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. 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...
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...
Figure 4. Patient satisfaction throughout the study
Figure 3. Bone level changes from loading to 5-year follow up
Figure 2. Clinical parameters and soft tissue parameters. a Modified plaque index. Error bars indicate standard deviation. * = p ≤ 0.05, *** = p ≤ 0.001. b Sulcus bleeding index. Error bars indicate standard deviation. * = p ≤ 0.05, *** = p ≤ 0.001. c Pocket probing depth. The asterisk represents statistically significant differences (* = p ≤ 0.05) observed between ...
Figure 1. Study flow diagram: follow up status and reasons for not completing the study; six-month, 2-year and 4-year follow up was optional
Figure 1. Study flow diagram: follow up status and reasons for not completing the study; six-month, 2-year and 4-year follow up was optional
Table 4 Life table analysis showing the cumulative success rate according to Albrektsson et al. and Buser et al.
Interval(months)
Implants in interval
According to Albrektsson et al.
According to Buser et al.
Implants withdrawn during interval
Failures during interval
Cumulative success rate (%)
Implants withdrawn during interval
Failures during interval
Cumulativ...
Table 3 Patient demographics with respect to implants
Overall
Subgroup*
Platform switching
Platform matching
Total Implants, n
285
203*
68*
Number of implants placed per patient, n (%)
1
125 (63.8)
97 (67.4)
20 (48.8)
2
56 (28.6)
37 (25.7)
16 (39.0)
3
12 (6.1)
7 (4.9)
5 (12.2)
4
3 (1.5)
3 (2.1)
0 (0.0)
Implant...
Table 2 Patient demographics
Overall
Subgroup*
Platform switching
Platform matching
Patients, n (%)
196 (100)
144
41
Sex, n (%)
Male
87 (44.4)
62 (43.1)
19 (46.3)
Female
109 (55.6)
82 (56.9)
22 (53.7)
Age, years
Mean (SD)
51.5 (14.2)
53.1 (14.4)
47.4 (12.9)
Range
17.9–82.1
17.9–82.1
19.3–78.5
Pr...
Investigator*
City/country
Number of patients included
Number of implants included
Dr. Helfried Hulla
Strass in Steiermark, Austria
10
15
Prof. DDr. Gerald Krennmair
Marchtrenk, Austria
10
20
Dr. S. Marcus Beschnidt (PI)
Baden-Baden, Germany
8
12
Dr. Karl-Ludwig Ackermann
Filderstadt, Germany
14
18
Dr. Thomas Barth
Leipzig, Germany
15
28
Dr...
Abbreviations
ASA:
American Society of Anesthesiologists
MPI:
Modified Plaque Index
PPD:
Pocket probing depth
RCT:
Randomized controlled clinical trial
SBI:
Sulcus Bleeding Index
SD:
Standard deviation
SLA:
Sand-blasted, large grit, acid-etched
References
Hjalmarsson L, Gheisarifar M, Jemt T. A systematic review of survival of s...
The appearance of poorer oral hygiene later in the study also appears to correspond with the drop in follow-up attendance, which again supports the importance of follow-up. All other complications could be resolved and were not persisting. Furthermore, patients selected for inclusion in this study were optimal candidates for dental implants. Though the inclusion criteria predestinate the patient s...
At 5-year follow-up, the overall SBI was 0.32 ± 0.49, reflective of no bleeding given that 0 equals no bleeding and 1 equals isolated bleeding spots visible [27]. The PPD initially decreased within the first 6 months from which point it significantly increased to 2.34 ± 1.18 mm at 5-year follow-up.
Nevertheless, the measured mean PPD still reflects the norm for conventionally placed i...
On the one hand, the variety of bone level changes in this study may be explained by different vertical soft tissue thicknesses, but cannot be validated due to these missing data. On the other hand, there are multiple confounding factors influencing the change in bone level, such as the size of the platform (mismatch), occlusal loading, and the microgap. Additional to the standard success criteria...
