Figure 5. at the time of placement) to 0.25 mm outside (the same width of the aforementioned) of the virtual implant.
Figure 5. Measurement site of the voxel values. The width of the measurement site was defined as 0.50 mm, i.e., from 0.25 mm inside (the to-be-compressed area at the time of placement) to 0.25 mm outside (the same width of the aforementioned) of the virtual implant.
Figure 4. rtual implant was placed in the implant cavity by simulation.
Figure 4. Setting the evaluation site. An implant placement simulation software (Osaka Landmarker ver. 5.0 with special specifications for study purposes, iCAT, Osaka, Japan) was used as the image analysis software. The virtual implant was placed in the implant cavity by simulation.
Figure 3. The special implant cavity-forming device. This device is able to adjust the up-and-down movement speed and the rotation speed of the drill.
Figure 3. The special implant cavity-forming device. This device is able to adjust the up-and-down movement speed and the rotation speed of the drill.
Figure 2. hanically polished surface.
Figure 2. The implants in this study. Two kinds of diameters (3.8 mm, 5.0 mm) and two kinds of lengths (7.0 mm, 12.0 mm) having a general threadlike shape with a mechanically polished surface.
Figure 1.
Figure 1. The bone model in this study (a pig's ilium). (a) The whole picture of the ilium. (b) The flat part of the posterior margin of the ilium. (c) The CT image of the ilium.
Dependent variable = ITVs
(n = 49)
Independent variables
Standardized partial regression coefficient (P value)
Thickness of the cor...
Dependent variable = ITVs
(n = 47)
Independent variables
Standardized partial regression coefficient (P value)
Thickness of the cor...
Bone factors/stability factors
Diameter (mm)
Length (mm)
r
P
n
Thickness of the cortical bone/ITVs
3.8
7
0.744**
Wada, M., Tsuiki, Y., Suganami, T. et al. The relationship between the bone characters obtained by CBCT and primary stability of the implants. Int J Implant Dent 1, 3 (2015). https://doi.org/10.1186/s40729-014-0003-x
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Received: 18 September 2014
Accepted: 20 November 2014
Published: 12 February 2015
DOI: https://doi.org/10.1186/s40729-014-0003-x
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and in...
Masahiro Wada, Yasutane Tsuiki, Tohru Suganami, Kazunori Ikebe, Motofumi Sogo, Ikuhisa Okuno and Yoshinobu Maeda declare that they have no competing interests.
MW drafted the article and collected the data. YT and TS collected the data. KI performed the data analysis and statistical analysis. MS interpreted the data. IO analyzed the data. YM designed the research and approved the article. All aut...
Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
Masahiro Wada, Yasutane Tsuiki, Tohru Suganami, Kazunori Ikebe, Motofumi Sogo, Ikuhisa Okuno & Yoshinobu Maeda
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This study was partially supported by GC Company.
Nkenke E, Hahn M, Weinzierl K, Radespiel-Troger M, Neukam FW, Engelke K. Implant stability and histomorphometry: a correlation study in human cadavers using stepped cylinder implants. Clin Oral Implants Res. 2003; 14:601–9.
Motoyoshi M, Yoshida T, Ono A, Shimizu N. Effect of cortical bone thickness and implant placement torque on stability of orthodontic mini-implants. Int J Oral Maxillofac Imp...
Lekholm U, Zarb G. Patient selection and preparation. In: Osseointegration in Clinical Dentistry. Chicago: Quintessence Publishing Co, Inc. 1985; p. 199–209
Misch CE. Contemporary Implant Dentistry. St. Louis: Mosby, 1993; p. 469–85.
Turkyilmaz I, Sennerby L, McGlumphy EA, Tozum TF. Biomechanical aspects of primary implant stability: a human cadaver study. Clin Implant Dent Relat Res. 2009; ...
Ottoni JM, Oliveira ZF, Mansini R, Cabral AM. Correlation between placement torque and survival of single-tooth implants.
Int J Oral Maxillofac Implants. 2005; 20:769–76.
Beer A, Gahleitner A, Holm A, Tschabitscher M, Homolka P. Correlation of insertion torques with bone mineral density from dental quantitative CT in the mandible.
Clin Oral Implants Res. 2003; 14(5):616–20.
Meredith N. Ass...
In this limited study, there was a correlation between the thickness of the cortical bone or the voxel values obtained from the CBCT scanning images prior to the implant placement and the implant stabilities. Besides, it was confirmed that the thickness of the cortical bone, the voxel value, and the length of the implant had positive correlations with the ITVs and that the thickness and length had...
Although this study is different from the previous studies in that the thickness of the cortical bone and bone density were determined from the voxel values calculated by CBCT, a significantly positive correlation of the thickness of the cortical bone and the voxel values with ITVs and ISQ values was confirmed as in the previous studies. Furthermore, the multiple regression analysis with the ITVs ...
Ikumi used a MDCT scan for actual patients to calculate the CT values of the 1-mm surrounding area of the planned implant placement site using implant simulation software [25]. However, it is likely that the precise measurement cannot be performed in the case where the actual implant cavity was formed off the planned implant site because the density of the bone around the planned implant site was ...
A significant positive correlation was found between the thickness of the cortical bone and ITVs or ISQ values in all kinds of implants. In addition, a significant positive correlation was also found between the voxel values and ITVs. On the other hand, in the relationship between the voxel values and ISQ values, we cannot confirm a correlation of the implant of 5.0 mm in width and 12.0 mm in le...
The relationships of the thickness of the cortical bone and the voxel values with the ITVs and the ISQ values were analyzed using Pearson's correlation coefficient. Then, multiple regression analysis was performed using the ITVs or the ISQ values as the dependent variable and using the thickness of the cortical bone, the voxel value, and the length of the implant as the independent variables to ev...
All the procedures of forming an implant cavity were unified as follows according to protocols. Firstly, the implant cavity was constructed by using a 2.0-mm-depth drill after marking the implant site using a guide drill. Secondly, a 3.1-mm pilot drill and a 3.1-mm twist drill were used to form a cavity for an implant with 3.8-mm diameter, and a 4.3-mm pilot drill and a 4.3-mm twist drill were use...
A flat part of a pig's ilium was used as the implant placement site to secure as vertical implant placement and an equal depth of insertion to the bone surface as possible (Figure 1).
GXCB-500® (GENDEX, Des Plaines, IL, USA) was used as the CBCT device to obtain almost identical voxel values to the CT values that could be obtained from MDCT. Scanning conditions were as follows: the tube current...
It is therefore considered that MDCT is appropriate for the precise evaluation of bone density. However, since the use of CBCT is spreading rapidly among general practitioners, it is clinically of great significance to predict the primary stability after implant placement using the information obtained by CBCT. In addition, in late years, CBCT or the calibration software which can convert the voxe...
Some of the methods to evaluate the bone quality that influences the primary implant stability have already been applied in a clinical practice. Lekholm and Zarb classified bone density into four types in terms of radiography, with the thickness of the cortical bone and the density of the spongy bone as the indexes [14]. This classification method is accepted most commonly at present but is proble...
The primary stability of an implant at the time of placement is considered as one of the key factors for clinical success of implant treatment [1-6]. Orenstein et al. reported that implants that were appropriately stabilized without any mobility at the time of placement had a significantly high survival rate compared with those that were not [7].
The evaluation of the primary implant stability is...
The aim of this study is to investigate the correlation between the thickness of the cortical bone or the voxel values that are obtained by cone beam CT (CBCT) and the insertion torque values (ITVs) or the implant stability quotient (ISQ) values.
A pig's ilium was used as the implant placement site. The implants used in this study were two kinds of diameters (3.8 mm, 5.0 mm) and two kinds of le...
Fig. 1. Approval of the Bioethics Committee of the Santa Maria University
Fig. 1. Approval of the Bioethics Committee of the Santa Maria University
Simeone, S.G., Rios, M. & Simonpietri, J. “Reverse torque of 30 Ncm applied to dental implants as test for osseointegration”—a human observational study. Int J Implant Dent 2, 26 (2016). https://doi.org/10.1186/s40729-016-0060-4
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Received: 12 September 2016
Accepted: 22 November 2016
Published: 07 December 2016
DOI: https://doi.org/10.1186/s40729-016-0060-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Santa Maria University, Calle La Línea, Residencias El Parque, Piso 5, Apto B–5B. La Carlota. Municipio Sucre, Caracas, 1071, Venezuela
Sabrina G. Simeone, María Rios & Jeannette Simonpietri
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You can also search for this author in PubMed Google Scholar
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Corresponde...
Carvalho C, Carvalho L, Costa L, et al. Titanium implants: a removal torque study in osteopenic rabbits. Indian J Dent Res. 2010;21(3):349–52.
Gehrke S, Dos Santos M, Dedavid B, et al. Potencial de Osseointegra¢ão versus características da superficie microtexturizada Vellox. Revista Implant News. 2011;8:229–37.
Mall N, Dhanasekar B, Aparna I. Validation of implant stability: a measure of ...
