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This study was performed in order to investigate changes in primary stability within an experimental setup of different insertion protocols and insertion modes.

Discussion : Implant primary stability depending on protocol and insertion mode (1)

author: Henning Staedt,Peer W Kmmerer,Elisabeth Goetze,Daniel G E Thiem,Bilal Al-Nawas, Diana Heimes | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Discussion

This study was performed in order to investigate changes in primary stability within an experimental setup of different insertion protocols and insertion modes. In order to obtain a high level of diagnostic certainty, three different methods for measurement of primary stability were recorded. As a secondary outcome parameter, potential differences between implants of different length and diameter have been evaluated. Within this study, no statistically significant difference could be shown so that the groups were not separated regarding the implant’s geometry while further analyzing the insertion mode and the drilling protocol. In line with the research hypothesis, the ODP showed significant lower stability values when compared with implants inserted via SP. The optimization of loading protocols requires establishing a patient-specific protocol. The relationship between shape and shear strength during implant placement modulates the bone compression. Osteotomy techniques with a narrower final drill have been shown to create a better bone-to-implant contact with enhanced primary stability values. As micromotions’ risk osseointegration, there is consensus that implant stability immediately and early after placement is desirable. Primary stability is generally associated with the expectation of good secondary stability, which would ensure the likelihood of implant success and osseointegration under-dimensioned protocols are thought to induce a tight contact immediately after placement: in soft bone, the use of wide diameter implants and an under-dimensioned preparation has been recommended to preserve the cortical layer. A study by Campos et al. reported a significant increase in bone-to-implant contact between SP and under-dimensioned protocols, but they could not show any effect in histometrical parameters. Okazaki et al. analyzed the impact of different loading protocols on implant removal torque values and showed stability values to be up to eleven times lower at the time of insertion in ODPs, whereas no difference between SP and ODP could be observed after a healing phase of 6 to 12 weeks.

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