Over the 5-year study period, we report
At 3-year follow-up, bone loss was noted in one patient (reclassified as peri-implantitis at the 4-year follow-up) and an important bone loss (due to poor oral hygiene and bruxism; two implants) in a patient with psychosocial issues who could not be treated during the study. Such a patient would not have been included in an RCT.
Consequently, three implants were lost based on the bone loss criter...
Discussion and conclusions
This large, multicenter study provides real-life long-term data on 285 implants placed in 196 patients. The results show that the placement of CAMLOG SCREW-LINE implants with platform-matching or platform-switching abutments results in high survival and success in the long term. The overall success rate for implants was 97.1% at 5-year post-loading, and 97.4% and 96.2...
Jemt papilla score
At loading, the Jemt papilla score was 1.93 ± 1.01, significantly increasing to 2.14 ± 0.95 at 5-year follow-up (p = 0.023) (Fig. 2d). For the platform-switching subgroup, a significant difference was observed between baseline and 5-year follow-up (p
Implant survival
The cumulative survival rate was 100% at 1-year follow-up, 99.6% at 3-year follow-up, and 98.6% at 5-year follow-up. All three late failures were in the platform-switching subgroup.
Clinical parameters/soft tissue parameters
Plaque index
Mean modified plaque indices were very low at below 0.5 for all but one measurement throughout the course of the study (Fig. 2a). At loading...
Results
Patient demographics
In total, 196 patients from 17 centers met the inclusion criteria for this study and were included in the per-protocol analysis. In total, 285 implants were placed (Table 1). At the 5-year follow-up, data were available for the 137 patients who completed the study (Fig. 1). Patient demographic data is presented in Tables 2 and 3.
Implant success
Implant success...
The primary stability of the implant was assessed during surgery. Implant success and survival were evaluated in the group of implants restored with abutments [5, 29] at both placements of the provisional and definitive prostheses and at each follow-up visit thereafter. Implants were deemed successful in accordance with the criteria for implant success laid down by Albrektsson et al. [30]. Implan...
Assessments
Throughout the study, only radiographs consistent with standard implant procedures were taken. Bone level changes were assessed based on available and evaluable standardized periapical radiographs with a film-holder using parallel-technique or panoramic radiographs (depending on the standard in the study centers). Baseline was defined as the time of the first prosthetic installati...
The treatment indications were single or multiple tooth replacement in the maxilla or mandible without the use of simultaneous augmentation or membrane, of which the implants were to be restored with either fixed single crown or fixed partial denture restorations.
Treatment procedure
Patients were to be treated according to standard practice for implant procedures applicable in the countries par...
Methods
Study design
This was a prospective multicenter non- interventional study to assess implant success and survival rates in daily dental practices using the CAMLOG SCREW-LINE implants (CAMLOG Biotechnologies AG, Basel, Switzerland) used with or without platform-switching abutments. Patients were enrolled over a period of 2 years from October 2008 to September 2010 from 17 sites across f...
In the present study, CAMLOG SCREW-LINE implants with the Promote plus surface (sandblasted and acid-etched surface) were used. These implants in combination with platform-matching abutments have been shown to have high long-term success rates ranging from 97.8 to 100% at 5-year to 10-year follow-up [9,10,11,12,13]. They can be restored with either platform-matching or platform-switching abutments...
Background
Success and survival rates of endosseous implants are well-documented in a number of controlled clinical trials and systematic reviews [1,2,3]. Generally, controlled trials evaluate endosseous implants in specific clinical situations; thus, the patient population is subjected to rigorous inclusion criteria and follow-up. Accordingly, controlled clinical trials do not reflect th...
Implant success and survival rates in daily dental practice: 5-year results of a non-interventional study using CAMLOG SCREW-LINE implants with or without platform-switching abutments
Abstract
Background
The performance of dental implants in controlled clinical studies is often investigated in homogenous populations. Observational studies are necessary to evaluate the outcome of implant resto...