Efficacy of topical application of corticosteroids in the remineralization of dental pulp tissue. A systematic review of the literature.

OBJECTIVES: The aim of this systematic review was to demonstrate the efficacy of topical application of corticosteroids in remineralization of dental pulp tissues to preserve their vitality and function. DATA, SOURCES AND STUDY SELECTION: An electronic search was performed using MEDLINE by PubMed, EMBASE, Web of Science (WOS), and Scopus databases. The inclusion criteria were in vitro studies that employed dental pulp tissue obtained from extracted healthy permanent human teeth and were subjected to topical administration of corticosteroids and evaluated tissue remineralization by performing any mineralization assay. A total of 11 studies were selected for inclusion. PRISMA guidelines were followed, and the methodological quality and risk of bias of the included studies were evaluated using the RoBDEMAT guidelines. Also, tables were designed for data extraction, including tissue mineralization and osteogenic differentiation as primary and secondary outcomes, respectively. CONCLUSIONS: Alizarin Red S (ARS) has been able to demonstrate a possible mineralizing power of corticosteroids, applied at an adequate dose. The up-regulation of Alkaline phosphatase (ALP), osteocalcin (OCN), osteopontin (OSP), sialophosphoprotein (DSPP), runt-related transcription factor 2 (RUNX2), collagen type 1 alpha 1(COL1α1) and dentin matrix protein 1 (DMP-1) induced the osteogenic/odontogenic differentiation of dental pulp stem cells (DPSCs). CLINICAL SIGNIFICANCE: Deep carious lesions treatment is still challenging in restorative dentistry. Some treatments have been focused on dental pulp tissue remineralization to maintain the function and vitality. After corticosteroids topical application, mineral deposition and osteogenic differentiation have been detected.

Chitosan coatings on titanium-based implants - From development to characterization and behavior: A systematic review.

Chitosan is a promising natural polymer for coatings, it combines intrinsic antibacterial and pro-osteoblastic properties, but the literature still has a gap from the development to behavior of these coatings, so this systematic review aimed to answer, "What is the relationship between the physical and chemical properties of polymeric chitosan coatings on titanium implants on antibacterial activity and osteoblast viability?". PRISMA guidelines was followed, the search was applied into 4 databases and grey literature, without the restriction of time and language. The selection process occurred in 2 blinded steps by the authors. The criteria of eligibility were in vitro studies that evaluated the physical, chemical, microbiological, and biological properties of chitosan coatings on titanium surfaces. The risk of bias was analyzed by the specific tool. Of 734 potential articles 10 were included; all had low risk of bias. The coating was assessed according to the technique of fabrication, FT-IR, thickness, adhesion, roughness, wettability, antibacterial activity, and osteoblast viability. The analyzed coatings showed efficacy on antibacterial activity and cytocompatibility dependent on the class of material incorporated. Thus, this review motivates the development of time-dependent studies to optimize manufacturing and allow for an increase in patents and availability on the market.

A Randomized Controlled Trial on the Timing of Soft-Tissue Augmentation in Immediate Implant Placement: Hard-Tissue Changes and Clinical Outcome.

AIM: To assess the impact of the timing of soft-tissue augmentation (STA) on mean buccal bone changes following immediate implant placement (IPP) in the anterior maxilla. MATERIALS AND METHODS: Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15-25) were enrolled in this randomized controlled trial. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate STA performed during the same surgical procedure) or the test group (delayed STA performed 3 months later). Implants were placed with a surgical guide and immediately restored with an implant-supported provisional crown. Changes in bone dimensions were assessed using superimposed CBCT images taken prior to surgery and at 1-year follow-up. Clinical outcomes were registered at 1-year follow-up. RESULTS: Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). Ten patients in the control group and 13 patients in the test group had a thick bone wall phenotype. Estimated marginal mean horizontal buccal bone loss at 1 mm below the implant shoulder was -0.553 and -0.898 mm for the control and test group, respectively. The estimated mean difference of 0.344 mm in favour of the control group was not significant (95% CI: -0.415 to 1.104; p = 0.363). Also at all other horizontal and vertical levels, no significant differences could be observed between the groups. The combination of socket grafting and STA enabled counteraction of any buccal soft-tissue loss (≥ 0 mm) at 1 mm below the implant shoulder in 82% of the patients in the control group and in 75% of the patients in the test group (p = 1.000). The clinical outcome was favourable in both groups, yet implants in the control group demonstrated slightly less marginal bone loss (median difference 0.20 mm; 95% CI: 0.00-0.44; p = 0.028). CONCLUSION: In patients with an intact and mainly thick buccal bone wall in the anterior maxilla, the timing of STA following IIP had no significant impact on mean buccal bone loss. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05537545.

