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Stavropoulos A, Cochran D, Obrecht M, Pippenger BE, Dard M. Effect of Osteotomy Preparation on Osseointegration of Immediately Loaded, Tapered Dental Implants. Adv Dent Res 2017; 28:34-41. [PMID: 26927486 DOI: 10.1177/0022034515624446] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the present preclinical in vivo study was to evaluate whether a modified "drill-only" protocol, involving slight underpreparation of the implant site, may have an effect on aspects of osseointegration of a novel bone-level tapered implant, compared with the "standard drilling" protocol involving taping and profiling of the marginal aspect of the implant socket. In each side of the edentulated and completely healed mandible of 11 minipigs, 2 tapered implants (8 mm long × 4.1 mm Ø, BLT; Institut Straumann AG, Basel, Switzerland) were installed either with the drill-only or the standard drilling protocol. Significantly lower average insertion torque values were recorded for the standard drilling protocol group (52 ± 29 Ncm) compared with the drill-only group (70 ± 27 Ncm) (t test, P ≤ 0.05); no significant difference was observed between the 2 groups regarding implant stability, by means of resonance frequency analysis (75 ± 8 vs. 75 ± 6, respectively). Half of the implants were immediately loaded and the rest were submerged, providing observation times of 8 or 4 wk, respectively. Non-decalcified histological and histomorphometric analysis of the implants with surrounding tissues showed no significant differences between the 2 drilling protocols regarding the distance from the implant platform to the first coronal bone-to-implant contact (f-BIC), the total bone-to-implant contact (BIC) as a percentage of the total implant perimeter, and the bone density in an area extending 1 mm laterally from the implant (BATA) within 2 rectangular regions of interest (ROIs) 4 mm in height, representing the coronal (parallel-walled) and apical (tapered) aspect of the implant (ROI 1 and ROI 2, respectively) in non-submerged implants. In general, marginal peri-implant bone levels were at or slightly apical to the implant platform, and large amounts of bone-to-implant contact were observed. In contrast, immediately loaded implants placed with the drill-only protocol showed statistically significantly lower BIC values (66% ± 13.7%) compared with those installed with the standard drilling protocol (74.8% ± 11.2%) (P = 0.018). In addition, although marginal bone levels were in most of the immediately loaded implants at or slightly apical to the implant platform, some of the implants installed with the drill-only protocol showed marginal bone loss and crater formation. Thus, in this model system, even slight underpreparation of the implant socket appeared to compromise osseointegration of immediately loaded bone-level tapered implants.
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Affiliation(s)
- A Stavropoulos
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - D Cochran
- University of Texas Health Sciences Center, Department of Periodontics, San Antonio, Texas, USA
| | - M Obrecht
- Institut Straumann, Basel, Switzerland
| | | | - M Dard
- Institut Straumann, Basel, Switzerland Department of Periodontology and Implant Dentistry, College of Dentistry, New York University, New York City, New York, USA
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Sierra-Rebolledo A, Allais-Leon M, Maurette-OʼBrien P, Gay-Escoda C. Primary Apical Stability of Tapered Implants Through Reduction of Final Drilling Dimensions in Different Bone Density Models: A Biomechanical Study. IMPLANT DENT 2017; 25:775-782. [PMID: 27540846 DOI: 10.1097/id.0000000000000479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE A biomechanical study of the primary apical stability obtained in tapered implants through the reduction of final drilling dimensions in different bone density models. MATERIAL AND METHODS An in vitro study of maximum insertion torque and primary stability based on the resonance frequency analysis (RFA) of 24 conical implants measuring 13 mm in length and 3.75 and 4.20 mm in diameter, randomly inserted in 10-mm sockets prepared in 4 polyurethane blocks with a density of 15, 20, 30, and 40 pounds per cu ft, respectively, reducing the diameter of the final drill at constant speed (400 rpm) to obtain exclusive 4 mm anchoring of the apical third of each implant. RESULTS The decrease in drilling diameter resulted in an increase in the insertion torque and implant stability quotient (ISQ) values in all implants, although without reaching statistical significance. In turn, a significant direct correlation was found between increasing bone analog block density and the insertion torque and ISQ values. CONCLUSIONS Under the conditions of this study, the primary apical stability obtained may be more dependent on bone density than on reduction of the final drilling diameter.
