on biochemical and radiological parameters of crestal bone ( CB ) loss .  MATERIAL AND METHODS In this r and omized , controlled , clinical study , 38 osteotomies were prepared with PS and drilling in the posterior maxilla in a split-mouth design . Implants were placed and left for non-submerged healing . Osteotomy time , insertion torque , pain perception , probing depth , and modified gingival and plaque indices were recorded . Peri-implant sulcular fluid ( PISF ) was collected from four sites of each implant at 2 , 4 , 8 , 12 , and 24 weeks . PISF sample s were analyzed by ELISA for receptor activator of nuclear factor kappa-B-lig and ( RANKL ) and osteoprotegerin . CB loss was assessed on periapical radiographs at the 12th and on cone beam computed tomography ( CBCT ) at the 24th weeks . The influence of time and osteotomy method on biochemical and radiological parameters of CB loss employed statistical method of Brunner-Langer . RESULTS Osteotomy time for PS group was significantly longer than the drill group ( P < 0.05 ) . Pain perception that was lower in the PS than in the drill group depended on osteotomy method ( P < 0.05 ) . PS group had lower RANKL total amount than the drill group ( P < 0.05 ) . Mean CB loss on periapical radiographs at the 12th week for PS and drill groups were 0.11 and 0.18 mm , respectively ( P > 0.05 ) . At the 24th week , PS and drill groups showed 0.11 and 0.12 mm CB losses on CBCT , respectively ( P > 0.05 ) . However , CB loss values did not depend on osteotomy modality ( P > 0.05 ) . CONCLUSION PS may modify and reduce bone-destructive inflammatory response during implant osseointegration . Therefore , on the molecular level , it might be a less traumatic osteotomy modality than drilling although this was not reflected by CB loss values in the present study PURPOSE The aim of this prospect i ve r and omized controlled clinical study was to assess the crestal bone loss and the implant stability in implants that were placed by the osteotome technique compared with the conventional drilling technique . MATERIAL S AND METHODS Forty-six screw type Straumann SLA ® oral implants ( Straumann AG , Waldenburg , Switzerl and ) were inserted in the anterior segment of maxilla of 30 patients . The implant site was prepared r and omly using either osteotome technique ( test group ) or the conventional drilling technique ( control group ) . Radio frequency analysis ( RFA ) values at implant placement and after 3 months were recorded . The crestal bone loss was measured using digital subtraction radiography technique after 3 , 6 , and 12 months . RESULTS RFA demonstrated a statistically significant higher primary stability for implants in the osteotome group than that of the conventional group ( p=.026 ) at the time of implant insertion . However , there was no statistically significant difference between both groups 3 months after the surgery ( p=.06 ) . At month 3 , the osteotome group caused significantly more crestal bone loss than the conventional group ( p=.04 ) . At months 6 and 12 , both groups had comparable bone levels ( p=.29 ) . CONCLUSION Osteotome technique yielded higher primary stability than conventional drilling technique . However , this technique was not superior to conventional technique after 3 months Background : The aim of this work is to evaluate differences occurring in bone tissue around dental implants positioned using piezoelectric or conventional drill technique . Methods : Twenty-four implants were inserted bilaterally in the iliac crest of 6 sheep after site preparation through a  piezoelectric instrument  ( Test  ) or after site  preparation  through 
    Output:
    
The meta- analysis on bone to implant contact suggested no difference between CDs and other techniques and the meta- analysis on crestal bone loss suggested no difference between CDs and PD .
The survival of implants in sites prepared with CDs vs. OT or PD presented no significant differences .
The use of PD provided lower inflammatory response and earlier bone formation when compared to CDs .
ODs provided significant biomechanical improvement in comparison to CDs .
LS did not provide any relevant improvement in comparison to CDs or PD .