{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:24:52Z","timestamp":1790828692989,"version":"4.1.0"},"reference-count":42,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Versah LLC"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Biomimetics"],"abstract":"<jats:p>Osseodensification (OD) has emerged as a favorable osteotomy preparation technique that preserves and compacts autogenous bone along the osteotomy walls during site preparation, enhancing primary stability and implant osseointegration. While OD has demonstrated promising results in low-density trabecular bone, especially when used in conjunction with acid-etched (AE) implant surfaces, its efficacy in high-density cortical bone remains unclear\u2014particularly in the context of varying implant surface characteristics. In this study, Grade V titanium alloy implants (Ti-6Al-4V, 4 mm \u00d7 10 mm) with deep threads, designated bone chambers and either as-machined (Mach) or AE surfaces were placed in 3.8 mm diameter osteotomies in the submandibular region of 16 adult sheep using either OD or conventional (Reg) drilling protocols. Insertion torque values (N\u00b7cm) were measured at the time of implant placement to evaluate primary stability. Mandibles were harvested at 3-, 6-, 12-, or 24-weeks post-implantation (n = 4 sheep\/time point), and histologic sections were analyzed to quantify bone-to-implant contact (BIC) and bone area fractional occupancy (BAFO). Qualitative histological analysis confirmed successful osseointegration among all groups at each of the healing time points. No statistically significant differences were observed between OD and conventional drilling techniques in insertion torque (p &gt; 0.628), BIC (p &gt; 0.135), or BAFO (p &gt; 0.060) values, regardless of implant surface type or healing interval. The findings indicate that neither drilling technique nor implant surface treatment significantly influences osseointegration in high density cortical bone. Furthermore, as the osteotomy was not considerably undersized, the use of OD instrumentation showed no signs of necrosis, inflammation, microfractures, or impaired osseointegration in dense cortical bone. Both OD and Reg techniques appear to be suitable for implant placement in dense bone, allowing flexibility based on surgeon preference and clinical circumstances.<\/jats:p>","DOI":"10.3390\/biomimetics10100662","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T14:27:42Z","timestamp":1759328862000},"page":"662","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Osseodensification Versus Subtractive Drilling in Cortical Bone: An Evaluation of Implant Surface Characteristics and Their Effects on Osseointegration"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7107-3235","authenticated-orcid":false,"given":"Sara E.","family":"Munkwitz","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Ting","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2469-2587","authenticated-orcid":false,"given":"Hana","family":"Shah","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, FL 33136, USA"},{"name":"Florida International University Herbert Wertheim College of Medicine, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5935-997X","authenticated-orcid":false,"given":"Nicholas J.","family":"Iglesias","sequence":"additional","affiliation":[{"name":"DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2739-0339","authenticated-orcid":false,"given":"Vasudev Vivekanand","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA"},{"name":"Dr. John T. Macdonald Foundation Biomedical Nanotechnology Institute (BioNIUM), University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Castellano","sequence":"additional","affiliation":[{"name":"Mackenzie Evangelical School of Medicine Paran\u00e1, Curitiba 80730-000, PR, Brazil"},{"name":"Federal University of Paran\u00e1, Curitiba 80060-000, PR, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1458-6527","authenticated-orcid":false,"given":"Lukasz","family":"Witek","sequence":"additional","affiliation":[{"name":"Biomaterials and Regenerative Biology Division, NYU College of Dentistry, New York, NY 10010, USA"},{"name":"Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY 11201, USA"},{"name":"Hansj\u00f6rg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10016, USA"},{"name":"Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, New York, NY 10010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo G.","family":"Coelho","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA"},{"name":"Dr. John T. Macdonald Foundation Biomedical Nanotechnology Institute (BioNIUM), University of Miami, Miami, FL 33136, USA"},{"name":"DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA"},{"name":"Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"ref_1","first-page":"217","article-title":"Osseodensification: An Overview of Scientific Rationale and Biological Background","volume":"40","author":"Pikos","year":"2019","journal-title":"Compend. Contin. Educ. Dent."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jdent.2010.05.013","article-title":"The role of primary stability for successful immediate loading of dental implants. 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