Relationship Between Original Research Experiences and Evidence-Based Practice Among Undergraduate Dental Hygiene Students.

OBJECTIVES: For the dental hygiene profession, a need exists to engage students in research experiences as undergraduate students to foster interest in research and improve the implementation of evidence-based practice. The purpose was to explore the relationships between original research experiences and evidence-based practice among undergraduate dental hygiene students. METHODS: This quantitative survey research study of undergraduate dental hygiene students in the USA was conducted in 2021. Original research experience was measured using the Wessex Research Network (WReN) spider instrument and evidence-based practice was measured using the Knowledge, Attitudes, Access and Confidence Evaluation (KACE) instrument. Invitation e-mails were sent to the directors of US entry-level dental hygiene programs to forward the survey e-mail message to students in the last semester of their dental hygiene programs. The data were analysed using descriptive statistics, bivariate analysis and multiple linear regression analysis. RESULTS: A total of 128 responses were analysed. The foundational knowledge domain of research experience was found to be a significant predictor of evidence-based practice and the mediators of evidence-based knowledge, evidence-based attitudes, evidence-based access and evidence-based confidence. CONCLUSION: Research experience was found to be a significant predictor of Evidence-Based Practice. Engaging undergraduate dental hygiene students in research opportunities may prepare students for the clinical application of evidence-based practice and original research projects.

Successful retreatment of a maxillary central incisor with a wide-open apex using MTA to fill the entire canal: 24-year follow-up.

Managing teeth with open apices can be a challenging scenario for clinicians. This case report describes the 24-year follow-up of a maxillary central incisor that failed to develop after a traumatic injury resulting in a wide-open apex. A 10-year-old girl presented complaining of discomfort in her upper teeth. Tooth #9 had received a traumatic blow several years before and was discoloured with a resin composite restoration on the mesio-incisal edge. The tooth was painful to percussion and palpation. An inadequate root canal filling and incomplete root formation were observed on the initial periapical radiograph. Root canal retreatment was initiated, and the canal filled entirely with mineral trioxide aggregate (MTA) because of the extremely wide canal and open apex. The patient was asymptomatic at the 24-year follow-up with the cone beam computed tomography and periapical radiographs demonstrating the stability of the MTA.

GREM1 Negatively Regulates Osteo-/Dentinogenic Differentiation of Dental Pulp Stem Cells via Association with YWHAH.

OBJECTIVE: To investigate the biological regulatory function of Gremlin1 (GREM1) and tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein eta (YWHAH) in dental pulp stem cells (DPSCs), and determine the underlying molecular mechanism involved. METHODS: Alkaline phosphatase (ALP) activity, alizarin red staining, scratch migration assays and in vitro and in vivo osteo-/dentinogenic marker detection of bone-like tissue generation in nude mice were used to assess osteo-/dentinogenic differentiation. Coimmunoprecipitation and polypeptide microarray assays were employed to detect the molecular mechanisms involved. RESULTS: The data revealed that knockdown of GREM1 promoted ALP activity, mineralisation in vitro and the expression of osteo-/dentinogenic differentiation markers and enhanced osteo-/ dentinogenesis of DPSCs in vivo. GREM1 bound to YWHAH in DPSCs, and the binding site was also identified. Knockdown of YWHAH suppressed the osteo-/dentinogenesis of DPSCs in vitro, and overexpression of YWHAH promoted the osteo-/dentinogenesis of DPSCs in vitro and in vivo. CONCLUSION: Taken together, the findings highlight the critical roles of GREM1-YWHAH in the osteo-/dentinogenesis of DPSCs.

Peracetic Acid Efficacy on Disinfection of Photostimulable Phosphor Plates.