Cehreli M, Karasoy D, Akca K, et al. Meta-analysis of methods used to assess implant stability. Int J Oral Maxillofac Implants. 2009;24(6):1015–32.
Gomes J, Campos F, Marin C, et al. Implant biomechanical stability variation at early implantation times in vivo: an experimental study in dogs. J Oral Maxillofac Implants. 2013;28(3):128–34.
Gehrke S. Acondicionamiento de la textura superficial ...
Under the ideal conditions of the study herein, the application of a 30-Ncm reverse torque at the time of the stage 2 surgery, before the prosthetic restoration, allowed the clinical identification of the stability of 40 dental implants.
Primary stability depends on the micro and macroscopic characteristics of the dental implant. Thus, after the application of a 30-Ncm reverse torque, both implan...
In order to exclude risk factors, as there are no previous researches on reverse torque in humans, the research was made following a conventional protocol, only on lower jaw implants, with implants of treated surface, which have benefits that greatly compensate for the risks, allowing for faster osseointegration levels because the rugosity increases the contact surface between the implant and the ...
The reverse torque technique proposed by Roberts in 1984 to evaluate dental implants integration proved to be successful. The most recent researches are aimed at evaluating current results. Thus, the objective of this research was to evaluate, by means of the 30 Ncm reverse torque test, 40 dental implants on the lower jaw, during the stage 2 surgery, as a mechanical and clinical, non-invasive tre...
This study reports on the clinical behavior of 40 dental implants placed on the lower jaw, on ideal bone, and under ideal surgical and systemic conditions, subjected to a 30-Ncm reverse torque during the stage 2 surgery, on 17 patients.
The patients evaluated only showed normal signs and symptoms of post-operatory swelling. According to the distribution of the implants on the mandibular region, 2...
On the data collection table, the existence of any peri-implant radiolucency radiographic images previous to the stage 2 surgery was recorded. After the application of the 30 Ncm reverse torque, the presence or absence of dental implant movement was recorded, as well as any incidence of symptomatology (pain), or presence of any clinical signs.
A clinical trial was carried out, in which 17 patients treated with implants at the School of Dentistry of the Santa Maria University and which had had 40 dental implants placed from two different commercial brands, with NanoTec™ and Vellox® surfaces, on the lower jaw, with the approval of the Bioethics Committee of the Santa Maria University (Fig. 1).
Patients 18 years old or older;
Signed...
Since the study herein is not found in humans [5, 9], last phase of study, and counting on previous results from in vitro and in vivo researches with animal models on long bones (femur, tibia, mandibles) in dogs, pigs, baboons, rabbits, and even in mastoid bones [6, 9–16], which provide necessary information to design human trials, this mechanical test was performed on dental implants in humans,...
The reverse torque test proposed by Roberts et al. in 1984, and developed by Johansson and Albrektsson in 1987 [6], is considered as a special advantage in stage 2 surgery, because it represents a definitive clinical verification of initial integration of the dental implant with the bone surface. The torque level required is commonly expressed in Newton centimeters (Ncm) [7, 8].
This way, a clini...
Primary stability has been reestablished as a previous clinical requirement to achieve osseointegration. The presence of movements between the surface of the implant and the bone tissue induces a bone resorption that produces fibrointegration, in which the implant is surrounded by an interphase of soft or connective tissue, and not bone tissue [1, 2].
Strategies used to improve bone response incl...
On bone implantology, stability of a dental implant is an essential clinical tool during osseointegration evaluation, as it is a reflection of the structural and functional connection between the bone and the implant.
The sample was comprised by 17 patients with 40 NanoTec™ and Vellox® implants, placed on the lower jaw, under optimum conditions, after a minimum healing period of 3 months, duri...
Fig. 5. Reverse torque at 30 Ncm
Fig. 5. Reverse torque at 30 Ncm
Fig. 4. Reverse torque test
Fig. 4. Reverse torque test
Fig. 3. 30 Ncm, measurement
Fig. 3. 30 Ncm, measurement
Fig. 2. Informed consent for patients
Fig. 2. Informed consent for patients
Fig. 1. Approval of the Bioethics Committee of the Santa Maria University
Fig. 1. Approval of the Bioethics Committee of the Santa Maria University
Simeone, S.G., Rios, M. & Simonpietri, J. “Reverse torque of 30 Ncm applied to dental implants as test for osseointegration”—a human observational study. Int J Implant Dent 2, 26 (2016). https://doi.org/10.1186/s40729-016-0060-4
Download citation
Received: 12 September 2016
Accepted: 22 November 2016
Published: 07 December 2016
DOI: https://doi.org/10.1186/s40729-016-0060-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Santa Maria University, Calle La Línea, Residencias El Parque, Piso 5, Apto B–5B. La Carlota. Municipio Sucre, Caracas, 1071, Venezuela
Sabrina G. Simeone, María Rios & Jeannette Simonpietri
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
Corresponde...
Carvalho C, Carvalho L, Costa L, et al. Titanium implants: a removal torque study in osteopenic rabbits. Indian J Dent Res. 2010;21(3):349–52.
Gehrke S, Dos Santos M, Dedavid B, et al. Potencial de Osseointegra¢ão versus características da superficie microtexturizada Vellox. Revista Implant News. 2011;8:229–37.
Mall N, Dhanasekar B, Aparna I. Validation of implant stability: a measure of ...
Cehreli M, Karasoy D, Akca K, et al. Meta-analysis of methods used to assess implant stability. Int J Oral Maxillofac Implants. 2009;24(6):1015–32.
Gomes J, Campos F, Marin C, et al. Implant biomechanical stability variation at early implantation times in vivo: an experimental study in dogs. J Oral Maxillofac Implants. 2013;28(3):128–34.
Gehrke S. Acondicionamiento de la textura superficial ...
Under the ideal conditions of the study herein, the application of a 30-Ncm reverse torque at the time of the stage 2 surgery, before the prosthetic restoration, allowed the clinical identification of the stability of 40 dental implants.
Primary stability depends on the micro and macroscopic characteristics of the dental implant. Thus, after the application of a 30-Ncm reverse torque, both implan...
In order to exclude risk factors, as there are no previous researches on reverse torque in humans, the research was made following a conventional protocol, only on lower jaw implants, with implants of treated surface, which have benefits that greatly compensate for the risks, allowing for faster osseointegration levels because the rugosity increases the contact surface between the implant and the ...
The reverse torque technique proposed by Roberts in 1984 to evaluate dental implants integration proved to be successful. The most recent researches are aimed at evaluating current results. Thus, the objective of this research was to evaluate, by means of the 30 Ncm reverse torque test, 40 dental implants on the lower jaw, during the stage 2 surgery, as a mechanical and clinical, non-invasive tre...
This study reports on the clinical behavior of 40 dental implants placed on the lower jaw, on ideal bone, and under ideal surgical and systemic conditions, subjected to a 30-Ncm reverse torque during the stage 2 surgery, on 17 patients.
The patients evaluated only showed normal signs and symptoms of post-operatory swelling. According to the distribution of the implants on the mandibular region, 2...
On the data collection table, the existence of any peri-implant radiolucency radiographic images previous to the stage 2 surgery was recorded. After the application of the 30 Ncm reverse torque, the presence or absence of dental implant movement was recorded, as well as any incidence of symptomatology (pain), or presence of any clinical signs.
A clinical trial was carried out, in which 17 patients treated with implants at the School of Dentistry of the Santa Maria University and which had had 40 dental implants placed from two different commercial brands, with NanoTec™ and Vellox® surfaces, on the lower jaw, with the approval of the Bioethics Committee of the Santa Maria University (Fig. 1).
Patients 18 years old or older;
Signed...
Since the study herein is not found in humans [5, 9], last phase of study, and counting on previous results from in vitro and in vivo researches with animal models on long bones (femur, tibia, mandibles) in dogs, pigs, baboons, rabbits, and even in mastoid bones [6, 9–16], which provide necessary information to design human trials, this mechanical test was performed on dental implants in humans,...
The reverse torque test proposed by Roberts et al. in 1984, and developed by Johansson and Albrektsson in 1987 [6], is considered as a special advantage in stage 2 surgery, because it represents a definitive clinical verification of initial integration of the dental implant with the bone surface. The torque level required is commonly expressed in Newton centimeters (Ncm) [7, 8].
This way, a clini...
Primary stability has been reestablished as a previous clinical requirement to achieve osseointegration. The presence of movements between the surface of the implant and the bone tissue induces a bone resorption that produces fibrointegration, in which the implant is surrounded by an interphase of soft or connective tissue, and not bone tissue [1, 2].
Strategies used to improve bone response incl...
On bone implantology, stability of a dental implant is an essential clinical tool during osseointegration evaluation, as it is a reflection of the structural and functional connection between the bone and the implant.
The sample was comprised by 17 patients with 40 NanoTec™ and Vellox® implants, placed on the lower jaw, under optimum conditions, after a minimum healing period of 3 months, duri...
