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Marcantonio ACM, de Oliveira GJPL, Tassi PA, Manfrinato JPL, Segnini B, de Souza Bezerra Araújo RF, Trojan LC, Fontão FNGK, de Mattias Sartori IA, Sartori EM, Padovan LEM, Zandim-Barcelos DL, Marcantonio E. Full-arch prostheses supported by implants with different macrostructures: A multicenter randomized controlled trial. Clin Implant Dent Relat Res 2024. [PMID: 39360638 DOI: 10.1111/cid.13392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 10/04/2024]
Abstract
OBJECTIVES This study evaluates the clinical performance of implants with hydrophilic surface and two different macrostructures: cylindrical with perforating triangular threads (CT) and cylindrical-tapered with the association of square and condensing and perforating triangular threads (TST). MATERIALS AND METHODS This was a multicenter split-mouth, simple-blinded, randomized, and controlled trial. Thirty patients with edentulous mandible received two CT and two TST implants. Primary stability was determined by insertion torque and resonance frequency analysis (RFA). Implants were loaded with full fixed-arch prostheses within 24 h after insertion. Clinical parameters (visible plaque index, marginal bleeding index; bleeding on probing; probing depth; and clinical attachment level) and the RFA were assessed at 2, 6, 12, and 24 months after implant loading. Marginal bone level changes were measured by comparison of standardized radiographs taken on the day of implant placement and 6, 12, and 24 months thereafter. RESULTS Twenty-eight patients completed the 2-year follow-up. The survival rates were 99.16% for CT implants and 100% for TST implants. One CT implant was lost until the 2 months follow-up. No significant differences were found between the two implant types for marginal bone level changes (CT 0.34 [0.24; 0.55 mm]; 0.33 [0.18; 0.55 mm]; 0.41 [0.12; 0.7 mm] vs TST 0.36 [0.14; 0.74 mm]; 0.33 [0.23; 0.63 mm]; 0.30 [0.20; 0.64 mm] at 6, 12, and 24 months, respectively) and other clinical parameters. CONCLUSION The macrostructure of the implants had no influence on survival rate, primary and secondary stability, marginal bone level changes, and peri-implant clinical parameters outcomes. Both implants can be predictably used for immediate loading of full-arch mandibular prostheses.
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Affiliation(s)
| | | | - Paulo Afonso Tassi
- Implantology, Instituto Latino-americano de Pesquisa Odontológica (ILAPEO), Curitiba, Brazil
| | | | - Bruno Segnini
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Univ. Est. Paulista/UNESP, Araraquara, Brazil
| | | | - Larissa Carvalho Trojan
- Implantology, Instituto Latino-americano de Pesquisa Odontológica (ILAPEO), Curitiba, Brazil
| | | | | | - Elisa Mattias Sartori
- Implantology, Instituto Latino-americano de Pesquisa Odontológica (ILAPEO), Curitiba, Brazil
| | | | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Univ. Est. Paulista/UNESP, Araraquara, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Univ. Est. Paulista/UNESP, Araraquara, Brazil
- Department of Periodontology, School of Dentistry at Uberlândia, Federal University of Uberlândia, Uberlândia, Brazil
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de Elío Oliveros J, Gago García A, López Sacristán H, Truchuelo Díez P, Barrilero Martín C, Del Canto Díaz M, Del Canto Pingarrón M. Insertion Torque and Resonance Frequency Analysis in Tapered and Parallel Dental Implants. J ORAL IMPLANTOL 2023; 49:347-354. [PMID: 37527177 DOI: 10.1563/aaid-joi-d-21-00305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 02/01/2023] [Accepted: 04/15/2023] [Indexed: 08/03/2023]
Abstract