OBJECTIVES: To evaluate the antimicrobial efficacy of white vinegar, acetic acid and peracetic acid on photostimulable phosphor (PSP) plates disinfection, and to assess the disinfectant influence on the radiographic quality. METHODS: Eight PSP plates (Express system) were contaminated with Streptococcus mutans and Candida albicans. These plates were wiped with tissues without any substance, with white vinegar, acetic acid, and peracetic acid, followed by an agar imprint. Number of microbial colonies formed was recorded. Afterwards, the quality of radiographs was tested using the more efficient disinfectant. Before disinfection and after every five disinfections, two radiographs of an acrylic-block and two radiographs of an aluminum step-wedge were acquired for each plate. Density, noise, uniformity, and contrast were analyzed. Three oral radiologists evaluated the images for the presence of artifacts. One-way Analysis of Variance compared changes on gray values among the disinfections (α = 0.05). Intra- and inter-examiner agreement for the presence of artifacts was calculated by weighted Kappa. RESULTS: Peracetic acid was the only one that eliminated both microorganisms. Density and uniformity decreased after 100 disinfections, and contrast changed without a pattern in the course of disinfections (P ≤ 0.05). Small artifacts were observed after 30 disinfections. Intra- and inter-examiner agreements were almost perfect. CONCLUSIONS: Disinfection with peracetic acid eliminated both microorganisms. However, it also affected density, uniformity and contrast of radiographs, and led to the formation of small artifacts.

The impact of various substrates, ceramic shades, and brands on the ultimate color and masking capacity of highly translucent monolithic zirconia: an in vitro study.

This study aimed to examine the impact of substrates, ceramic shades, and brands on the color and masking ability of highly translucent monolithic zirconia (HTMZ) using CIELab and CIEΔE2000 metrics. A total of 156 1-mm thick HTMZ disks in shades A1, A2, and A3 were produced using Dental Direkt and Kerox zirconia brands. Four 3-mm thick substrates (nickel-chromium alloy, non-precious gold alloy (NPG), zirconia shade A2, and resin composite shade A2) were prepared. HTMZ disks were overlaid on these substrates, and color measurements were taken with a spectrophotometer. Color differences (ΔE) were analyzed using CIELab and CIEΔE2000 formulas. The influence of brand, shade, substrate, and their interactions on ΔE values was assessed with a General Linear Model (GLM) and LSD pairwise comparison test. Spearman's correlation test examined the relationship between CIELab and CIEΔE2000 values. Results indicated that ΔEab was significantly influenced by substrate type and shade, while ΔE2000 was also affected by the ceramic brand. Mean color differences across ceramic-substrate groups were within clinically acceptable and perceptible ranges (clinically perceptible: ∆Eab ≥ 1.3 and ∆E2000 ≥ 0.8; clinically acceptable: 0.8 < ∆E2000 ≤ 1.8 and 1.3 < ∆Eab ≤ 2.7), except for NPG, which had ΔE values exceeding the perceptible range (ΔE2000: 1.1 ± 0.11 to 1.8 ± 0.31; ΔEab: 1.61 ± 0.15 to 2.16 ± 0.36). A significant correlation (r = 0.974, P < 0.001) was found between ΔEab and ΔE2000. Various ceramic brands and shades led to notable ΔE variations, yet average color differences within all ceramic-substrate groups remained clinically acceptable. Both ΔEab and ΔE2000 were reliable methods with a strong correlation for measuring color differences.

Stigmatizing attitudes and beliefs about obesity among dental team members.

Background: Weight stigma is prevalent within healthcare settings and is an aspect of the lived experience of people living with obesity. There is international evidence of weight stigma in the dental setting, where currently there is also evidence indicating limited training amongst dental professionals regarding obesity or obesity-related stigma. There has been Australian research and none have included dental support staff. Aims: This cross-sectional survey aimed to assess stigmatizing attitudes and beliefs of dental professionals (registered general dentists, oral health therapists) and support staff (dental assistants, dental receptionists) working in private and public regional practices in New South Wales and specialists in Special Needs Dentistry across Australia toward people living with obesity. Methods: An anonymous electronic validated survey was administered through REDCap™ to assess stigmatizing attitudes and beliefs held amongst respondents in relation to people living with obesity. Results: Fifty-three participants completed the survey (n = 33 clinicians, n = 20 support staff). The majority 47/53 (88.7%) held positive attitudes toward people living with obesity. Of the clinicians, 15/33 (45.5%) reported 1 hour or less and 14/33 (42.4%) reported two to 5 hours of obesity-related education. 14/20 (70%) of the support staff reported no prior education or training about obesity. Of responses reflecting weight stigma, only three clinicians reported negative reactions toward the appearance, or discomfort during examination, of a patient with obesity, or a perception of laziness, compared with normal weight individuals. A higher proportion 4/20 (20%) of support staff reported responses indicating negative attitudes for people with obesity compared with normal weight individuals. Conclusion: Survey responses reflected evidence of weight stigma in both dental professionals and support staff. Professional development targeting weight stigma reduction in the dental setting is needed for both clinicians and support staff.