Fig. 3. ISQ values of MDIs and Ankylos® after euthanasia
Fig. 3. ISQ values of MDIs and Ankylos® after euthanasia
Fig. 2. ISQ values of MDIs and Ankylos® immediately upon insertion
Fig. 2. ISQ values of MDIs and Ankylos® immediately upon insertion
Fig. 1. Customized SmartPeg diagrams
Fig. 1. Customized SmartPeg diagrams
Dhaliwal, J.S., Albuquerque, R.F., Fakhry, A. et al. Customized SmartPeg for measurement of resonance frequency of mini dental implants. Int J Implant Dent 3, 4 (2017). https://doi.org/10.1186/s40729-017-0066-6
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Received: 09 November 2016
Accepted: 13 January 2017
Published: 01 February 2017
DOI: https://doi.org/10.1186/s40729-017-0066-6
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
Jagjit Singh Dhaliwal, Ali Fakhry & Jocelyne S. Feine
Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
Rubens F. Albuquerque Jr
Department of Zoology, Panjab University, Chandigarh, India
Sukhbir Kaur
PAPRSB Institute of Health Sci...
Dhaliwal J, Albuquerque R, Murshed, M, Tamimi, F, Feine, JS. A histomorphometric comparison of osseointegration with MDIs and standard implants. IADR/AADR/CADR 91st General Session, Seattle, Washington, USA, March 20–23, 2013
Zix J, Hug S, Kessler-Liechti G, Mericske-Stern R. Measurement of dental implant stability by resonance frequency analysis and damping capacity assessment: comparison of b...
Barros RR, Novaes Jr AB, Muglia VA, Iezzi G, Piattelli A. Influence of interimplant distances and placement depth on peri-implant bone remodeling of adjacent and immediately loaded Morse cone connection implants: a histomorphometric study in dogs. Clin Oral Implants Res. 2010;21(4):371–8. Epub 2010/02/05.
Marin C, Bonfante EA, Granato R, Suzuki M, Granjeiro JM, Coelho PG. The effect of alterati...
Meredith N, Book K, Friberg B, Jemt T, Sennerby L. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Clin Oral Implants Res. 1997;8(3):226–33. Epub 1997/06/01.
Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the im...
Ersanli S, Karabuda C, Beck F, Leblebicioglu B. Resonance frequency analysis of one-stage dental implant stability during the osseointegration period. J Periodontol. 2005;76(7):1066–71. Epub 2005/07/16.
Bornstein MM, Chappuis V, von Arx T, Buser D. Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients...
Shatkin TE, Oppenheimer BD, Oppenheimer AJ. Mini dental implants for long-term fixed and removable prosthetics: a retrospective analysis of 2514 implants placed over a five-year period. Compend Contin Educ Dent. 2007;28(2):92–9. quiz 100-1. Epub 2007/02/27.
Griffitts TM, Collins CP, Collins PC. Mini dental implants: an adjunct for retention, stability, and comfort for the edentulous patient. Or...
Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100. Epub 1969/01/01.
Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont. 1998;11(5):491–501. Epub 1999/01/29.
Lioubavina-Hack N, Lang NP, Karring T. Significance of primar...
The results of this animal study indicate that ISQ measurement of these single-piece MDIs is possible with the help of a custom-made SmartPeg and that 3M™ESPE™MDIs attain primary and secondary stability at the same levels as standard implants in the rabbit tibia.
As there are no studies that provide data based on resonance frequency measurements for single-piece MDIs, the exact RFA threshold values for MDIs may have to be identified with more studies conducted in vivo.
The resonance frequency assessment with a customized SmartPeg would be a useful tool to provide clinically useful information about the condition of the bone-implant interface of 3M™ ESPE...
If the initial ISQ value is high, a small drop in stability normally levels out with time. A big drop in stability or decrease should be taken as a warning sign. Lower values are expected to be higher after the healing period. The opposite could be a sign of an unsuccessful implant, and actions should be taken accordingly.
Studies have shown that the resonance frequency value is greatly associate...
It is important to measure the Implant Stability Quotient (ISQ) of single-piece mini dental implants as they are becoming increasingly popular, with the concomitant increase in publications demonstrating their high survival and success rates. Although the clinical use of Osstell devices is also increasing, there is lack of studies on its use with single-piece implants, which do not have internal t...
The ISQ values obtained while calibrating the customized SmartPeg were similar to in vivo results. Median ISQ values at insertion and at 6 postoperative weeks were 53.3 (IQR 8.3) and 60.5 (5.5) for the 3M™ESPE™MDIs, and 58.5 (4.75) and 65.5 (9.3) for the Ankylos® implants, respectively, with no statistical difference (Figs. 2 and 3). The ISQ values of both 3M™ESPE™ MDI and Ankylos® (Fig...
ISQ values were averaged and compared between implant types and times using Wilcoxon’s matched pairs signed-rank tests at a significance level of p
For the MDIs, a small longitudinal skin incision was made just distal to the tibia/femur joint. The tibia/femur head was exposed subperiosteally, and an osteotomy was performed with the pilot drill under copious irrigation with saline solution, transposing the cortical bone to the depth of 0.5 mm. The implants were aseptically transferred to the bone site and manually rotated clockwise while exer...
Single use Osstell SmartPegs for standard implants are made from a soft metal with a zinc-coated magnet mounted on top of it and attached to the implants or abutments’ internal threads. As the company does not provide SmartPegs for one-piece implants, we developed a customized SmartPeg for mini dental implants (3M™ESPE™ MDIs), which do not have internal threads (Fig. 1). After confirming th...
The aim of the study is to test the feasibility of a customized SmartPeg for ISQ measurement of single-piece mini dental implants and to compare the primary stability of a standard and the mini dental implant (3M™ESPE™MDI) in a rabbit model after 6 weeks of healing.
There are no published studies on the ISQ measurement of mini dental implants, as SmartPegs for these implants are not available till date. Since these are one-piece implants and do not have an internal thread for the SmartPeg’s attachment, a custom-made SmartPeg needs to be fabricated for ISQ measurement. Therefore, we developed and tested a customized SmartPeg for 3M™ESPE™ MDIs to measure ...
Mechanical testing methods like reverse torque, or “pullout test,” have been used to study and measure the mechanical interface between implant and bone in various ways [22, 23]. The Branemark group has evaluated the mechanical properties of osseointegrated implants using torsion and pullout tests and lateral loading tests [24, 25]. Presence or absence of mobility and the bone level around the...
Osseointegration refers to the phenomenon for close apposition of the bone to the surface of an implant with no interposing tissue that can be clinically demonstrated by absence of mobility [1, 2]. Obtaining primary stability seems to be a precondition for a successful osseointegration [3]. Dental implants have a success rate of over 90% and are available in various sizes with different surfaces [...
The new custom-made SmartPeg is suitable for measuring the Implant Stability Quotient of 3M™ESPE™MDIs. The primary stability of 3M™ESPE™MDIs is similar to the primary stability attained by standard implants in the rabbit tibia.
One-piece narrow diameter implants (NDIs) have been recommended as “Single-tooth replacements in the anterior zones, single posterior, multiple-unit fixed dental prosthesis (FDP), edentulous jaws to be rehabilitated with FDP, and edentulous jaws rehabilitation with overdentures in situations with reduced mesiodistal space or reduced ridge width.” (ITI consensus 2013). Since NDIs can be immedia...
Simeone, S.G., Rios, M. & Simonpietri, J. “Reverse torque of 30 Ncm applied to dental implants as test for osseointegration”—a human observational study.
Int J Implant Dent 2, 26 (2016). https://doi.org/10.1186/s40729-016-0060-4
Download citation
Received: 12 September 2016
Accepted: 22 November 2016
Published: 07 December 2016
DOI: https://doi.org/10.1186/s40729-0...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Santa Maria University, Calle La Línea, Residencias El Parque, Piso 5, Apto B–5B. La Carlota. Municipio Sucre, Caracas, 1071, Venezuela
Sabrina G. Simeone, María Rios & Jeannette Simonpietri
You can also search for this author in
PubMed Google Scholar
You can also search for this author in
PubMed Google Scholar
You can also search for ...
Carvalho C, Carvalho L, Costa L, et al. Titanium implants: a removal torque study in osteopenic rabbits. Indian J Dent Res. 2010;21(3):349–52.
Gehrke S, Dos Santos M, Dedavid B, et al. Potencial de Osseointegra¢ão versus características da superficie microtexturizada Vellox. Revista Implant News. 2011;8:229–37.
Mall N, Dhanasekar B, Aparna I. Validation of implant stability: a measure of ...
Cehreli M, Karasoy D, Akca K, et al. Meta-analysis of methods used to assess implant stability. Int J Oral Maxillofac Implants. 2009;24(6):1015–32.
Gomes J, Campos F, Marin C, et al. Implant biomechanical stability variation at early implantation times in vivo: an experimental study in dogs. J Oral Maxillofac Implants. 2013;28(3):128–34.
Gehrke S. Acondicionamiento de la textura superficial ...
Under the ideal conditions of the study herein, the application of a 30-Ncm reverse torque at the time of the stage 2 surgery, before the prosthetic restoration, allowed the clinical identification of the stability of 40 dental implants.
