Frequently Asked Questions – View PDF
Q. Who is Versah?
Versah, LLC is a Michigan-based company started in 2014. The Founder, President and Chief Executive Officer of the company is Dr. Salah Huwais, DDS, a practicing periodontist in Jackson, Michigan. The mission of Versah, LLC is to market and sell to dental professionals high quality dental devices based on a new technology for drilling into bone tissue that we have coined “osseodensification.”
Q. Is Versah affiliated with any other surgical instrument or implant company?
No. We are an independent surgical tool manufacturer. Our dental burs can be used with common surgical equipment and all commercially available implants.
Q. How can I contact Versah, LLC?
Q. Where can I buy Densah® Bur Products in the UK?
The distributor in the UK is Implantium UK, and the Biomaterials Store. Please click here to visit the Versah UK Shop.
Q. What are the prices of the Densah® Bur products?
These can be found at the Versah UK Shop on the Biomaterials Store.
Q. I only place tapered implants, so do I need to buy the full Densah® Bur Kit (VDBK)?
The VT5 Densah® Bur Kit of 4 progressively larger tapered
Q. I only place straight (non-tapered) implants, so do I only need to buy the VS8 Densah® Bur Kit?
The VS8 Densah® Bur Kit contains four “finishing” burs for placing straight (non-tapered) implants. The VS8 Densah® Bur Kit must be paired with either the VT5 or the VT8 Densah® Bur kit to accomplish all but the final osteotomy expansion steps. In dense bone, it may be advisable to implement a milder expansion rate by progressively alternating the VT5 and VT8 Densah® Burs. For placing straight implants in these dense bone, the practitioner will want the full VDBK Densah® Bur Kit, which contains all of the burs in the VT5 & VT8 plus the VS8 Densah® Burs.
Q. What is Densah® Bur Technology?
The Densah® Bur technology is based on a new technology for osteotomy preparation that we have coined “osseodensification.” Unlike traditional bone drilling technologies, osseodensification does not excavate bone tissue. Rather, bone tissue is simultaneously compacted and auto-grafted in an outwardly expanding direction to form the osteotomy, somewhat akin to a traditional hammered osteotome but without the trauma and other limitations. When a Densah® Bur is rotated at high speed in a reversed, non-cutting direction with steady external irrigation, a strong and dense layer of bone tissue is formed along the walls and base of the osteotomy. Dense compacted bone tissue produces stronger purchase for your favorite dental implant, higher initial implant stability, higher initial torque values, and may facilitate faster healing
Q. How does Densah® Bur Technology work?
The multi-fluted Densah® Bur creates and expands a pilot hole without excavating significant amounts of bone tissue through a unique, highly controllable, fast and efficient procedure with minimal heat elevation. In the densifying mode, downward surgical pressure coupled with steady external irrigation creates a gentle hydrodynamic compression wave inside the osteotomy that works with the fluting to generate a strong, densified layer of surrounding bone, while plastically expanding the bony ridge at the same time. The tapered design allows the surgeon to modulate pressure and
Q. Do I need to use special implants with the Densah® Bur?
No. You can use any tapered or straight anchor/implant that you would otherwise choose for a particular application. Select the correct Densah® Bur Kit based on your preferred implant type and size.
Q. What patients make good candidates for the Densah® Bur osseodensification procedure?
All patients otherwise healthy enough for receiving dental implants are candidates for osseodensification. The Densah® Bur may form a stronger osteotomy in all bone types (Types I-IV) compared with traditional drilling. In addition, the Densah® system often allows for expansion of a narrow ridge to receive an implant that previously would have required a grafting procedure. Thus, more patients become candidates for safely placing an implant with fewer procedures and less waiting time.
Q. Is Osseodensification biomechanically valid?
The Experimental Biomechanics Laboratory at Lawrence Technological University in Southfield, Michigan performed a biomechanical as well as histological validation study of the Densah® Bur osseodensification technology in 2013-2014. The study concluded that osseodensification increases primary stability and creates a densification crust around the preparation site by compacting and autografting bone along the entire depth and bottom of the hole.
Q. Is the Densah® Bur osseodensification procedure more painful for my patient?
Patient-sensed discomfort associated with the Densah® Bur procedure is equivalent to that of traditional drilling.
Q. How long does the average osseodensification procedure take?
Most surgical practitioners are surprised at the fast feed rates of each progressively larger Densah® Bur. Numerous videos showing actual surgical procedures have been uploaded to our website that will give you a realistic understanding of just how efficient this new technology is. For an average large dental implant (in the 5.7-6.0mm range), the pilot osteotomy is followed by four progressively larger Densah® Burs. Narrower implants typically take less time because fewer expansion steps to reach final osteotomy size are required. Osteotomies in Dense bone might take slightly more time if you need to progressively alternate the VT5 and VT8
Q. What differences will I notice with the osseodensification procedure?
The most striking difference most dental surgeons will notice is the modulation technique. The unique design of the Densah® Bur combined with irrigation creates a gentle hydrodynamic compression wave inside the osteotomy. The surgeon will feel through their handpiece the “push-back” from this hydrodynamic compression wave and be able to control its intensity by modulating downward pressure. This real-time haptic feedback enables the skilled practitioner to intuitively find the pressure point at which the bone begins to plastically expand. The surgeon then controls (i.e., modulates) the downward pressure so that the osteotomy continues expanding at a suitable rate.
Q. Do I need a pilot hole?
Yes. The formation of a standard 1.7mm pilot hole to the desired depth must precede the use of the first 1525 or 1828 Densah® Bur. Never use a Densah® Bur without a properly sized initial pilot hole.