A novel implant placement technique using a three-dimensionally printed duplicate denture for implant-supported overdenture in patients with severe residual ridge resorption: A case report.

The treatment method of placing a small number of implants in the mandible as a removable implant-supported overdenture (IOD) enables implant placement and denture stability, even in cases with severe residual ridge resorption. In this case report, a new implant placement technique was performed using a three-dimensionally (3D)-printed duplicate denture fabricated by a 3D printer, resulting in the restoration of masticatory function through IOD.

Crafting Confidence: A Comprehensive Case Study of Full-Mouth Reconstruction Utilizing Implant-Supported Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) Zirconia Restorations.

A 67-year-old male patient reported to the department with a chief complaint of tooth mobility. The patient presented with a medical history of diabetes for which he was on medication, and he also reported a history of chronic periodontitis. After a thorough assessment of the patient, a proper treatment plan was designed, which included full-mouth rehabilitation, prior to which the patient was advised full-mouth extraction. Six implants were inserted into the mandibular and maxillary arches as part of the treatment. After the implant was placed, zirconia was the preferred choice for the restoration because of its superior aesthetic results. Polyvinyl siloxane impression material was used to make implant impressions after an eight-week healing period. The case report provides the technique for the current approach to full-mouth rehabilitation with all six concepts of implant placement. In these situations, it is crucial to plan and insert implants correctly and adhere to the entire treatment plan. Restorations were performed using the latest computer-aided design/computer-aided manufacturing (CAD/CAM) technologies for a more aesthetically pleasing result. The case study highlights the significance of meticulous preparation and implementation for the accomplishment of successful full-mouth rehabilitation.

Evaluation of Radiant Power of the Light Curing Units Used in Clinics at Governmental and Privates Dental Faculties.

Background:  To evaluate the radiant power of the light cure units (LCUs) in relation to their type, radiant exitance, number of years in clinical use, and condition of LCUs tips in governmental and public clinics in Dental Faculties in Sana'a City. Materials and Methods: LCUs were collected from different colleges at Sanaa City, Yemen, then LCU data as type, clinical age (<1 year, between 1-5 and ˃ 5-years), tip condition was visually inspected for damage and adhering debris, and the radiant exitance values of the tested LCUs. Radiant exitance values were subcategorized into three groups: <400, 400-850, and >850 mW/cm², labeled as inadequate, marginal, and adequate radiant exitances, respectively. A Woodpecker radiometer was used with a mode lasting of 20 seconds was used with each LCU. Descriptive statistics of the different parameters were evaluated with SPSS version 25. One-way ANOVA and Mann-Whitney tests were performed to determine the mean difference between the groups with a significance value of ˂ 0.05 was considered. Results: Two hundred twenty-three LCUs were surveyed, and the majority were Light-emitting diode (LED). Forty-nine (21.9%), 117 (52.4%), 57 (25.6%) recorded lesser than, 400-850, and more than 850 mW/cm², respectively. Radiant exitances of < year-old units were found to be higher than those of units used for ˃ 5 years with significant differences (p=0.001). The ANOVA test showed significant differences between the radiant exitance with clinical age and LCU tip conditions and a strong correlation p ˃ 0.050. Conclusion: LED curing lights were the most used in the tested Dental Faculties. More than half of the used LCU offered sufficient radiant exitance. Clinical age, the presence or absence of composite buildups, and damage to curing tips showed significantly affect radiant exitance values.

Applications of 3D-printed teeth in dental education: A narrative review.

Background: The contemporary era of education prompts the need for innovation that facilitates the comprehensible and immersive learning of students. Three-dimensional (3D) printing or additive manufacturing in the form of 3D-printed teeth provides an attractive alternative to extracted teeth and standard dental models, as they provide educational equality and realistic simulation of natural teeth. Aim: This review article summarises the literature that has proven the role and effectiveness of 3D-printed teeth in dental education. Method: This review article follows the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. Two electronic research databases, PubMed and Google Scholar, were used to search for relevant studies. Studies discussing the applications of 3D-printed teeth in dental education were included. Results: The positive and highly valuable role of 3D-printed teeth in dental education has been validated because of their feasible nature. Improvements in dental students' confidence, clinical skills, and learning experiences have also been proven. Conclusion: 3D-printed teeth can serve as a convenient and accessible alternative to extracted and standard dental models for dental education.