Primary stability depends on the micro and macroscopic characteristics of the dental implant. Thus, after the application of a 30-Ncm reverse torque, both implan...
In order to exclude risk factors, as there are no previous researches on reverse torque in humans, the research was made following a conventional protocol, only on lower jaw implants, with implants of treated surface, which have benefits that greatly compensate for the risks, allowing for faster osseointegration levels because the rugosity increases the contact surface between the implant and the ...
The reverse torque technique proposed by Roberts in 1984 to evaluate dental implants integration proved to be successful. The most recent researches are aimed at evaluating current results. Thus, the objective of this research was to evaluate, by means of the 30 Ncm reverse torque test, 40 dental implants on the lower jaw, during the stage 2 surgery, as a mechanical and clinical, non-invasive tre...
This study reports on the clinical behavior of 40 dental implants placed on the lower jaw, on ideal bone, and under ideal surgical and systemic conditions, subjected to a 30-Ncm reverse torque during the stage 2 surgery, on 17 patients.
The patients evaluated only showed normal signs and symptoms of post-operatory swelling. According to the distribution of the implants on the mandibular region, 2...
On the data collection table, the existence of any peri-implant radiolucency radiographic images previous to the stage 2 surgery was recorded. After the application of the 30 Ncm reverse torque, the presence or absence of dental implant movement was recorded, as well as any incidence of symptomatology (pain), or presence of any clinical signs.
A clinical trial was carried out, in which 17 patients treated with implants at the School of Dentistry of the Santa Maria University and which had had 40 dental implants placed from two different commercial brands, with NanoTec™ and Vellox® surfaces, on the lower jaw, with the approval of the Bioethics Committee of the Santa Maria University (Fig. 1).
Patients 18 years old or older;
Signed...
Since the study herein is not found in humans [5, 9], last phase of study, and counting on previous results from in vitro and in vivo researches with animal models on long bones (femur, tibia, mandibles) in dogs, pigs, baboons, rabbits, and even in mastoid bones [6, 9–16], which provide necessary information to design human trials, this mechanical test was performed on dental implants in humans,...
The reverse torque test proposed by Roberts et al. in 1984, and developed by Johansson and Albrektsson in 1987 [6], is considered as a special advantage in stage 2 surgery, because it represents a definitive clinical verification of initial integration of the dental implant with the bone surface. The torque level required is commonly expressed in Newton centimeters (Ncm) [7, 8].
This way, a clini...
Primary stability has been reestablished as a previous clinical requirement to achieve osseointegration. The presence of movements between the surface of the implant and the bone tissue induces a bone resorption that produces fibrointegration, in which the implant is surrounded by an interphase of soft or connective tissue, and not bone tissue [1, 2].
Strategies used to improve bone response incl...
On bone implantology, stability of a dental implant is an essential clinical tool during osseointegration evaluation, as it is a reflection of the structural and functional connection between the bone and the implant.
The sample was comprised by 17 patients with 40 NanoTec™ and Vellox® implants, placed on the lower jaw, under optimum conditions, after a minimum healing period of 3 months, duri...
Dhaliwal, J.S., Albuquerque, R.F., Fakhry, A. et al. Customized SmartPeg for measurement of resonance frequency of mini dental implants.
Int J Implant Dent 3, 4 (2017). https://doi.org/10.1186/s40729-017-0066-6
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Received: 09 November 2016
Accepted: 13 January 2017
Published: 01 February 2017
DOI: https://doi.org/10.1186/s40729-017-0066-6
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
Jagjit Singh Dhaliwal, Ali Fakhry & Jocelyne S. Feine
Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
Rubens F. Albuquerque Jr
Department of Zoology, Panjab University, Chandigarh, India
Sukhbir Kaur
PAPRSB Institute of Health Sci...
Dhaliwal J, Albuquerque R, Murshed, M, Tamimi, F, Feine, JS. A histomorphometric comparison of osseointegration with MDIs and standard implants. IADR/AADR/CADR 91st General Session, Seattle, Washington, USA, March 20–23, 2013
Zix J, Hug S, Kessler-Liechti G, Mericske-Stern R. Measurement of dental implant stability by resonance frequency analysis and damping capacity assessment: comparison of b...
Barros RR, Novaes Jr AB, Muglia VA, Iezzi G, Piattelli A. Influence of interimplant distances and placement depth on peri-implant bone remodeling of adjacent and immediately loaded Morse cone connection implants: a histomorphometric study in dogs. Clin Oral Implants Res. 2010;21(4):371–8. Epub 2010/02/05.
Marin C, Bonfante EA, Granato R, Suzuki M, Granjeiro JM, Coelho PG. The effect of alterati...
Meredith N, Book K, Friberg B, Jemt T, Sennerby L. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Clin Oral Implants Res. 1997;8(3):226–33. Epub 1997/06/01.
Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the im...
Ersanli S, Karabuda C, Beck F, Leblebicioglu B. Resonance frequency analysis of one-stage dental implant stability during the osseointegration period. J Periodontol. 2005;76(7):1066–71. Epub 2005/07/16.
Bornstein MM, Chappuis V, von Arx T, Buser D. Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients...
Shatkin TE, Oppenheimer BD, Oppenheimer AJ. Mini dental implants for long-term fixed and removable prosthetics: a retrospective analysis of 2514 implants placed over a five-year period. Compend Contin Educ Dent. 2007;28(2):92–9. quiz 100-1. Epub 2007/02/27.
Griffitts TM, Collins CP, Collins PC. Mini dental implants: an adjunct for retention, stability, and comfort for the edentulous patient. Or...
Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100. Epub 1969/01/01.
Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont. 1998;11(5):491–501. Epub 1999/01/29.
Lioubavina-Hack N, Lang NP, Karring T. Significance of primar...
The results of this animal study indicate that ISQ measurement of these single-piece MDIs is possible with the help of a custom-made SmartPeg and that 3M™ESPE™MDIs attain primary and secondary stability at the same levels as standard implants in the rabbit tibia.
As there are no studies that provide data based on resonance frequency measurements for single-piece MDIs, the exact RFA threshold values for MDIs may have to be identified with more studies conducted in vivo.
The resonance frequency assessment with a customized SmartPeg would be a useful tool to provide clinically useful information about the condition of the bone-implant interface of 3M™ ESPE...
If the initial ISQ value is high, a small drop in stability normally levels out with time. A big drop in stability or decrease should be taken as a warning sign. Lower values are expected to be higher after the healing period. The opposite could be a sign of an unsuccessful implant, and actions should be taken accordingly.
Studies have shown that the resonance frequency value is greatly associate...
It is important to measure the Implant Stability Quotient (ISQ) of single-piece mini dental implants as they are becoming increasingly popular, with the concomitant increase in publications demonstrating their high survival and success rates. Although the clinical use of Osstell devices is also increasing, there is lack of studies on its use with single-piece implants, which do not have internal t...
The ISQ values obtained while calibrating the customized SmartPeg were similar to in vivo results. Median ISQ values at insertion and at 6 postoperative weeks were 53.3 (IQR 8.3) and 60.5 (5.5) for the 3M™ESPE™MDIs, and 58.5 (4.75) and 65.5 (9.3) for the Ankylos® implants, respectively, with no statistical difference (Figs. 2 and 3). The ISQ values of both 3M™ESPE™ MDI and Ankylos® (Fig...
ISQ values were averaged and compared between implant types and times using Wilcoxon’s matched pairs signed-rank tests at a significance level of p
For the MDIs, a small longitudinal skin incision was made just distal to the tibia/femur joint. The tibia/femur head was exposed subperiosteally, and an osteotomy was performed with the pilot drill under copious irrigation with saline solution, transposing the cortical bone to the depth of 0.5 mm. The implants were aseptically transferred to the bone site and manually rotated clockwise while exer...
Single use Osstell SmartPegs for standard implants are made from a soft metal with a zinc-coated magnet mounted on top of it and attached to the implants or abutments’ internal threads. As the company does not provide SmartPegs for one-piece implants, we developed a customized SmartPeg for mini dental implants (3M™ESPE™ MDIs), which do not have internal threads (Fig. 1). After confirming th...
The aim of the study is to test the feasibility of a customized SmartPeg for ISQ measurement of single-piece mini dental implants and to compare the primary stability of a standard and the mini dental implant (3M™ESPE™MDI) in a rabbit model after 6 weeks of healing.
There are no published studies on the ISQ measurement of mini dental implants, as SmartPegs for these implants are not available till date. Since these are one-piece implants and do not have an internal thread for the SmartPeg’s attachment, a custom-made SmartPeg needs to be fabricated for ISQ measurement. Therefore, we developed and tested a customized SmartPeg for 3M™ESPE™ MDIs to measure ...
Mechanical testing methods like reverse torque, or “pullout test,” have been used to study and measure the mechanical interface between implant and bone in various ways [22, 23]. The Branemark group has evaluated the mechanical properties of osseointegrated implants using torsion and pullout tests and lateral loading tests [24, 25]. Presence or absence of mobility and the bone level around the...