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Affiliation(s)
- Alejandro Sierra-Rebolledo
- *Associate Professor of Oral Surgery and Implantology and Biotechnology Coordinator of Unit of Morphopathological Research, University of Carabobo Dental School, Valencia, Venezuela. †Professor-in-Chief of Oral and Maxillofacial Surgery, Santa Maria University Dental School, Caracas, Venezuela. ‡Assistant Professor of Oral and Maxillofacial Surgery and Dental Research, Dr. Raul Vicentelli Institute, Central of Venezuela Dental School, Caracas, Venezuela. §Cathedratic of Oral and Maxillofacial Surgical Pathology, Chairman of Oral and Maxillofacial Surgery, University of Barcelona Dental School; Coordinator of the Research Group of Maxillofacial Pathology and Dental Therapeutics, IDIBELL, Head of the Department of Oral Surgery, Implantology and Maxillofacial Surgery, TEKNON Medical Center, Barcelona, Spain
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The Effect of Osteotomy Dimension on Implant Insertion Torque, Healing Mode, and Osseointegration Indicators: A Study in Dogs. IMPLANT DENT 2017; 25:739-743. [PMID: 27513163 DOI: 10.1097/id.0000000000000476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated the effect of the osteotomy diameter for implant placement torque and its effect on the osseointegration. MATERIALS AND METHODS Eight male beagle dogs received 48 implants (3.75 mm × 10 mm) in their right and left radius, 3 implants per side and allowed to heal for 3 weeks. Three experimental groups were evaluated. Group 1: implant with an undersized osteotomy of 3.0 mm; group 2: osteotomy of 3.25 mm, and group 3: osteotomy of 3.5 mm. The insertion torque was recorded for all implants. Histological sectioning and histometric analysis were performed evaluating bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). RESULTS Implants of group 1 presented statistically higher insertion torque than those of groups 2 and 3 (P < 0.01). No differences in BIC or BAFO were observed between the groups. From a morphologic standpoint, substantial deviations in healing mode were observed between groups. CONCLUSION Based on the present methodology, the experimental alterations of surgical technic can be clinically used with no detrimental effect over the osseointegration process.
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New Osseodensification Implant Site Preparation Method to Increase Bone Density in Low-Density Bone: In Vivo Evaluation in Sheep. IMPLANT DENT 2017; 25:24-31. [PMID: 26584202 PMCID: PMC4770273 DOI: 10.1097/id.0000000000000358] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate a new surgical technique for implant site preparation that could allow to enhance bone density, ridge width, and implant secondary stability. MATERIALS AND METHODS The edges of the iliac crests of 2 sheep were exposed and ten 3.8 × 10-mm Dynamix implants (Cortex) were inserted in the left sides using the conventional drilling method (control group). Ten 5 × 10-mm Dynamix implants (Cortex) were inserted in the right sides (test group) using the osseodensification procedure (Versah). After 2 months of healing, the sheep were killed, and biomechanical and histological examinations were performed. RESULTS No implant failures were observed after 2 months of healing. A significant increase of ridge width and bone volume percentage (%BV) (approximately 30% higher) was detected in the test group. Significantly better removal torque values and micromotion under lateral forces (value of actual micromotion) were recorded for the test group in respect with the control group. CONCLUSION Osseodensification technique used in the present in vivo study was demonstrated to be able to increase the %BV around dental implants inserted in low-density bone in respect to conventional implant drilling techniques, which may play a role in enhancing implant stability and reduce micromotion.