The effect of different types of water sources on dental unit waterline contamination: A systematic review and meta analysis.

To systematically review the effect of different types of water sources on dental unit waterline (DUWL) contamination. 5 databases were searched from their inception to December 23, 2023. Two reviewers independently extracted the data and assessed the quality of the literature. The risk ratio (RR) was used as measure of effect size in meta-analysis. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for evaluating quality of the evidence. Meta-analysis was completed by RevMan 5.4.5 studies involving 561 water samples were quantified for meta-analysis. The results indicated that no significant differences were found in view of contamination rate (RR = 1.01; 95 % CI, 0.72-1.41; P = 0.96, I 2  = 62 %; GRADE low)and detection rate of Pseudomonas aeruginosa (RR = 0.78; 95 % CI, 0.15-4.13; P = 0.77; I 2  = 83 %; GRADE very low) between using purified water and tap water as water sources of DUWL. The available evidence suggests that there is no significant difference between purified water and tap water in controlling DUWL contamination. However, the conclusions need to be further validated through more randomized controlled trials with robust design and a large sample size.

A Rare Cause of Pain in the Oral Cavity: Osteomyelitis of Tori.

A 63-year-old man presented with a 1-month history of worsening mouth pain, particularly under the tongue bilaterally, with left more than right. A physical examination revealed multiple dental caries and bilateral mandibular tori, with the left mandibular torus being exquisitely tender to palpation. Lab tests showed increased inflammatory markers in the absence of leukocytosis. A maxillofacial computed tomography scan revealed findings concerning for chronic osteomyelitis with osteolysis of the left mandibular torus. The patient was started on intravenous antibiotics and transferred to another institution for further management through their oral and maxillofacial surgery service. The surgical pathology after torectomy confirmed the diagnosis of acute osteomyelitis with osteonecrosis. Although rare, this case underscores the importance of familiarity with osteomyelitis in tori of the oral cavity, also highlighting the imaging and clinical correlation. Further research is necessary to understand the risk factors and optimal management strategies for similar cases.

A novel brief questionnaire using a face rating scale to assess dental anxiety and fear.

PURPOSE: This study aimed to evaluate the reliability and validity of a four-item questionnaire using a face rating scale to measure dental trait anxiety (DTA), dental trait fear (DTF), dental state anxiety (DSA), and dental state fear (DSF). MATERIALS AND METHODS: Participants were consecutively selected from patients undergoing scaling (S-group; n = 47) and implant placement (I-group; n = 25). The S-group completed the questionnaire both before initial and second scaling, whereas the I-group responded on the pre-surgery day (Pre-day), the day of implant placement (Imp-day), and the day of suture removal (Post-day). RESULTS: The reliability in the S-group was evaluated using the test-retest method, showing a weighted kappa value of DTA, 0.61; DTF, 0.46; DSA, 0.67; DSF, 0.52. Criterion-related validity, assessed using the State-Trait Anxiety Inventory's trait anxiety and state anxiety, revealed positive correlations between trait anxiety and DTA/DTF (DTA, ρ = 0.30; DTF, ρ = 0.27, ρ: correlation coefficient) and between state anxiety and all four items (DTA, ρ = 0.41; DTF, ρ = 0.32; DSA, ρ = 0.25; DSF, ρ = 0.25). Known-group validity was assessed using the initial data and Imp-day data from the S-group and I-group, respectively, revealing significantly higher DSA and DSF scores in the I-group than in the S-group. Responsiveness was gauged using I-group data, showing significantly lower DSA and DSF scores on post-day compared to other days. CONCLUSION: The newly developed questionnaire has acceptable reliability and validity for clinical use, suggesting its usefulness for research on dental anxiety and fear and for providing patient-specific dental care.

Application of Chairside CAD/CAM and Its Influencing Factors among Chinese Dental Practitioners: a Crosssectional Study.