Osseointegration refers to the phenomenon for close apposition of the bone to the surface of an implant with no interposing tissue that can be clinically demonstrated by absence of mobility [1, 2]. Obtaining primary stability seems to be a precondition for a successful osseointegration [3]. Dental implants have a success rate of over 90% and are available in various sizes with different surfaces [...
The new custom-made SmartPeg is suitable for measuring the Implant Stability Quotient of 3M™ESPE™MDIs. The primary stability of 3M™ESPE™MDIs is similar to the primary stability attained by standard implants in the rabbit tibia.
One-piece narrow diameter implants (NDIs) have been recommended as “Single-tooth replacements in the anterior zones, single posterior, multiple-unit fixed dental prosthesis (FDP), edentulous jaws to be rehabilitated with FDP, and edentulous jaws rehabilitation with overdentures in situations with reduced mesiodistal space or reduced ridge width.” (ITI consensus 2013). Since NDIs can be immedia...
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
Fig. 3. One possible missing category (depicted as “X”) would be a bone type with thick cortical layer and sparse trabecular bone, which ...
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
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 (...
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
Fig. 1. Clinical case of a short implant (4.1 × 6 mm) placed in the region of the left maxillar...
Variable
Meana
Std error
95% confidence interval
P value (F; DF)
Arch
Variables
Torque
Tactile
CT visual
MGV_avg
MGV_axial
M...
Variable
Frequency
Mean
SD
95% confidence interval
Patient
...
Triches, D.F., Alonso, F.R., Mezzomo, L.A. et al. Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants.
Int J Implant Dent 5, 9 (2019). https://doi.org/10.1186/s40729-019-0158-6
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Received: 07 October 2018
Accepted: 06 January 2019
Published: 11 February...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This study was conducted in accordance with the tenets of the Declaration of Helsinki, and all procedures involving human subjects were approved by the ethics committee of the Pontifical Catholic University of Rio Grande do Sul/UBEA (ethical approval letter OF.CEP-772/10; research protocol CEP 10/05074).
Written informed consent was obtained from all study participants.
Diego Fernandes Triches, ...
All authors (1) made substantial contributions to the conception and/or design of the work or the acquisition, analysis, or interpretation of data for the work; (2) drafted the paper or revised it critically; (3) approved the final version of this manuscript; and (4) agreed to be accountable for all aspects of the work. Categories of authors’ contribution are as follows: concept/design (RSS, DFT...
Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 – Prédio 6, Porto Alegre, RS, 90619-900, Brazil
Diego Fernandes Triches, Fernando Rizzo Alonso, Danilo Renato Schneider, Eduardo Aydos Villarinho, Maria Ivete Rockenbach, Eduardo Rolim Teixeira & Rosemary Sadami Shinkai
Postgraduate Program in Dentistry,...
The authors would like to thank Professor Helena de Oliveira and Dr. Geisa Medeiros for their early assistance with CT software.
The work was supported by a research grant from Coordination for the Improvement of Higher Education Personnel (CAPES, Brazil; PNPD grant), the National Counsel of Technological and Scientific Development (CNPq, Brazil; Universal grant), and the International Team for I...
Kaya S, Yavuz I, Uysal I, Akkus Z. Measuring bone density in healing periapical lesions by using cone beam computed tomography: a clinical investigation. J Endod. 2012;38:28–31.
Brosh T, Yekaterina BE, Pilo R, Shpack N, Geron S. Can cone beam CT predict the hardness of interradicular cortical bone? Head Face Med. 2014;10:12.
Tatli U, Salimov F, Kürkcü M, Akoğlan M, Kurtoğlu C. Does cone be...
Nomura Y, Watanabe H, Honda E, Kurabayashi T. Reliability of voxel values from cone-beam computed tomography for dental use in evaluating bone mineral density. Clin Oral Implants Res. 2010;21:558–62.
Reeves TE, Mah P, McDavid WD. Deriving Hounsfield units using gray levels in cone beam CT: a clinical application. Dentomaxillofac Radiol. 2012;41:500–8.
Cassetta M, Stefanelli LV, Pacifici A, P...
Degidi M, Daprile G, Piattelli A. Determination of primary stability: a comparison of the surgeon’s perception and objective measurements. Int J Oral Maxillofac Implants. 2010;25:558–61.
Alonso FR, Triches DF, Mezzomo LAM, Teixeira ER, Shinkai RSA. Primary and secondary stability of single short implants. J Craniofac Surg. 2018. https://doi.org/10.1097/SCS.0000000000004567.
Ribeiro-Rotta RF,...
Cone beam computed tomography
Computed tomographic
Digital Imaging and Communications in Medicine
Field of view
Mean gray values
Region of interest
In summary, within the conditions and limitations of this study, the results suggest that bone quality has a significant effect on the primary stability of short implants as measured by insertion torque. Insertion torque had significant correlation with all assessment methods of bone quality. For preoperative CT evaluation of bone quality, mean gray values (optical density) had stronger associatio...
The present study also used the same preoperative CT images for visual evaluation of bone quality at the exact implant site, using the axial, coronal, and sagittal sections in a standardized procedure. There was a fairly moderate correlation between CT visual assessment and mean gray values, but no statistical difference was found in average mean gray values between the visual classification of bo...
In this study, low- and medium-density values (air and a central FOV soft tissue) were used as reference calibration points for image normalization. The use of a reference object in the FOV containing at least two materials of known density could allow for a calibration similar to the use of reference phantoms in quantitative CT, rather than the “standard” automatic normalization function avai...
This study showed that low bone quality, as assessed by clinical and image methods, is related with low primary stability of 6-mm short implants placed at the posterior region of the maxilla and mandible. Higher insertion torque values were associated with better bone types and higher mean gray values in CT images. Insertion torque had a negative moderate association with bone type categorization ...
Descriptive statistics of the sample are shown in Table 1. For statistical analysis, some data were missing: one implant had mobility after surgery and was lost and four CT scans, containing 11 ROIs, were not used for bone quality analysis due to technical problems. As only one case was categorized as bone type 1 by CT visual or by tactile evaluation, the corresponding mean gray values were exclu...
The mean gray value of each rescaled ROI was measured on the three orthogonal planes: axial, coronal, and sagittal, totaling three ROIs per implant site. The average of the rescaled gray values for the three ROIs was computed for each implant site.
Data were analyzed by descriptive and inferential statistics using the software XLSTAT version 2018 (Addinsoft SARL, New York, USA), and a two-tailed ...
Axial ROI: Using the reference implant location line, the ROI was defined as the alveolar bone area with a 6-mm width corresponding to 3 mm on each side of the future implant center, including the buccal and lingual cortical layers.
Coronal ROI: Area defined by the outer border of the cortical bone with a 6-mm height and a line joining the buccal and lingual cortical layers.
Sagittal ROI: A 6...
The insertion torque was measured using the manual torque wrench (Straumann Dental Implant System®, Waldenburg, Switzerland) (Fig. 1b), according to three categories: 35 N cm. A healing cap was installed, and the suture was made with nylon 5-0 (Fig. 1c). The patients were prescribed with antibiotics (amoxicillin 500 mg, 8/8 h for 7 days), anti-inflammatory drugs (nimesulide 100 mg,...
This study reports cross-sectional, correlational data of a prospective clinical research project [2] approved by the university Institutional Review Board (10/05074). The research protocol followed the precepts of the Declaration of Helsinki and its amendments. All patients signed an informed consent form.
A consecutive, non-probabilistic sample consisted of 45 implants placed in 20 patients tre...
Both multislice CT and cone beam CT are used for presurgical assessment of bone density and quality [4,5,6,7,8,9,10,11]. There is a strong correlation between gray values in cone beam CT and Hounsfield units in multislice CT [4, 12,13,14]. The visual inspection of CT sections avoids the superimposition of anatomical structures seen in radiographs; thus, the region of interest in trabecular bone ca...
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]. Clin...
This study assessed the relationship between insertion torque and bone quality evaluated during surgery and in preoperative computed tomographic (CT) images analyzed either visually or by rescaled mean gray values (MGVs). The study also tested the correlation between the clinical and radiographic measures of bone quality.
The consecutive sample was composed of 45 short implants (4.1 × 6 mm...
RFs (log rank, p = 0.006)
Fig. 2. The cumulative survival rates for the different RF groups revealing a significant difference for patients without any and patients with local and systemic RFs (log rank, p = 0.006)
Fig. 1. On Kaplan-Meier survival estimates, the cumulative survival rate was 91.5%
Fig. 1. On Kaplan-Meier survival estimates, the cumulative survival rate was 91.5%
Region
Systemic RF
Local RF
Immediate procedure
Bone grafting
Time of failure (months...
Systemic RF
No. of implants (n = 31)
No. of patients (n = 14)
Local RF
No. of implants (n = 100)
...
Saridakis, S.K., Wagner, W. & Noelken, R. Retrospective cohort study of a tapered implant with high primary stability in patients with local and systemic risk factors—7-year data.