Primary implant stability (PIS) is known to vary with recipient bone mass and density, dental implant design and surgical technique. The objective of this preliminary study was to compare rotational and lateral PIS of same-coronal-diameter conical and parallel implants, using insertion torque recorded with a dental implant motor set and implant stability quotient obtained from resonance frequency analysis (performed with both Osstell and Penguin systems) as measures of rotational and lateral stability, respectively. Additionally, the relationship between PIS and alveolar ridge width (ARW) was explored in both implant types. Sixty dental implants (30 tapered and 30 parallel) were randomly placed with a split-mouth design in 17 patients. Bone density and ARW were estimated from cone beam computed tomography images taken with radiological-surgical templates. Density and width values were similar in the 2 groups (P > .05). Implant coronal diameters were 3.75 mm in all cases, while consistent with the manufacturer's recommendations, final drill bit diameters used were 3.25 and 3.4 mm for parallel and tapered implants, respectively. Insertion torque was higher (P < .05) with parallel implants, but between-group differences in implant stability quotient were not significant (P > .05). In tapered implants, insertion torque was inversely correlated with ARW (P < .001). Notably, significant differences were observed between resonance frequency analysis values from Osstell and Penguin systems (P < .001). In conclusion, future studies should explore how PIS may be influenced by final drill bit size regardless of implant design and potential limits on the effectiveness of tapered implants to achieve good stability in thick low-density bone.
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Comuzzi L, Tumedei M, Di Pietro N, Romasco T, Heydari Sheikh Hossein H, Montesani L, Inchingolo F, Piattelli A, Covani U. A Comparison of Conical and Cylindrical Implants Inserted in an In Vitro Post-Extraction Model Using Low-Density Polyurethane Foam Blocks. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5064. [PMID: 37512339 PMCID: PMC10384017 DOI: 10.3390/ma16145064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023]
Abstract
Combining tooth extraction and implant placement reduces the number of surgical procedures that a patient must undergo. Thus, the present study aimed to compare the stability of two types of conical implants (TAC and INTRALOCK) and another cylindrical one (CYROTH), inserted with a range of angulation of 15-20 degrees in low-density polyurethane blocks (10 and 20 pounds per cubic foot, PCF) with or without a cortical lamina (30 PCF), which potentially mimicked the post-extraction in vivo condition. For this purpose, a total of 120 polyurethane sites were prepared (10 for each implant and condition) and the Insertion Torque (IT), Removal Torque (RT), and Resonance Frequency Analysis (RFA) were measured, following a Three-Way analysis of variance followed by Tukey's post hoc test for the statistical analysis of data. The IT and RT values registered for all implant types were directly proportional to the polyurethane density. The highest IT was registered by INTRALOCK implants in the highest-density block (32.44 ± 3.28 Ncm). In contrast, the highest RFA, a well-known index of Implant Stability Quotient (ISQ), was shown by TAC implants in all clinical situations (up to 63 ISQ in the 20 PCF block without the cortical sheet), especially in lower-density blocks. Although more pre-clinical and clinical studies are required, these results show a better primary stability of TAC conical implants in all tested densities of this post-extraction model, with a higher ISQ, despite their IT.
