Background : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [1]
The early clinical success of short implants can be affected by poor bone quality and low primary stability because implant micromovement can promote the formation of a fibrous capsule during the osseointegration process. It has been reported that the greater the insertion torque, the greater the resistance of the bone-implant interface to the shear forces that tend to rotate the implant [1]. Clinically, insertion torque is the most practical method for measuring primary stability and can be recorded with the manual torque wrench or contra-angle and motor used for implant placement. Resonance frequency and damping capacity have also been used to measure the primary and secondary stability of short implants in research [2], but the procedures are more complex and require sophisticated equipment and extra clinical time.
Bone quality is a generic term for the characterization of bone tissue in three dimensions: the structural quality, related to the amount of the cortical bone and to the trabecular bone pattern; the bone density, related to the amount of bone mineralization and/or the amount of bone by its volume; and the amount of bone, related to the volume of bone available [3]. Bone quality varies intra- and inter-subject depending on the thickness of cortical bone, the amount of trabecular bone, and the amount of bone tissue mineralization in the region of interest for implant placement [4]. Some classifications of bone quality have considered cortical bone thickness and trabecular bone structure based on preoperative panoramic radiographs and tactile perception during exploratory drilling of the implant site; bone density based on the tactile sensation and Hounsfield units of computed tomography (CT) images; radiographic pattern of trabecular bone; and intra-surgical bone density and biopsy with histomorphometric evaluation [5,6,7,8]. However, most classifications of bone quality for routine clinical use still are not validated by using objective and subjective assessment methods.
Serial posts:
- Abstract : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Background : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [1]
- Background : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [2]
- Methods : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [1]
- Methods : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [2]
- Methods : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [3]
- Methods : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [4]
- Results : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Discussion : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [1]
- Discussion : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [2]
- Discussion : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [3]
- Conclusions : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Abbreviations : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- References : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [1]
- References : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [2]
- References : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [3]
- Acknowledgements : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Author information : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [1]
- Author information : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants [2]
- Ethics declarations : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Rights and permissions : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- About this article : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Table 1 Descriptive statistics of the sample : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Table 2 Matrix of Spearman correlation coefficients and P values (in brackets) for the association among assessment methods of bone quality (intra-surgical tactile perception, preoperative CT visual evaluation, preoperative CT mean gray values (MGVs)) and primary stability (insertion torque) : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Table 3 Comparison of CT mean gray values (average of the axial, coronal, and sagittal ROIs) as a function of arch, dental region, insertion torque, and bone types as classified by CT visual assessment and by intra-surgical tactile evaluation : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants
- Fig. 1. Clinical case of a short implant (4.1 × 6 mm) placed in the region of the left maxillary first molar. a Implant installed. b Insertion torque measurement using the manual torque wrench. c Implant with healing cap and flap suture. d Immediate periapical radiograph after surgery : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implant
- Fig. 2. Preoperative CT image showing the site for the definition of the ROI (simulated area delimited by a yellow dashed line for illustration purpose) in the axial (a), coronal (b), and sagittal (6 × 6 mm) (c) sections : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implant
- Fig. 3. One possible missing category (depicted as “X”) would be a bone type with thick cortical layer and sparse trabecular bone, which would have intermediate characteristics and behavior between the types with thick (2) or thin (3) cortical bones : Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implant