Int J Implant Dent 4, 41 (2018). https://doi.org/10.1186/s40729-018-0151-5
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Received: 20 May 2018
Accepted: 24 October 2018
Published: 17 December 2018
DOI: https://doi.org/10...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This article contains data obtained during follow-up in a cohort of patients treated with a CE-certified implant in a University Medical Center. Since the product is already approved in accordance with the German Medical Devices Act, no additional ethics approval was not required for treatment. All procedures performed in studies involving human participants were in accordance with the ethical sta...
Department of Oral and Maxillofacial Surgery – Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Augustusplatz 2, 55131, Mainz, Germany
Sotirios Konstantinos Saridakis, Wilfried Wagner & Robert Noelken
Private Practice for Oral Surgery, Lindau/Lake Constance, Germany
Robert Noelken
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The work was supported by the Clinic of Oral and Maxillofacial Surgery, University Medical Center, Mainz.
The dataset supporting the conclusions of this article is partially included within the article. The SPSS data can be given on demand of the editor.
Schropp L, Isidor F, Kostopoulos L, Wenzel A. Patient experience of, and satisfaction with, delayed-immediate vs delayed single-tooth implant placement. Clin Oral Implants Res. 2004;15:498–503.
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U.S. Census Bureau, 2012 Population Estimates and 2014 National Projections. [Zitiert:18.12.2014]. https://www.census.gov/data/tables/2014/demo/popproj/2014-summary-tables.html.
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This study was based on the recruitment of a quite heterogeneous group of patients treated with NobelActive implants, for the purpose of investigating the influence of local and systemic risk factors on implant survival and marginal bone levels. It can be considered that the presence of local or systemic risk factors does not influence implant survival whereas the combination of local and systemic...
A major weakness of the study is the relative small size of the group with systemic RFs (14 implants by 6 patients) as well as of the group with systematic and local RFs (17 implants by 6 patients). Because of the relative small size of the sample, this study can provide the basis for further investigations based on larger patient samples.
The survival rate for 93 implants in 45 patients with no RFs was 94.8%. Moraschini et al. [44] have exhibited in their systematic review, based on 7711 implants, similar SRs with cumulative mean values of 94.6%. Moreover, in the subcohort of our study, by 44 of the above 93, implants were performed immediate procedures (25 immediate implantations, 35 immediate restorations, 16 both of them) so the...
In one patient with three implants and long intake of corticosteroids against rheumatoid arthritis (7.5 mg prednisolone per day for at least 2 years), no complication was detected in our study. Long-term use of corticosteroids can also lead to implant failures, according to Wood and Vermilyea [34] by modifying the patient’s response to bacterial infection [35], but at the present time, there i...
Most implant studies deal only with local risk factors, although the existence of systemic risk factors plays a significant role to the implant survival. We use the NobelActive dental implant in this study in order to investigate if this promising implant with the special design could achieve better survival rates in difficult situations with several risk factors. The present study revealed no sta...
Regarding the implant shoulder level, the average interproximal marginal bone level was − 0.49 ± 0.83 mm (range, 0 to − 3.3 mm) at the mesial aspect and − 0.51 ± 0.82 mm (range, 0 to − 3.9 mm) at the distal aspect of the implants.
When the marginal bone level was considered as a function of time, there was no strict correlation between the marginal bone status and th...
Ninety-eight patients with 207 implants complied with the treatment protocol attended the follow-up.
During the follow-up period, 15 implants failed in 12 patients. Age and gender were not correlated with a lower implant survival. The implant losses occurred in a time range between 0.5 and 39 months following implant placement (mean 7.3 ± 11.1 months). The reasons for implant failure were ...
Subpopulations within the study group (immediate vs. delayed placement) were compared using the Wilcoxon-Mann-Whitney non-parametric U test. The reported p values were two sided. All calculations were carried out using SPSS for Mac, Version 22 (SPSS Inc., Chicago, IL, USA).
Preservation of all alveolar socket walls via longitudinal extraction after periotomy avoiding oro-vestibular luxation.
Meticulous cleaning of the extraction site.
Placement of rather long implants that allow for a high level of primary stability.
Implant dimensions were as follows: implant length 8.5 mm, 24 implants; 10 mm, 6 implants; 11.5 mm, 64 implants; 13 mm, 80 implants; 15 mm, 31 i...
These patients received a total of 207 NobelActive implants (Nobel Biocare, Zurich, Switzerland) placed by two experienced surgeons. Between November 2011 and February 2015, 188 implants were placed in the maxilla, and 19 implants in the mandible. All implant placement procedures were conducted at the Department of Oral and Maxillofacial Surgery of the University Medical Center, Mainz, Germany. Fi...
One hundred and ten patients were invited for follow-up evaluation. All patients were treated in the period from 10/2008 to 02/2015 in the Clinic of Oral and Maxillofacial Surgery, University Medical Center Mainz. Inclusion criteria were as follows: implant placement of a NobelActive implant, study subjects over 18 years old, residual bone dimension in the edentulous region of at least 5 mm in h...
Primary stability is a prerequisite for successful osseointegration and remains the most significant factor for the survival of dental implants [16]. Therefore, current research focuses on amelioration of existing augmentation techniques and materials or on the development of new implants with self-tapping properties for improving bone contact as well for increasing primary stability.
The aim of ...
Based on published demographic data, the median age of the world population constantly increases [1]. This has led to an increase in the number of dental implants inserted in senior individuals with local and systemic risk factors [2]. Nevertheless, despite numerous studies having been conducted on this topic, the results remain controversial, almost 50 years after the first dental implant placem...
This retrospective study examined the mid- to long-term clinical and radiographic performance of a tapered implant in various treatment protocols in patients with local and systemic risk factors (RFs).
Two hundred seven NobelActive implants were inserted in 98 patients in the period from 10/2008 to 02/2015. The subdivision of the cohort was defined by local (n = 40), systemic (n = 6), loc...
Code
IT(N•cm)
RT(N•cm)
ISQ
12S
13.67 (1.88)
11.68 (1.06)
51.40 (2.95)
06D
20.19 (1.61)
17.45 (1.28)
53.77 (2.73)
06S
22.30 (1.78)
20.25 (2.47)
55.66(1.62)
Implant code
Thread type
Pitch (mm)
Lead (mm)
Lead angle (degree)
Total thread length (mm)
12S
Single-threaded
1.2
1.2
8.1
64
06D
Double-threaded
0.6
1.2
8.1
129
06S
Single-threaded
0.6
0.6
4.65
129
Figure 6. Bone debris at the contact interfaces. a Numbers of debris particles. b Number and size of debris particles. Each dot indicates a debris particle, and dashes indicate median particle sizes. Particle sizes: small, < 1000 μm2; medium, 1000–10000 μm2, and large, ≥ 10,000 μm2. c Particle size distribution
Figure 5. Microscopic analysis of contact interfaces. Microscopic observations of the artificial bone-implant and number of debris particles. The small arrows in the panel indicate voids in the implant-bone interface
Figure 4. Torque kinetics. Immediately after insertion terminated, the implant was removed using the same load and rotation speed. Torque kinetics were measured during implant insertion (top) and removal (bottom)
Figure 3. Comparison between IT and RT. Maximum IT value was measured when insertion was terminated. Immediately after insertion, the implant was removed, and the RT value was measured when removal commenced
Figure 2. Insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ)
Figure 1. Implants. Implant code 12S is similar to a commercially available standard single-threaded implant with equal thread pitch and a 1.2-mm lead. The thread length of implant code 06D is doubled by adding the second thread (light blue). The thread length of implant code 06S is doubled by a 50% reduction in pitch and lead angles. Characteristics of each implant are summarized in Table 1
Fi...
References
Javed F, Ahmed HB, Crespi R, Romanos GE. Role of primary stability for successful osseointegration of dental implants: factors of influence and evaluation. Interv Med Appl Sci. 2013;5:162–7.
Falco A, Berardini M, Trisi P. Correlation between implant geometry, implant surface, insertion torque, and primary stability: in vitro biomechanical analysis. Int J Oral Maxillofac Implan...
Although bone models composed of a combination of cortical and cancellous bone are also available, this study used a single bone model with a homogeneous density to eliminate any effect of cortical bone and evaluate only the effect of design features on torque and ISQ values.
Experimental implant placement using artificial bone models is generally conducted to si...
Clinicians are advised to recognize the risk associated with using a multithreaded implant with a high lead angle, which may compromise primary stability because of greater bone tissue damage despite faster insertion. The question of placement speed warrants further consideration. Indeed, another advantage of double-threaded implants is placement speed. The implantation speed...
Moreover, the IT and RT values of 12S were consistent with those of the standard implant (Straumann) measured in our previous study. Here, the RT value of each implant was lower compared with their respective IT values, consistent with other reports. The IT and RT values of 06S were highest, followed by 06D and 12S. In contrast, the differences between RT and IT values were highest for...
In the artificial bone adjacent to 06D, there were more voids compared with those associated with 06S or 12S, which accounts for the increase in torque. The highest numbers and larger sizes of debris particles were associated with 06D, followed by 0S and 12S, indicating the potential for greater tissue damage. These results likely explain the lower (50%) torque value of 06S compared with tho...