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Affiliation(s)
- Luca Comuzzi
- Independent Researcher, San Vendemiano-Conegliano, 31020 Treviso, Italy
| | - Margherita Tumedei
- Department of Medical, Surgical, and Dental Sciences, University of Milan, 20122 Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
| | - Tea Romasco
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
| | - Hamid Heydari Sheikh Hossein
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Villa Serena Foundation for Research, Via Leonardo Petruzzi 42, 65013 Città Sant'Angelo, Italy
| | | | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Ugo Covani
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
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Wakure P, Ghalaut P, Rathee M, Jain P, Alam M, Malik S. Comparative evaluation of implant stability and crestal bone level between tapered and cylindrical implants in the posterior regions of the mandible: A prospective, randomized, split-mouth clinical trial. Natl J Maxillofac Surg 2023; 14:242-248. [PMID: 37661993 PMCID: PMC10474532 DOI: 10.4103/njms.njms_514_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/30/2022] [Accepted: 07/25/2022] [Indexed: 09/05/2023] Open
Abstract
Purpose To compare the clinical outcome of tapered and cylindrical implants placed in the posterior region of mandible by measuring implant stability and crestal bone level at the healing period. Materials and Methods A prospective clinical study was conducted on 15 patients who were included in the study based on the inclusion and exclusion criteria. A total of 30 dental implants were placed in both groups: 15 implants in Group I (tapered implants) and 15 implants in Group II (cylindrical implants) in the posterior region of mandible. Implant stability assessment by periotest was done at the time of implant placement (baseline) and after 3 months. The crestal bone level was measured with the help of radiovisiography (RVG) at the time of implant placement (baseline) and at 3 and 6 months. Results At baseline, there was statistically significant (P < 0.01) difference in primary implant stability. Tapered implants had higher primary implant stability than cylindrical implants. However, at 3 months, there was no statistically significant (P > 0.05) difference in the secondary implant stability of both the groups. Also, the crestal bone level on the mesial and distal sides of dental implant for tapered and cylindrical implants was statistically nonsignificant (P > 0.05) at all time intervals, that is, at baseline and at 3 and 6 months. Conclusion Tapered implants had higher primary stability than cylindrical implants, and no difference was found in secondary stability. The crestal bone level was similar for both groups during early healing and early post-loading periods.
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Affiliation(s)
- Poonam Wakure
- Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B. D Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Pankaj Ghalaut
- Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B. D Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Manu Rathee
- Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B. D Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Prachi Jain
- Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B. D Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Maqbul Alam
- Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B. D Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Sanju Malik
- Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B. D Sharma University of Health Sciences, Rohtak, Haryana, India
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Gehrke SA, Cortellari GC, de Oliveira Fernandes GV, Scarano A, Martins RG, Cançado RM, Mesquita AMM. Randomized Clinical Trial Comparing Insertion Torque and Implant Stability of Two Different Implant Macrogeometries in the Initial Periods of Osseointegration. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010168. [PMID: 36676792 PMCID: PMC9862599 DOI: 10.3390/medicina59010168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
Objectives: The present study compared two implants with different macrogeometries placed in healed alveolar sites, evaluating the insertion torque (ITV) and implant stability quotient (ISQ) values at three different periods. Methods: Seventy patients with a total of 100 dental implants were allocated into two groups (n = 50 per group): DuoCone implants (DC group) that included 28 implants in the maxilla and 22 in the mandible, and Maestro implants (MAE group) that included 26 in the maxilla and 24 in the mandible. The ITV was measured during the implant placement, and the ISQ values were measured immediately at implant placement (baseline) and after 30 and 45 days. Results: The mean and standard deviations of the ITV were statistically significant (p < 0.0001), 56.4 ± 6.41 Ncm for the DC group and 29.3 ± 9.65 Ncm for the MAE group. In the DC group, the ISQs ranged between 61.1 ± 3.78 and 69.8 ± 3.86, while the MAE group presented similar values compared with the other group, ranging between 61.9 ± 3.92 and 72.1 ± 2.37. Conclusions: The value of implant insertion torque did not influence the ISQ values measured immediately after implant placement. However, the ITV influenced the ISQ values measured in the two initial periods of osseointegration, with implants installed with lower torques presenting higher ISQ values.