OBJECTIVE: To examine the increased use of chairside CAD/CAM among Chinese dental practitioners, and to explore the existing barriers influencing its further application and satisfaction levels. METHODS: A semi-structured questionnaire was developed to gather respondents' demographic information, as well as their experiences and behaviours regarding the implementation of chairside CAD/CAM. A specialised web-based survey system and WeChat were used to display and distribute the final questionnaire. Then, the data were analysed with Chi-square tests and regression analyses to determine the effects of various demographic variables on chairside CAD/ CAM applications. RESULTS: A total of 1,969 questionnaire responses were included in the analyses. Chairside CAD/ CAM systems were used by 36.9% of participants, with a higher usage rate observed among prosthodontists (60.0%) and dental practitioners holding a PhD degree (57.7%). Chairside CAD/ CAM-fabricated prostheses were most commonly used in the posterior maxilla (83.3%) and mandible (86.0%), followed by the anterior maxilla and mandible (63.8% and 48.6%, respectively). Major barriers to further application included high initial investment, frequent updates of equipment and software programs, and a lack of expertise in chairside CAD/CAM usage. CONCLUSION: Most dental practitioners did not use chairside CAD/CAM systems. The application rate was significantly influenced by sex, location, educational background, department and type of healthcare facility. Chairside CAD/CAM users showed limited satisfaction with the aesthetic performance of the fabricated prostheses. To improve the popularity of chairside CAD/CAM systems, especially among dental practitioners lacking advanced academic degrees, it is highly advisable to optimise CAD software programs and offer comprehensive training opportunities.

The Effectiveness of Technology-Enhanced Learning in Prosthodontic Education: A Systematic Review.

OBJECTIVE: To compare the effectiveness of technology-enhanced learning (TEL) with traditional learning in prosthodontic education. METHODS: The protocol was registered before commencement [CRD42023390277]. The search was conducted to identify randomized controlled trials (RCTs) focused on comparative assessment of TEL and traditional learning in prosthodontic education up to 6 June 2024. A comprehensive search strategy was formulated, encompassing multiple electronic databases. Screening, data extraction and risk of bias assessment using the Cochrane tool (RoB 2) were performed. Educational outcomes were evaluated by Kirkpatrick's four-level evaluation model. RESULTS: Of 2830 records identified, 14 RCTs were included. All the trials were judged at high risk of bias or had some concerns. The included studies assessed the short-term benefits of various TEL approaches, including e-learning, blended learning, video demonstration specialized self-evaluation software and virtual reality simulation in prosthodontic education for undergraduates. Promising results were found in individual studies, particularly in terms of perceived learning conditions with problem-based learning (PBL) and self-reported understanding and confidence when using video demonstrations. Most studies reported comparable outcomes to traditional learning in practical skills assessments, while the results regarding the acquisition of theoretical knowledge through the incorporation of TEL approaches were contradictory. One study reported promising results in perceived learning conditions with the PBL approach, as well as improved self-reported understanding and confidence with the use of video demonstrations. Furthermore, there was a limited number of studies assessing the effect of TEL approaches on students' behaviour. CONCLUSION: There is a lack of high-quality evidence to support the adoption of TEL approaches in prosthodontics. However, the incorporation of virtual reality simulation has demonstrated promising results, particularly in improving practical clinical skills.

Primary stability with osseodensification drilling of dental implants in the posterior maxilla region in humans: A systematic review.

Currently, a new non-subtractive drilling technique, called osseodensification (OD), has been developed. It involves using specially designed drills with large negative cutting angles that rotate counterclockwise, causing expansion through plastic bone deformation, thus compacting the autologous bone to the osteotomy walls, which improves the primary stability of the implant.The present systematic review aimed to determine whether the OD technique can increase the primary stability of dental implants in the posterior maxilla region as compared to the conventional drilling (CD) technique.Five databases were searched up to June 30, 2022. The inclusion criteria embraced observational clinical studies, randomized and non-randomized controlled trials, human studies in vivo, comparing OD and CD, with the measurement of the primary stability of implants in the posterior maxilla region by means of the implant stability quotient (ISQ). The tools used to assess the risk of bias were RoB 2 and the NewcastleOttawa Scale (NOS).Seven articles met the inclusion criteria, with 4 classified as having a low risk of bias and 3 with a moderate risk of bias. The OD technique consistently demonstrated an average ISQ value of 73 KHz across all studies, whereas CD yielded an average value of 58.49 kHz (p < 0.001 for 5 articles).It can be concluded that in comparison with CD, OD improves primary stability at baseline in low-density bone, such as the maxilla.