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Baires-Campos FE, Jimbo R, Bonfante EA, Fonseca-Oliveira MT, Moura C, Zanetta-Barbosa D, Coelho PG. Drilling dimension effects in early stages of osseointegration and implant stability in a canine model. Med Oral Patol Oral Cir Bucal 2015; 20:e471-9. [PMID: 25858087 PMCID: PMC4523249 DOI: 10.4317/medoral.20557] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 02/21/2015] [Indexed: 11/21/2022] Open
Abstract
Background This study histologically evaluated two implant designs: a classic thread design versus another specifically designed for healing chamber formation placed with two drilling protocols. Material and Methods Forty dental implants (4.1 mm diameter) with two different macrogeometries were inserted in the tibia of 10 Beagle dogs, and maximum insertion torque was recorded. Drilling techniques were: until 3.75 mm (regular-group); and until 4.0 mm diameter (overdrilling-group) for both implant designs. At 2 and 4 weeks, samples were retrieved and processed for histomorphometric analysis. For torque and BIC (bone-to-implant contact) and BAFO (bone area fraction occupied), a general-linear model was employed including instrumentation technique and time in vivo as independent. Results The insertion torque recorded for each implant design and drilling group significantly decreased as a function of increasing drilling diameter for both implant designs (p<0.001). No significant differences were detected between implant designs for each drilling technique (p>0.18). A significant increase in BIC was observed from 2 to 4 weeks for both implants placed with the overdrilling technique (p<0.03) only, but not for those placed in the 3.75 mm drilling sites (p>0.32). Conclusions Despite the differences between implant designs and drilling technique an intramembranous-like healing mode with newly formed woven bone prevailed. Key words:
Histomorphometry, biomechanical, in vivo, initial stability, insertion torque, osseointegration.
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Influence of Underpreparation on Primary Stability of Implants Inserted in Poor Quality Bone Sites: An In Vitro Study. J Oral Maxillofac Surg 2015; 73:1084-8. [DOI: 10.1016/j.joms.2015.01.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 10/24/2022]
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Osseointegration of Plateau Root Form Implants: Unique Healing Pathway Leading to Haversian-Like Long-Term Morphology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 881:111-28. [PMID: 26545747 DOI: 10.1007/978-3-319-22345-2_7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Endosteal dental implants have been utilized as anchors for dental and orthopedic rehabilitations for decades with one of the highest treatment success rates in medicine. Such success is due to the phenomenon of osseointegration where after the implant surgical placement, bone healing results into an intimate contact between bone and implant surface. While osseointegration is an established phenomenon, the route which osseointegration occurs around endosteal implants is related to various implant design factors including surgical instrumentation and implant macro, micro, and nanometer scale geometry. In an implant system where void spaces (healing chambers) are present between the implant and bone immediately after placement, its inherent bone healing pathway results in unique opportunities to accelerate the osseointegration phenomenon at the short-term and its maintenance on the long-term through a haversian-like bone morphology and mechanical properties.
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Osseointegration: hierarchical designing encompassing the macrometer, micrometer, and nanometer length scales. Dent Mater 2014; 31:37-52. [PMID: 25467952 DOI: 10.1016/j.dental.2014.10.007] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/14/2014] [Accepted: 10/31/2014] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Osseointegration has been a proven concept in implant dentistry and orthopedics for decades. Substantial efforts for engineering implants for reduced treatment time frames have focused on micrometer and most recently on nanometer length scale alterations with negligible attention devoted to the effect of both macrometer design alterations and surgical instrumentation on osseointegration. This manuscript revisits osseointegration addressing the individual and combined role of alterations on the macrometer, micrometer, and nanometer length scales on the basis of cell culture, preclinical in vivo studies, and clinical evidence. METHODS A critical appraisal of the literature was performed regarding the impact of dental implant designing on osseointegration. Results from studies with different methodological approaches and the commonly observed inconsistencies are discussed. RESULTS It is a consensus that implant surface topographical and chemical alterations can hasten osseointegration. However, the tailored combination between multiple length scale design parameters that provides maximal host response is yet to be determined. SIGNIFICANCE In spite of the overabundant literature on osseointegration, a proportional inconsistency in findings hitherto encountered warrants a call for appropriate multivariable study designing to ensure that adequate data collection will enable osseointegration maximization and/or optimization, which will possibly lead to the engineering of endosteal implant designs that can be immediately placed/loaded regardless of patient dependent conditions.