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Affiliation(s)
- Sergio Alexandre Gehrke
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Instituto de Bioingenieria, Universidad Miguel Hernández, Avda. Ferrocarril s/n., 03202 Elche, Spain
- Department of Biotechnology, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
- Department of Materials Engineering, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre 90619-900, Brazil
- Correspondence: ; Tel./Fax: +598-29015634
| | | | | | - Antonio Scarano
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
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Tardelli J, da Costa Valente M, Macedo A, dos Reis A. Evaluation of Biomechanical and Stress Distribution of Different Dental Implant Designs: Primary Stability and Photoelastic Analysis. Ing Rech Biomed 2022. [DOI: 10.1016/j.irbm.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mechanical Behaviour and Primary Stability of a Self-Condensing Implant: A Laboratory Critical Simulation of a Severe Maxillary Atrophy on Polyurethane Lamina. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12030966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background: Posterior maxillary atrophies could emerge after the loss of teeth, trauma, infections, or lesions that often require regenerative approaches. In these critical conditions, the achievement of implant primary stability represents a clinical challenge in the operative practice. Therefore, a two-stage approach is often preferred with a delay of the rehabilitation time and a consistent increasing of the biological and the operative costs. The aim of this study was to evaluate the mechanical behaviour of a self-condenser implant compared to a standard implant in a critical simulation on different thicknesses and densities of polyurethane lamina. Materials and methods: A total of two implant models were tested: a self-condensing device (test) and a standard implant (control). The study evaluated the insertion torque and the pull-out strength values of the test and control implants inserted in different sizes (1, 2, and 3 mm) and density polyurethane lamina (10, 20, and 30 pcf) for a total of 320 experimental sites. Results: In total, 320 experimental sites were produced in the polyurethane samples. A statistically significant difference of insertion and pull-out torque values between the test and control Implants was found in the different bone densities (p < 0.05). The insertion and pull-out torque values were always higher for the test implants in all experimental conditions. In all bone densities, the insertion torque values were higher than the pull-out torque values. The self-condenser dental implant design evaluated in this in vitro study showed a high level of stability in all experimental conditions. Conclusions: The test implant could represent a useful tool for a one-stage surgical approach in the presence of limited residual native bone as an alternative to a delayed technique.
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An In Vitro Analysis on Polyurethane Foam Blocks of the Insertion Torque (IT) Values, Removal Torque Values (RTVs), and Resonance Frequency Analysis (RFA) Values in Tapered and Cylindrical Implants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179238. [PMID: 34501824 PMCID: PMC8431239 DOI: 10.3390/ijerph18179238] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/24/2022]
Abstract
Background: Several different dental implant microgeometries have been investigated in the literature for use in low-density bone sites. The polyurethane solid rigid blocks represent an optimal in vitro study model for dental implants, because their composition is characterized by symmetrical linear chains of monomers of hexa-methylene sequences producing a self-polymerization process. The aim of the present investigation was to evaluate the primary stability of cylindrical and tapered implants positioned into low-density polyurethane solid rigid blocks. Materials and Methods: Two different macrogeometries, cylindrical (4 mm diameter and 10 mm length) and tapered dental implants (4.20 mm diameter and 10 mm length), were investigated in the present study. The implants were inserted into 10 PCF and 20 PCF polyurethane blocks, with and without an additional cortical layer. The insertion torque (IT) values, the removal torque values (RTVs), and the resonance frequency analysis (RFA) values were measured and recorded. Results: A total of 80 sites were tested, and a significant increased primary stability (PS) was detected in favour of tapered dental implants when compared to cylindrical implants in all experimental conditions (p < 0.05). Higher IT, RT, and RFA values were measured in tapered implants in 10 and 20 PCF polyurethane blocks, both with and without the additional cortical layer. Conclusions: Both implants showed sufficient primary stability in poor density substrates, while, on the other hand, the tapered microgeometry showed characteristics that could also lead to clinical application in low-density posterior maxillary sites, even with a drastically decreased bone cortical component.
