## 1 Introduction  
Bone tissue, a specialized connective tissue, exhibits a substantial capacity for regeneration and remodeling, which is crucial for maintaining structural and functional integrity [1, 2]. However, localized bone osseointegration, the structural and functional connection between living bone and the surface of a load-bearing implant, is fundamental to the long-term success of dental implants [3, 4]. Adequate primary stability, defined as the mechanical stability of an implant at the time of placement, is widely recognized as an essential prerequisite for osseointegration to occur [1, 5]. Primary stability is influenced by the quality and quantity of native bone, the surgical technique, and implant features. Low primary stability in poor-quality bone increases the risk of micromotion and fibrous encapsulation, compromising the establishment of secondary stability and ultimately leading to implant failure [1, 6, 7].  
Secondary stability originates from biological fixation as newly formed woven bone transitions to mature lamellar bone. Implant micromotion, excessive loading, poor bone quality, and surgical trauma can all negatively impact secondary stability [4; 7; 8]. Low secondary stability is associated with reduced long-term survival [9; 10]. Therefore, enhancing early stabilization is key to avoiding micromotion, facilitating effective osseointegration, and enabling earlier loading protocols [5; 11; 12]. Numerous surgical techniques have been developed to improve primary stability in low-density bone, thereby setting the stage for optimal secondary stability and osseointegration [13; 14; 15; 16; 17].  
Two quantitative methods exist for clinically evaluating implant stability: insertion torque (IT) and resonance frequency analysis, also known as implant stability quotient (ISQ) [7; 8]. Insertion torque provides a direct measure of the rotational friction between the implant and bone as the implant is placed. Higher IT values indicate greater primary stability, with prior research demonstrating IT values above 30 Ncm are considered ideal [17]. ISQ utilizes vibration analysis to characterize the resonance frequency of the implant-bone complex, providing an indirect measure of stiffness and micromobility. While IT provides a one-time measure of primary stability at placement, ISQ can be utilized at multiple time points to monitor the progression of secondary stability via bone regeneration and remodeling at the implant interface [18].  
Osseedensification (OD) is a technique that involves the use of specialized drilling instruments to compress bone, thereby increasing bone-implant contact and friction [13; 19; 20]. However, its effectiveness is limited by the density of the patient's natural bone. Studies have shown that OD is more effective than traditional osteotomy preparation in low-density-bone models [21; 22; 23; 24; 25]. It is possible that the benefits of OD could be enhanced by utilizing particulate bone graft walls at the surgical site, although further investigations are necessary. Therefore, this study compared the effectiveness of OD-prepared implants with and without xenograft bone walls in enhancing primary implant stability in low-density bone.