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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 [1]

author: Diego Fernandes Triches, Fernando Rizzo Alonso, Luis Andr Mezzomo, Danilo Renato Schneider, Eduardo Aydos Villarinho, Maria Ivet | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

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.

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