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Brouwers JEIG, Buis S, de Groot PG, de Laat B, Remijn JA. Resonance frequency analysis with two different devices after conventional implant placement with ridge preservation: A prospective pilot cohort study. Clin Implant Dent Relat Res 2021; 23:789-799. [PMID: 34312973 DOI: 10.1111/cid.13031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/18/2021] [Accepted: 06/14/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Primary and secondary implant stability is of high importance for survival and success of dental implants in the short and long term. Measurements of implant stability during healing provide the opportunity to monitor the course of the osseointegration process. PURPOSE To compare implant stability quotient (ISQ) by resonance frequency analysis (RFA), recorded with two different devices after implant placement. MATERIALS AND METHODS Patients with the need of single tooth extraction in posterior sites of the maxilla and the mandible were treated in a surgical center. All patients received additional augmentation with a bovine bone substitute and platelet-rich fibrin (PRF) after atraumatic tooth extraction. After a healing period of 10 weeks, 28 self-tapping titanium-implants were placed. Implant stability was recorded with two different devices (Osstell and Penguin) at the time of implant insertion (T0), 10 days later (T1), and after 7 (T2), or 17 weeks (T3). RESULTS No implant was lost, and no postoperative complication occurred during follow-up. Patient cohort comprised 9 female (32.1%) and 19 male patients (67.9%), with a mean age of 52.8 years, 64.3 years, respectively. Mean overall insertion torque was 43.6 Ncm at implant placement with no significant difference between implant location, age, or gender. No patient dropped out. During observation period, a significant increase in mean ISQ was recorded with both devices. Significant positive correlations between insertion torque and ISQ were recorded with both devices at T0, T2, and T3. No significant differences were observed in ISQ-values between both devices, and measuring directions at any point of measurement. CONCLUSIONS Within the limitations of this cohort study, both devices were suitable for RFA-measurement and revealed comparable results. Due to the cordless design, handling of the Penquin device was more comfortable. Reusability of the Penguin MultiPeg-transducers may offer an additional benefit with regard on ecological aspects.
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Affiliation(s)
| | - Sharon Buis
- Institute for Dental Implantology, Amersfoort, the Netherlands
| | - Philip G de Groot
- Synapse Research Institute, Maastricht, the Netherlands.,Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Bas de Laat
- Synapse Research Institute, Maastricht, the Netherlands.,Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jasper A Remijn
- Synapse Research Institute, Maastricht, the Netherlands.,Department of Clinical Chemistry, Cardiovascular Research Institute Maastricht, Meander Medical Center, Amersfoort, the Netherlands.,Department of Clinical Chemistry and Hematology, Gelre Hospitals, Apeldoorn, the Netherlands
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The Influence of the Implant Macrogeometry on Insertion Torque, Removal Torque, and Periotest Implant Primary Stability: A Mechanical Simulation on High-Density Artificial Bone. Symmetry (Basel) 2021. [DOI: 10.3390/sym13050776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: The primary stability is a determinant clinical condition for the success of different dental implants macro-design in different bone density using a validated and repeatable in vitro technique employing solid rigid polyurethane blocks. Materials and Methods: Five implants 3.8 × 13 mm2 for each macro-design (i.e., IK—tapered; IC—cylindric; and IA—active blade shape) were positioned into 20- and 30- pounds per cubic foot (PCF) polyurethane blocks. Bucco-lingual (BL) and mesial-distal (MD) implant stability quotient score (ISQ) was assessed by resonance frequency analysis while, insertion/removal torques were evaluated by dynamometric ratchet. Results: IC implants shown better primary stability in terms of ISQ compared to IA and IK in lower density block (20 PCF), while IK was superior to IA in higher density (30 PCF). IC shown higher removal torque in 30-PCF compared to IA and IC. Conclusions: The study effectiveness on polyurethane artificial bone with isotropic symmetry structure showed that the implants macro-design might represent a key factor on primary stability, in particular on low-density alveolar bone. Clinicians should consider patients features and implant geometry during low-density jaws rehabilitation. Further investigations are needed to generalize these findings.