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Coelho PG, Jimbo R. Osseointegration of metallic devices: Current trends based on implant hardware design. Arch Biochem Biophys 2014; 561:99-108. [DOI: 10.1016/j.abb.2014.06.033] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 12/18/2022]
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Jimbo R, Tovar N, Marin C, Teixeira H, Anchieta R, Silveira L, Janal M, Shibli J, Coelho P. The impact of a modified cutting flute implant design on osseointegration. Int J Oral Maxillofac Surg 2014; 43:883-8. [DOI: 10.1016/j.ijom.2014.01.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 10/23/2013] [Accepted: 01/30/2014] [Indexed: 10/25/2022]
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Duyck J, Vandamme K. The effect of loading on peri-implant bone: a critical review of the literature. J Oral Rehabil 2014; 41:783-94. [DOI: 10.1111/joor.12195] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2014] [Indexed: 12/22/2022]
Affiliation(s)
- J. Duyck
- BIOMAT Research Group; Department of Oral Health Sciences; KU Leuven; Leuven Belgium
| | - K. Vandamme
- BIOMAT Research Group; Department of Oral Health Sciences; KU Leuven; Leuven Belgium
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Jimbo R, Tovar N, Anchieta RB, Machado LS, Marin C, Teixeira HS, Coelho PG. The combined effects of undersized drilling and implant macrogeometry on bone healing around dental implants: an experimental study. Int J Oral Maxillofac Surg 2014; 43:1269-75. [PMID: 24794761 DOI: 10.1016/j.ijom.2014.03.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 03/23/2014] [Accepted: 03/25/2014] [Indexed: 11/30/2022]
Abstract
This study investigated the effect of undersized preparations with two different implant macrogeometries. There were four experimental groups: group 1, conical implant with an undersized osteotomy of 3.2mm; group 2, conical implant with an undersized osteotomy of 3.5mm; group 3, cylindrical implant with an undersized osteotomy of 3.2mm; group 4, cylindrical implant with an undersized osteotomy of 3.5mm. Implants were placed in one side of the sheep mandible (n=6). After 3 weeks, the same procedure was conducted on the other side; 3 weeks later, euthanasia was performed. All implants were 4mm×10mm. Insertion torque was recorded for all implants during implantation. Retrieved samples were subjected to histological sectioning and histomorphometry. Implants of groups 1 and 2 presented significantly higher insertion torque than those of groups 3 and 4 (P<0.001). No differences in bone-to-implant contact or bone area fraction occupied were observed between the groups at 3 weeks (P>0.24, and P>0.25, respectively), whereas significant differences were observed at 6 weeks between groups 1 and 2, and between groups 3 and 4 (P<0.01). Undersized drilling affected the biological establishment of bone formation around both dental implant macrogeometries.