Q. Can I skip the recommended progression of Densah® Burs in suitably soft bone?
No. Even in soft bone, the recommended progression of Densah® Burs must be followed. For example: 3.5, 3.7 and 3.8 mm diameter-tapered implants, the progression following a 1.7mm pilot hole is 1525, 2535. For 4.0, 4.2 and 4.3mm diameter-tapered implants, the progression following a 1.7mm pilot hole is 1828, 2838. This sequence allows for the plastic deformation expansion and osseodensification to occur at an optimal rate.
Q. Where can I receive training to effectively use the Densah® Bur procedure?
Training is available through Dentale in the UK.
Q. May I eliminate the step of ridge augmentation in narrow ridges prior to implant placement?
With the Densah® Bur
Q. What peak insertion torque values should I expect with the osseodensification process?
Initial clinical data has shown that implants placed with the Densah® Bur system may routinely achieve a peak insertion torque of 40-85
Q. How long before the implant can be loaded?
Initial clinical data on file has shown an increase in total implant stability throughout healing, which may allow a shorter waiting period to loading. Observe the approved indications for use for the implant system and follow the implant manufacturers recommendation.
Q. What kinds of equipment are needed for the Densah® Bur?
Any commercially available surgical drill motor and
Q. Is it necessary to irrigate the osteotomy site during the osseodensification procedure?
Yes. Apply an abundant steady flow of sterile irrigating fluid to the osteotomy site throughout the procedure. Without ample irrigation, the risk of overheating and necrosis is high. Irrigation is necessary to facilitate the plastic deformation expansion of the bony tissue.
Q. Is the Densah® Bur reusable?
The Surgical drills and Burs should be replaced when they are dulled, worn out, or corroded. Versah recommends replacing surgical drills and burs after 12-20 osteotomies. It is recommended that replacement Densah® Burs be on hand in the event replacement is needed during a surgery.
Q. Can my Densah® Burs be re-sharpened/re-furbished?
Unfortunately, the manufacturing tolerances needed to achieve the requisite performance of our Densah® Burs are so precise that re-sharpening is not possible. Please dispose of used Densah® Burs that have reached the end of their useful life in a safe and responsible manner.
Q. Can Densah® Burs be used with computer generated implant placement guides?
Densah® Burs are compatible with Implantpilot. Visit implantpilot4dentists.co.uk for more information.
Q. What is the difference between the Densah® Burs and rotatory expanders?
Unlike the Densah® Burs, rotatory expanders cannot be used with high-speed rotation of 800-1500 RPM. They are only to be used with low speed rotation of 20-50 RPM. In addition, rotary expanders link the expansion rate to the rotation rate, which is controlled solely by the expander threads pitch. This limits surgical control, so bone is usually manipulated either at its elastic deformation region or with slight more force it can quickly reach its fracture limit. Densah® Burs are designed to unlink the rotation rate to the expansion rate to allow full surgical control to produce bone plasticity with a rate dependent stress to achieve a rate dependent strain. Optimizing Bone Plasticity utilizing osseodensification may reduce the risk of buccal bone fracture.
Q. Can I run the standard drilling bits in my implant kit in reverse to replicate the Versah osseodensification protocol?
Unlike conventional drills, Densah®
Q. Do I need to be concerned about High Insertion Torque (IT) values, achieved with osseodensification using the Densah® Bur System, causing pressure osseonecrosis during implant placement?
The short answer is NO – Bone pressure necrosis is not a concern with the high insertion torque values achieved by osseodensification using Densah® Burs. In fact, the literature supports that higher insertion torque values and
- Viscoelastic relaxation of bone.
remodelingby basic multicellular units whereby pre-stressed bone is replaced by new bone through internal remodelingrather than surface resorption. [11-12]
Higher insertion torque combined with the enhanced osseodensification of the implant site is highly desired.
 Heat Production by 3 implant drill systems after repeated drilling and sterilization. Chacon GE, Bower DL, Larsen PE, McGlumphy EA, Beck FM. J Oral Maxillofac Surg. 2006 Feb:64(2):265-9.
 Trisi, P., et al., Implant micromotion is related to peak insertion torque and bone density. Clin Oral Implants Res, 2009. 20(5): p. 467-71.
 Winwood, K., et al., The importance of the elastic and plastic components of strain in tensile and compressive fatigue of human cortical bone in relation to orthopaedic biomechanics. J Musculoskelet Neuronal Interact, 2006. 6(2): p. 134-41.
 Bashutski JD, D.S.N., Wang HL, Implant pressure necrosis: Current understanding and case report. J Periodontal 2009; 80:700-704., 2009(80): p. 700-704.
 Haider R, e.a., Histomorphometric analysis of bone healing after insertion of IMZ-1 implants independent of bone structure and drilling method. Stomatol, 1991(88): p. 507-521.
 Trisi, P., et al., High versus low implant insertion torque: a histologic, histomorphometric, and biomechanical study in the sheep mandible. Int J Oral Maxillofac Implants, 2011. 26(4): p. 837-49.
 Ottoni, J.M., et al., Correlation between placement torque and survival of single-tooth implants. Int J Oral Maxillofac Implants, 2005. 20(5): p. 769-76.
 Khayat PG1, A.H., Tourbah BI, Sennerby L., Clinical outcome of dental implants placed with high insertion torques (up to 176 Ncm). Clin Implant Dent Relat Res. , 2013. 15(2): p. 227-33.
 Perren, S.M., et al., The reaction of cortical bone to compression. Acta Orthop Scand Suppl, 1969. 125: p. 19-29.
 Svindland, A.D., et al., Periosteal response to transient ischemia. Histological studies on the rat tibia. Acta Orthop Scand, 1995. 66(5): p. 468-72.
 Halldin, A., et al., The effect of static bone strain on implant stability and bone remodeling. Bone, 2011. 49(4): p. 783-9.
 Perren, S.M., Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br, 2002. 84(8): p. 1093-110.