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Effect of macrogeometry and bone type on insertion torque, primary stability, surface topography damage and titanium release of dental implants during surgical insertion into artificial bone. J Mech Behav Biomed Mater 2021; 119:104515. [PMID: 33932754 DOI: 10.1016/j.jmbbm.2021.104515] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/12/2021] [Accepted: 04/05/2021] [Indexed: 11/20/2022]
Abstract
This study investigated the influence of implant macrogeometry and bone type on insertion torque (IT), primary stability (ISQ), surface topography damage, and the amount of titanium (Ti) released during insertion. Forty implants with different macrogeometries (Facility - Cylindrical with spiral-shaped threads; Alvim - Tapered with buttress-shaped threads) were inserted into artificial bone types I-II and III-IV. Surface morphology was evaluated by Scanning Electron Microscope (SEM) and roughness parameters with Laser Scanning Confocal Microscopy (LSCM) before and after insertion (AI). Implant macrogeometry was characterized by LSCM. The chemical composition of bone beds was determined by SEM associated with Energy Dispersive X-Ray Spectroscopy. The amount of Ti released was analyzed with Energy Dispersive X-Ray Fluorescence. Alvim had greater IT and ISQ than Facility. Bone types I-II require higher IT of implants. Alvim also had greater internal threads angle, higher initial roughness, and significant reduction of roughness AI, compared to Facility. The functional surface height reduced AI, especially in flank and valley of threads. Height of surface roughness of Alvim and Facility implants was similar AI. Implants surface morphology changes and metallic particles on bone beds were observed after implant insertion, mainly into bone types III-IV. Implants inserted into bone types I-II showed less surface damage. Alvim implants released more Ti (37.52 ± 25.03 ppm) than Facility (11.66 ± 28.55 ppm) on bone types III-IV. The implant macrogeometry and bone types affect IT, ISQ, surface damage, and Ti amount released during insertion. Alvim implants were more wear susceptible, releasing higher Ti concentration during insertion into bone types III-IV.
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Does the Modification of the Apical Geometry of a Dental Implant Affect Its Primary Stability? A Comparative Ex Vivo Study. MATERIALS 2021; 14:ma14071728. [PMID: 33915933 PMCID: PMC8036940 DOI: 10.3390/ma14071728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 01/14/2023]
Abstract
(1) Background: Primary stability—one fundamental criterion for the success of dental implants—is influenced by implant geometry even if the effect of apical shape modifications on implant primary stability has not yet been examined. Therefore, the aim of the ex vivo study was to compare primary stability of implants differing in apically located screw threads (J-line) or a flat tip (K-line) only. (2) Methods: 28 implants of each group of the same diameter (4.3 mm) were randomly inserted into porcine bone blocks. The first group (9, 11 and 13 mm) was inserted into “hard”, the second (11 mm) into “soft” bone, here using a normal and an undersized drilling protocol. Insertion torque (Ncm), Periotest® value, resonance frequency (implant stability coefficient, ISQ) and push-out force (N) were measured. (3) Results: In “hard” bone, primary stability increased with increasing length in both groups but it was significantly higher in J-line (p < 0.03). An undersized preparation of the implant bed in “soft” bone resulted in a significant increase in primary stability in both groups. Here, J-line also showed a significantly increased primary stability when compared to equally prepared K-line (insertion torque: 37 Ncm vs. 26 Ncm; Periotest®: −6.5 vs. −4.3; push-out force: 365 N vs. 329 N; p < 0.05 each). (4) Conclusions: Primary stability is significantly higher with increasing implant length and apically located screw threads as well as with undersized drilling protocols. When preparing the implant site and subsequently selecting the implant system, modifying factors such as implant geometry (also at the tip) should be taken into account.