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Affiliation(s)
- R Jimbo
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - N Tovar
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - R B Anchieta
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - L S Machado
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - C Marin
- Department of Dentistry, UNIGRANRIO, Duque de Caxias, RJ, Brazil
| | - H S Teixeira
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - P G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
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Calvo-Guirado JL, Delgado-Peña J, Maté-Sánchez JE, Mareque Bueno J, Delgado-Ruiz RA, Romanos GE. Novel hybrid drilling protocol: evaluation for the implant healing--thermal changes, crestal bone loss, and bone-to-implant contact. Clin Oral Implants Res 2014; 26:753-60. [PMID: 24502654 DOI: 10.1111/clr.12341] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate a new hybrid drilling protocol, by the analysis of thermal changes in vitro, and their effects in the crestal bone loss and bone-to-implant contact in vivo. MATERIALS AND METHODS Temperature changes during simulated osteotomies with a hybrid drilling technique (biologic plus simplified) (test) versus an incremental drilling technique (control) were investigated. One hundred and twenty random osteotomies were performed (60 by group) in pig ribs up to 3.75-mm-diameter drill to a depth of 10 mm. Thermal changes and time were recorded by paired thermocouples. In a parallel experiment, bilateral mandibular premolars P2, P3, P4, and first molar M1 were extracted from six dogs. After 2-month healing, implant sites were randomly prepared using either of the drilling techniques. Forty eight implants of 3.75 mm diameter and 10 mm length were inserted. The dogs were euthanized at 30 and 90 days, and crestal bone loss (CBL) and bone-to-implant contact (BIC) were evaluated. RESULTS The control group showed maximum temperatures of 35.3 °C ± 1.8 °C, ΔT of 10.4 °C, and a mean time of 100 s/procedure; meanwhile, the test group showed maximum temperatures of 36.7 °C ± 1.2 °C, ΔT of 8.1 °C, and a mean time of 240 s/procedure. After 30 days, CBL values for both groups (test: 1.168 ± 0.194 mm; control: 1.181 ± 0.113 mm) and BIC values (test: 43 ± 2.8%; control: 45 ± 1.3%) were similar, without significant differences (P > 0.05). After 90 days, CBL (test: 1.173 ± 0.187 mm; control: 1.205 ± 0.122 mm) and BIC (test: 64 ± 3.3%; control: 64 ± 2.4%) values were similar, without significant differences (P > 0.05). The BIC values were increased at 90 days in both groups compared with the 30-day period (P < 0.05). CONCLUSIONS Within the limitations of this study, the new hybrid protocol for the preparation of the implant bed without irrigation, increase the temperature similarly to the incremental conventional protocol, and requires twice the time for the completion of the drilling procedure in vitro. Crestal bone loss and bone-to-implant contact in the hybrid drilling protocol are comparable with the conventional drilling protocol and do not affect the osseointegration process in vivo.
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Duyck J, Roesems R, Cardoso MV, Ogawa T, De Villa Camargos G, Vandamme K. Effect of insertion torque on titanium implant osseointegration: an animal experimental study. Clin Oral Implants Res 2013; 26:191-6. [PMID: 24325598 DOI: 10.1111/clr.12316] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2013] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate the effect of implant insertion torque on the peri-implant bone healing and implant osseointegration. MATERIAL AND METHODS Bilaterally in the tibia of five adult New Zealand white rabbits, 20 implants were installed, subdivided into four groups, corresponding to two insertion torque conditions (low, < 10 Ncm vs. high > 50 Ncm) and 2 experimental periods (2 weeks vs. 4 weeks of healing). The implant insertion torque was determined by the surgical drill diameter relative to the implant diameter. Implant osseointegration was evaluated by quantitative histology (bone-to-implant contact with host bone [BIC-host], with neoformed bone [BIC-de novo], with both bone types [BIC-total], and peri-implant bone [BA/TA]). Every response was modelled over time using GEE (general estimation equation) with an unstructured variance-covariance matrix to correct for dependency between the measurements from one animal. The statistical significance level of α = 0.05 was applied. RESULTS Significantly, more BIC-host and BIC-total were recorded for H implants compared with L implants after 2 week of healing (P = 0.010 and P = 0.0001, respectively). However, this result was no longer found for the extended healing period. Furthermore, BIC-total significantly increased over time for L implants (P < 0.00001). In contrast, the significant increase in BA/TA over time was found for H implants (P < 0.01). Finally, H insertion torque led to an increased BA/TA after 4 week of healing (P < 0.02) compared with the L insertion protocol. CONCLUSION L insertion torque implants installed in the rabbit tibial bone osseointegrate with considerable de novo bone formation. This bone neoformation enables L implants to catch up, already during the early osseointegration stage, the initial inferior amount BIC contact compared with that of H implants. A negative impact of the created strain environment accompanying H insertion torque implant installation on the biological process of osseointegration could not be observed, at least not at tissue level.
