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Material and methods : Does the manual insertion torque of smartpegs affect the outcome of implant stability quotients (ISQ) during resonance frequency analysis (RFA)? [1]

Material and methods : Does the manual insertion torque of smartpegs affect the outcome of implant stability quotients (ISQ) during resonance frequency analysis (RFA)? [1]

author: Ingrid Kstel, Giles de Quincey, Jrg Neugebauer, Robert Sader, Peter Gehrke | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Three fresh bovine ribs from the same animal were selected for the current in vitro testing; the bovine ribs were of a similar size to those used by Gecikli et al. [16], thus attempting to imitate human edentulous bone with a similar composition of cortical and cancellous bone. The animal was farmed and sacrificed for food production. The bone was stored airtight, humid, and cool from the time the cow was dissected until the study was carried out. The implant sites were prepared following the standard protocol recommended by the manufacturer, and 30 self-tapping screw implants (XiVE S, Dentsply Sirona Implants, Bensheim, Germany) with a diameter of 3.8 mm and a length of 11 mm were inserted into the ribs with a bone quality of D1 (10 each) with a safe distance to each other. Since bone quality and surgical technique have an influence on the collected ISQ values [17, 18], Implant placement was performed by the same surgeon (IK). According to the manufacturers’ recommendation, the bone was center marked with a round bur at 800 rpm. This was followed by a pilot drill, an enlarging drill, and the final drill of D 3.8 mm. Because of high bone density (D1) preparation of the osteotomy was followed by a crestal countersink preparation at 15 rpm. All implants were inserted at 50 Ncm and the insertion abutments (XiVE TempBase, Dentsply Sirona Implants, Bensheim, Germany) were removed. In a test group, four different surgeons (S1–S4) with different skill levels and with different backgrounds of experience of RFA hand tightened the corresponding smartpeg components (Type 45, Ostell, FA W & H Dentalwerk, Bürmoos, Austria) into all implants. All examiners were blinded to the study protocol. Subsequently, ISQ values of the 30 implants were measured by each examiner (S1–S4) utilizing RFA (Ostell, IDx, FA W & H Dentalwerk, Bürmoos, Austria) from two orthogonal directions (mesial/buccal). The probe of the analyzer was seized 1 mm from the smartpeg transducer at a 90° angle, and the RFA value was registered as implant stability quotient (ISQ). To determine the insertion torque of the individually hand-tightened smartpeg by each examiner, the removal torque required when removing the device was recorded. This was carried out by using a BTG36N Analog Torque Meter (Fig. 1) (Tohnichi Manufacturing Co. Ltd., Tokyo, Japan). In a control group, the appropriate smartpeg magnetic devices were mechanically inserted into all implants using an electronical Meg Torq device (Fig. 2) (Megagen Implants UK, Luton Bedfordshire, UK) with a defined insertion torque of 5 Ncm. Prior to each insertion, the Meg Torq device was calibrated according to the manufacturer's specifications. Again, the ISQ values of all implants were measured from two orthogonal directions. To verify the insertion torque of the mechanically tightened smartpegs, the removal torque required to unscrew the transducer was recorded (Tohnichi Manufacturing Co. Ltd, Tokyo, Japan).

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