Discussion
We show here that increasing thread length and reducing pitch can increase primary implant stability without changing the size of an implant. Compared with the standard single-threaded implant with a 1.2-mm pitch/lead (12S), torque values and ISQ were significantly increased by doubling the thread length by adding the second thread (06D) or by reducing pitch/lead and lead angle o...
Results
The IT, RT, and ISQ values revealed significant differences among the implants (Table 2).
The IT and RT values of 12S were not significantly different compared with published data (IT, 13.13 ± 1.763 N cm; RT, 12.37 ± 1.746 N cm) (Student t test, df = 9, t = 2.91, p < .017). Compared with 12S, the IT and RT values of 06D and 06S were significantly different (147% and 150%, a...
Methods
Implants
Three types of grade-4 titanium cylindrical nonself-tapping implants (codes 12S, 06D, and 06S) were specially designed and manufactured (Suwa Co., Ltd., Fujiyoshida, Yamanashi, Japan) (Fig. 1 and Table 1). The code 12S single-threaded implant served as a reference. Codes 06D and 06S were designed to double the thread length compared to 12S. Code 06D was a double-threated impla...
Introduction
Secure primary stability is positively associated with successful long-term implant integration to ensure a successful clinical outcome. Initial implant stability is defined as biomechanical stability upon insertion, which is influenced by factors such as bone quantity and quality, geometry of the implant, surgical technique, and insertion torque (IT). New bone develops around the ...
Effects of implant thread design on primary stability—a comparison between single- and double-threaded implants in an artificial bone model
Abstract
Background
Primary implant stability is essential for osseointegration. To increase stability without changing the implant size, the thread length must be extended by reducing pitch, using a double-threaded implant, or reducing pitch/lead a...
Figure 5. Torque-time curves of the MK3 and MK4. a Insertion torque. b Removal torque
Figure 4. Torque-time curves of the TE. a Insertion torque. b Removal torque
Figure 3. Torque-time curves of the BL. a Insertion torque. b Removal torque
Figure 2. Torque-time curves of the ST. a Insertion torque. b Removal torque
Figure 1. Compressed longitudinally to one third for characteristics of implant design. ST Straumann standard implant, MK3 Nobel Biocare MKIII, BL Straumann bone level implant, TE Straumann tapered effect implant, MK4 Nobel Biocare MKIV. Outer surface of implant (solid line). Inner surface of implant (dotted line)
Figure 1. Compressed longitudinally to one third for characteristics of implant d...
Initial area
Parallel area
Tapered area
Platform area
ST6
1.42 ± 0.43
0.31 ± 0.14
–
–
ST8
3.57 ± 1.62
0.35 ± 0.09
–
–
ST10
2.49 ± 0.81
0.45 ± 0.05
–
–
BL8
2.16 ± 0.21
0.50 ± 0.08
2.32 ± 0.52
–
BL10
1.96 ± 0.49
0.35+0.04
2.45+0.23
–
BL12
1.82 ± 0.27
0.33 ±...
Code
Insertion torque
Removal torque
Effective thread length (ETL)
(N · cm)
(N · cm)
(×π mm)
ST6
6.19 ± 0.716
5.95 ± 0.718
11.53
ST8
8.06 ± 1.038
9.09 ± 1.093
15.11
ST10
13.13 ± 1.763
12.37 ± 1.746
21.48
BL8
17.67 ± 1.290
16.67 ± 2.140
20.88
BL10
23.56 ± 1.628
21.99 ± 1.530
31....
System
Length
Pitch
Lead
Code
Manufacturer
(mm)
(mm)
(mm)
Standard RN
6, 8, 10
1.2
1.2
ST
Straumann
Bone Level RC
8, 10, 12
0.8
0.8
BL
Straumann
Tapered Effect RN
10
0.8
0.8
TE
Straumann
Brånemark MKIII
10
0.6
1.2
MK3
Nobel Biocare
Brånemark MKIV
10
0.6
1.2
MK4
Nobel Biocare
Abbreviations
BL:
Bone Level RC
IT:
insertion torque value
MK3:
Brånemark MKIII
MK4:
Brånemark MKIV
RT:
removal torque value
ST:
Standard RN
TE:
Tapered Effect RN
References
Friberg B, Sennerby L, Roos J, Johansson P, Strid CG, Lekholm U. Evaluation of bone density using cutting resistance measurements and microradiography. An...
Influence of cortical bone
The reason why a simulation test for only cancellous bone without cortical bone was performed in the present study has already been described. It was reported that bone density and the ratio of cortical bone and cancellous bone have influence on the primary stability of an implant and that higher primary stability is achieved with thread, even at the slightest lev...
Although the removal torque curves measured in the present study had similar shapes to one another, they were divided into two groups upon detailed observation, comprising a group of ST with parallel only, and a group of BL, TE, MK3, and MK4 having tapers and platforms. Since the thread contacts the artificial bone sequentially at the time of insertion, the torque curves showed the character...
This indicates that the friction at the time of rotating and pressing is greater than that at the time of rotating and cutting the bones with a tap and is a reasonable result. In the parallel area, the torque curve was a line with a moderate gradient, and the torque rise rate obtained from the gradient of the line was 0.36 N · cm/s. From this, it is estimated that the torque increase w...
Discussion
Insertion torque curve
In 2000, O’Sullivan reported torque curves for a prosthetic implant for the first time, and evaluated the characteristics of the tapered type by torque curves obtained by inserting five kinds of implants into the maxillary bone of unembalmed human cadavers. In a subsequent review, Meredith cited six kinds of torque curves when the final osteotomy diamete...
For the TE, the lower part of the implant was parallel and the lateral surface and axial surface had the same taper in the cervical region. TE10 in Fig. 4a showed a torque curve with a similar form to BL10 in Fig. 3 and had three kinds of areas. The torque curves for MK3 and MK4 in Fig. 4a had an area in which the torque finally rose suddenly after reaching its critical point and became moderate...
Results
Insertion torque
The insertion torque curve was divided into four regions. The first was the region where the torque rose suddenly immediately after insertion, which was seen in all implant bodies (shown as ① in the figure, and hereinafter called the initial area). The second was the region where the torque rose linearly with a moderate gradient, which was seen in all implant bodie...
Methods
Implants
The type of implant used for the experiments and the characteristics of its design are shown in Table 1 and Fig. 1, respectively. Figure 1 shows that the implant is compressed longitudinally to one third. The outer surface of the implant is indicated with a solid line, and the inner surface of the implant is indicated with a dotted line.
Preparation of an implant socket in ...
Background
Primary stability following implant placement is an essential condition for osseointegration. The primary stability is affected by the implant design, including surface-modifying or implant cavity-forming techniques, as well as by the bone quantity and bone density of the patient. In recent years, the interest of implant manufacturers and clinicians has shifted to the acquisition of ...
Abstract
Background
Primary stability following implant placement is essential for osseointegration and is affected by both implant design and bone density. The aim of this study was to compare the relationships between torque-time curves and implant designs in a poor bone quality model.
Methods
Nine implant designs, with five implants in each category, were compared. A total of 90 implants ...
Figure 6. Bone debris at the contact interfaces. a Numbers of debris particles. b Number and size of debris particles. Each dot indicates a debris particle, and dashes indicate median particle sizes. Particle sizes: small, < 1000 μm2; medium, 1000–10000 μm2, and large, ≥ 10,000 μm2. c Particle size distribution
Figure 5. Microscopic analysis of contact interfaces. Microscopic observations of the artificial bone-implant and number of debris particles. The small arrows in the panel indicate voids in the implant-bone interface
Figure 4. Torque kinetics. Immediately after insertion terminated, the implant was removed using the same load and rotation speed. Torque kinetics were measured during implant insertion (top) and removal (bottom)
Figure 2. Insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ)
Table 2. Implants. Implant code 12S is similar to a commercially available standard single-threaded implant with equal thread pitch and a 1.2-mm lead. The thread length of implant code 06D is doubled by adding the second thread (light blue). The thread length of implant code 06S is doubled by a 50% reduction in pitch and lead angles. Characteristics of each implant are summarized in Table 1....
Code
IT(N•cm)
RT(N•cm)
ISQ
12S
13.67 (1.88)
11.68 (1.06)
51.40 (2.95)
06D
20.19 (1.61)
17.45 (1.28)
53.77 (2.73)
06S
22.30 (1.78)
20.25 (2.47)
55.66(1.62)
Implant code
Thread type
Pitch (mm)
Lead (mm)
Lead angle (degree)
Total thread length (mm)
12S
Single-threaded
1.2
1.2
8.1
64
06D
Double-threaded
0.6
1.2
8.1
129
06S
Single-threaded
0.6
0.6
4.65
129
The question of placement speed warrants further consideration. Indeed, another advantage of double-threaded implants is placement speed. The implantation speed of 06D was twice that of 06S, and implantation was completed twice as fast. Nevertheless, while plastic bottles and emergency valves have double-threaded screws for faster opening and closing, the effect...
