## 4 Discussion  
In the present study, notable improvements were observed in bone volume, trabecular thickness, and implant stability parameters, which were significantly amplified when employing xenograft bone walls in concert with counterclockwise oseeedensification [29; 30; 31; 32; 33]. This approach not only substantiates the growing body of evidence that advocates for this combination in enhancing early implant stabilization but also highlights the benefits of utilizing low-quality bone to fortify the trabecular spaces. Leveraging the principles of oseeedensification, this strategy integrates bone substitutes that have preferably undergone a sintering process during the same surgical phase, potentially fostering a scaffold that ensures greater particle stability at the time of implant installation, thereby granting more advantageous primary stability [20; 21; 24; 29]. The results of this study align with the findings presented in the systematic review and meta-analysis conducted by [PERSON] et al. In their comprehensive evaluation of various studies, they highlighted the advantages of counterclockwise oseeedensification, particularly in terms of improved bone-to-implant contact and insertion torque compared  
Figure 4: Histogram representation delineating the variation in insertion torque (IT) values across the different osteotomy approaches. Figure 5: Histogram representation illustrating the disparities in implant stability quotient (ISQ) values as dictated by the osteotomy techniques utilized. with clockwise osseedonsification [19; 30; 31; 32]. However, the bone area fraction occupied remained relatively consistent between the two techniques. The micro-CT results of this study support the mechanical benefits of osseedonsification, with localized densification that closely aligns with the biomechanical improvements noted in the meta-analysis. These findings suggest a potential shift in strategies for optimizing implant site preparations [33; 34; 35]. On the other hand, the technique used in the present research was characterized by the compaction of xenograft bone during the preparation of the implant bed to create a graft layer along the surface of the osteotomy site to improve the primary stability. This can lead to preservation and condensation of the implant bed, which is specifically important for low-density bones [1; 29; 36; 21]. Once the osteotomy reaches its final diameter, the implantation bed is filled with xenograft bone particles. Using osseedonsification drills, the particles are condensed against the bone walls to achieve a primary stability of over 30 Ncm [12; 24; 37]. This is done to ensure that any density deficiency in the host tissue is overcome, resulting in optimal stability [37; 38]. Furthermore, it remains imperative to highlight that utilizing these substitutes at varying surgical junctures might not yield identical clinical advantages, potentially signaling a decline in the cooperative efficacy between osseedonsification and the application of bone substitutes at distinct surgical intervals. Following a bone graft procedure, the bone substitute materials, such as xenografts and alloplastic biomaterials, assume a pivotal role as a scaffold fostering new bone formation. However, the bone that eventually materializes at the surgical site post-healing retains these biomaterials, consequently diminishing the concentration of collagen present, a fundamental component facilitating bone movement during the osseedonsification process [39; 40; 41; 42]. Given the prominent presence of bone substitute materials coupled with a diminished collagen concentration, the newly formed bone may not adhere to the established standards of the osseedonsification technique, potentially culminating in a heightened susceptibility to bone fracture during the drilling phase [22; 31; 32]. In light of these findings, this study advocates for the concurrent employment of osseedonsification techniques and biomaterials during site preparation immediately preceding the insertion of the dental implant.