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Affiliation(s)
- Joke Duyck
- Department of Oral Health Sciences & Dental Clinic, KU Leuven & University Hospitals Leuven, BIOMAT KU Leuven & Prosthetics Unit, Leuven, Belgium
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The effect of drilling speed on early bone healing to oral implants. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:550-5. [DOI: 10.1016/j.oooo.2013.07.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 05/25/2013] [Accepted: 07/05/2013] [Indexed: 11/19/2022]
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Goswami MM, Kumar M, Vats A, Bansal AS. Evaluation of dental implant insertion torque using a manual ratchet. Med J Armed Forces India 2013; 71:S327-32. [PMID: 26843747 DOI: 10.1016/j.mjafi.2013.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 07/18/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Dental implant insertion torque is crucial for the success of the implant and the prosthesis. This in-vivo study was undertaken to determine the average insertion torque being applied to the dental implant while surgically placing it with a non-calibrated manual ratchet. METHODS Three dental surgeons placed a total of 45 dental implants (Touareg, ADIN, Afula, Israel) in 42 selected patients. Each surgeon placed 15 implants. Standardised protocols were followed to prepare the site to place the dental implant. Each implant was placed using a manual non-calibrated implant ratchet first. Once the implant was nearly placed, a manual calibrated torque gauge ratchet was used to place the implant in its final position and at that instance, the maximum final torque applied was noted on the torque gauge scale. RESULTS The mean dental implant insertion torque applied by three surgeons using a non-calibrated manual ratchet was estimated to be 63.26 Ncm with a standard error of 6.80 i.e. (63.26 + 6.8), which was significantly higher than the baseline of 35 Ncm (p < 0.0001). The mean dental implant torque applied by Surgeon 1, 2 and 3, respectively, was 65.93 Ncm, 62.60 Ncm and 62.13 Ncm and this difference amongst them was found to be statistically insignificant (p > 0.05) and each of them had reached more than the baseline level of 35 Ncm individually and significantly (p < 0.0001). CONCLUSION Without the use of torque measuring devices, an average surgeon may achieve an average insertion torque of 63.26 + 6.8 Ncm.
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Affiliation(s)
- M M Goswami
- Dental Officer & Classified Specialist (Prosthodontics), Armed Forces Dental Clinic, Tyagraj Marg, New Delhi 110011, India
| | - Mukul Kumar
- Commanding Officer, Medical Dental Center, Meerut 900468, C/O 56 APO, India
| | - Abhinav Vats
- Dental Officer, 331 Field Hospital, C/O 56 APO, India
| | - A S Bansal
- Associate Professor (Community Medicine), Adesh Institute of Medical Sciences & Research, Bhatinda, Punjab, India
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Correlation Between Insertion Torque and Survival Rates in Immediately Loaded Implants in the Maxilla. IMPLANT DENT 2013; 22:250-4. [DOI: 10.1097/id.0b013e3182938cf1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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68
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Coelho PG, Marin C, Teixeira HS, Campos FE, Gomes JB, Guastaldi F, Anchieta RB, Silveira L, Bonfante EA. Biomechanical Evaluation of Undersized Drilling on Implant Biomechanical Stability at Early Implantation Times. J Oral Maxillofac Surg 2013; 71:e69-75. [DOI: 10.1016/j.joms.2012.10.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 10/05/2012] [Accepted: 10/06/2012] [Indexed: 11/16/2022]
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