Here, the RT value of each implant was lower compared with their respective IT values, consistent with other reports. The IT and RT values of 06S were highest, followed by 06D and 12S. In contrast, the differences between RT and IT values were highest for 12S, followed by 06D, and in 06S. We reported that the RT decreased more than IT. Thus, 06S had the lowest rate of decline (IT...
In the artificial bone adjacent to 06D, there were more voids compared with those associated with 06S or 12S, which accounts for the increase in torque. The highest numbers and larger sizes of debris particles were associated with 06D, followed by 0S and 12S, indicating the potential for greater tissue damage. These results likely explain the lower (50%) torque value of 06S compared wi...
In the artificial bone adjacent to 06D, there were more voids compared with those associated with 06S or 12S, which accounts for the increase in torque. The highest numbers and larger sizes of debris particles were associated with 06D, followed by 0S and 12S, indicating the potential for greater tissue damage. These results likely explain the lower (50%) torque value of 06S compared wi...
Discussion
We show here that increasing thread length and reducing pitch can increase primary implant stability without changing the size of an implant. Compared with the standard single-threaded implant with a 1.2-mm pitch/lead (12S), torque values and ISQ were significantly increased by doubling the thread length by adding the second thread (06D) or by reducing pitch/lead and lead angle o...
Results
The IT, RT, and ISQ values revealed significant differences among the implants (Table 2).
The IT and RT values of 12S were not significantly different compared with published data (IT, 13.13 ± 1.763 N cm; RT, 12.37 ± 1.746 N cm) (Student t test, df = 9, t = 2.91, p < .017). Compared with 12S, the IT and RT values of 06D and 06S were significantly different (147% and 150%, a...
Implants
Three types of grade-4 titanium cylindrical nonself-tapping implants (codes 12S, 06D, and 06S) were specially designed and manufactured (Suwa Co., Ltd., Fujiyoshida, Yamanashi, Japan) (Fig. 1 and Table 1). The code 12S single-threaded implant served as a reference. Codes 06D and 06S were designed to double the thread length compared to 12S. Code 06D was a double-threated implant with t...
Unfortunately, the effects of double- or triple-threaded implants on primary stability are known for only a few procedures, such as finite element analysis. An excessive lead angle for these implants may jeopardize their ability to sustain axial load despite faster insertion. Further, when micromotion is compared among implants with different lead angles with the same thread pitch, single-threaded...
Introduction
Secure primary stability is positively associated with successful long-term implant integration to ensure a successful clinical outcome. Initial implant stability is defined as biomechanical stability upon insertion, which is influenced by factors such as bone quantity and quality, geometry of the implant, surgical technique, and insertion torque (IT). New bone develops around the ...
Abstract
Background
Primary implant stability is essential for osseointegration. To increase stability without changing the implant size, the thread length must be extended by reducing pitch, using a double-threaded implant, or reducing pitch/lead and lead angle to half that of a single-threaded implant.
Materials and methods
We tested the stabilities of these configurations using artificial...
Figure 3. Comparison of standard and over-dimensioned protocol. The figure displayed shows the comparison between standard and over-dimensioned protocol. a Displays the measurements obtained by RFA. The unit is ISQ with a range of 0 to 100 (minimum to maximum stability). b Displays the results obtained by the torque in and c by the torque out test. Although, there was no statistically s...
Figure 2. Over-dimensioned protocol. The over-dimensioned protocol was conducted by a final drill of 1 mm narrower than the implant diameter. The final drill for implants of 3.3. mm was 3.2 mm and of implants measuring 3.75 mm, it was 3.65 mm. Within this study, an over-dimensioned protocol was defined as a final drill larger than recommended by the company, which is in this case 4 o...
Figure 1. Standard protocol. This figure shows the implant types and drilling protocol used within this study. Standard protocol was conducted by a final drill of 2.80 mm for 3.3 mm implants, 3.20 mm for 3.75 mm implants, and 3.65 mm for 4.2 mm implants. Permissions for reproducing the figures were received from HI-TEC IMPLANTS LTD. Source: Product Catalogue 12th Edition [40]
3.3 mm
3.75 mm
4.2 mm
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
ISQ
66.33 (4.59)
63.79–68.88
69.00 (5.98)
64.72–73.28
69.87 (8.88)
64.94–74.78
IT (Ncm)
102.65 (28.42)
86.91–118.39
90.97 (27.54)
71.27–110.67
78.19 (33.28)
59.76–96.62
TO (Ncm)
94.54 (29.09)
78.43–110.65
81.28 (28.89)
60.67–101.88
100.86 (36....
8.0 mm
10.0 mm
11.5 mm
13.0 mm
16.0 mm
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
ISQ
65.5 (8.40)
58.48–72.52
73.17 (3.60)
69.39–76.95
67.11 (6.09)
62.43–71.79
66.15 (8.15)
59.43–73.07
70.67 (4.97)
66.84–74.49
IT (Ncm)
98.23 (18.56)
82.71–113.74
99.49 (43.73)
53.60–145.48
101.02 (36.80)
72.74–...
Insertion mode — manual insertion
Insertion mode — machine-driven insertion
n
Mean (SD)
CI
n
Mean (SD)
CI
ISQ
45
68.33 (6.83)
66.14–70.51
45
70.25 (5.52)
68.38–72.12
IT (Ncm)
45
90.56 (31.27)
80.56–100.56
45
83.94 (31.81)
73.17–94.7
TO (Ncm)
45
93.59 (32.3)
83.27–103.92
45
89.80 (37.32)
77.18–102.43
ISQ impla...
Drilling sequence — standard protocol
Drilling sequence — over-dimensioned protocol
n
Mean (SD)
CI
n
Mean (SD)
CI
ISQ
45
68.33 (6.83)
66.14–70.51
30
68.5 (8.82)
65.08–71.92
IT (Ncm)
45
90.56 (31.27)
80.56–100.56
30
63.74 (48.61)
44.89–82.59
TO (Ncm)
45
93.59 (32.3)
83.27–103.92
30
58.35 (40.43)
42.67–74.02
ISQ im...
Contrary to the research hypothesis, there was no difference in primary stability between manually and machine-driven inserted implants. To date, little is known about the influence of the insertion mode on the dental implant primary stability. Novsak et al. assumed a better primary stability in implants inserted manually and suspected that this behavior was related to a higher tac...
However, caution is recommended when using under-dimensioned drilling protocols: although high insertion torques ensure a greater initial implant stability and prevent adverse micromotions under loading, the induced over-compression could jeopardize the healing process. In addition, high stress is known to alter angiogenesis and impair new vessel formations, to induce local hypoxia and n...
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 le...
Results
Drilling protocol: standard versus over-dimensioned
No statistically significant difference in RFA could be measured (Cohen’s d = − 0.022, effect size r = 0.011, p = 0.260), whereas IT values were significantly higher in implants inserted via SP (90.56 ± 31.27 Ncm) in comparison with the ODP (63.74 ± 48.61 Ncm, p = 0.002; Cohen’s d = 0.656, effect size r = 0.312). T...
Preparation protocol for oversized osteotomies (ODP)
This protocol repeated the steps of the standard protocol but then added a larger final drill. For the 3.3-mm implants, the final drill size was 3.2 mm; for the 3.75-mm implants, the final drill size was 3.65 mm (Fig. 2).
RFA
To analyze the data, an Osstell® SmartPeg threaded transducer (implant diameter 3.3 and 3.75 mm: SmartPeg Type ...
Methods
Bone specimens
Twenty mandibles from fresh porcine cadavers were obtained from a local slaughterhouse. The animals did not show any macroscopic signs of any pathologic bone conditions. After removal of the surrounding soft tissue, the surfaces of the bone samples were thoroughly cleaned. Each sample was checked macroscopically for irregularities and a minimum thickness of 20 mm at th...
Analyzing those, a decrease in primary and an increase in secondary stability with a shorter healing period for implants became apparent. Kim et al. compared the effect of oversized drilling sockets regarding bone-to-implant contact and bone density after 4 and 8 weeks in an in vivo dog model. They used a final drill of 4.00 mm for implants with a diameter of 4 mm in the oversized group and a ...
With increasing stiffness of the bone-implant interface, the vibration frequency of the sensor increases. While RFA is expressed in hertz, implant stability quotient (ISQ) is the scale used to quantify RFA values (range 1–100).
Even though RFA has been reported to be a reliable, reproducible, and objective method to measure the stiffness of bone-implant-complex, it has also been reported that R...
Background
A reliable option for replacing teeth is the insertion of osseointegrated implants. Dental implant primary stability (DIS) has also been reported to be a fundamental prerequisite for long-term success of dental implants, even though osseointegration has also been achieved without a certain amount of primary stability. Primary stability has been defined as the ability to withstand axi...
Abstract
Background
Dental implant primary stability is thought to be a fundamental prerequisite for the long-term survival and success. The aim of this study was to analyze the influence of protocol and insertion mode on dental implant stability ex vivo. One hundred and twenty implants were inserted either manually or machine-driven into porcine mandibles by a standard or over-dimensioned pro...