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A Radiographic and Clinical Comparison of Immediate vs. Early Loading (4 Weeks) of Implants with a New Thermo-Chemically Treated Surface: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031223. [PMID: 33572988 PMCID: PMC7908367 DOI: 10.3390/ijerph18031223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/11/2021] [Accepted: 01/26/2021] [Indexed: 01/18/2023]
Abstract
Background: Implant dentistry has evolved over time, resulting in better treatment outcomes for both patients and clinicians. The aim of this trial was to test whether the immediate loading of implants with a platform-switching design influences the marginal bone level, compared to four-week loading, after one year of follow-up. Moreover, a comparison of clinical data regarding implant survival, implant stability, and patient-reported outcome measures (PROMs) was conducted. Methods: Klockner® VEGA® implants with a ContacTi® surface were placed in partially edentulous patients in the posterior areas. Group A received an immediately loaded prosthesis (one week) and Group B received an early-loaded prosthesis (four weeks). All abutments were placed at the time of surgery. Radiographic and clinical data were recorded. Results: Twenty-one patients were treated (35 implants). No implants were lost during the study. The final marginal bone level did not show differences between groups. The bone loss at 12 months at the implant level was 0.00 mm for both groups (median). The final implant quotient stability (ISQ) values did not differ between groups (median 73 and 70.25), nor did the other clinical parameters or PROMs. Conclusions: The results suggest that neither of the loading protocols with the implants used influenced the marginal bone level—not the osseointegration rate, clinical conditions, or PROMs.
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Su YH, Peng BY, Wang PD, Feng SW. Evaluation of the implant stability and the marginal bone level changes during the first three months of dental implant healing process: A prospective clinical study. J Mech Behav Biomed Mater 2020; 110:103899. [PMID: 32957204 DOI: 10.1016/j.jmbbm.2020.103899] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 11/16/2022]
Abstract
Achievement of adequate implant stability is one of the determinants for long-term successful osseointegration. Resonance frequency analysis was developed to monitor implant stability and is now a well-recognized, non-invasive tool for determining the appropriate time for functional loading. However, there have been few studies with continuous evaluation and comparison of implant stability and marginal bone level changes between two different macro designs and clinical situations during the implant healing process. Thus, the purpose of this clinical trial is to evaluate the implant stability and marginal bone level changes of straight and conical implants during the implant healing process. In this prospective clinical trial, 25 participants were randomized to either straight or conical implants. A total of 32 titanium dental implants with a length of 9 mm or 11 mm were installed in the maxilla and the mandible according to the manufacturer's instructions. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the time of implant placement and after 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, and 12 weeks of healing. The changes in the peri-implant marginal bone level were evaluated from digital radiographic films taken at the time of implant placement and after 4 weeks, 8 weeks, and 12 weeks of healing. The preliminary results of this study revealed higher ISQ values and better healing tendency for conical implants in comparison with straight implants in the maxilla. Similar ISQ values and healing tendency were observed for straight and conical implants in the mandible. No significant differences in marginal bone loss were found between the straight and conical implants. However, in the mandible, slightly more marginal bone loss was found with the conical implants than straight implants after 12 weeks of healing. In conclusion, ISQ healing tendency and marginal bone loss are influenced by implant macro-design and jaw regions. Straight implants revealed similar ISQ healing tendency and marginal bone loss in both the mandible and maxilla. Conical implants were confirmed more beneficial for maintenance of implant stability and marginal bone level in the maxilla.
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Affiliation(s)
- Yi-Han Su
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Bou-Yue Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Peter-D Wang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Department of Periodontics, College of Dental Medicine, Columbia University, New York, USA
| | - Sheng-Wei Feng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan.
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Díaz-Castro MC, Falcao A, López-Jarana P, Falcao C, Ríos-Santos JV, Fernández-Palacín A, Herrero-Climent M. Repeatability of the resonance frequency analysis values in implants with a new technology. Med Oral Patol Oral Cir Bucal 2019; 24:e636-e642. [PMID: 31422408 PMCID: PMC6764718 DOI: 10.4317/medoral.22761] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 05/12/2019] [Indexed: 11/24/2022] Open
Abstract
Background Assess the reliability (by means of reproducibility and repeatability) of the PenguinRFA system, analyse the ISQ values of different implant types and correlate the ISQ with the insertion torque during the placement of the implant. Material and Methods 120 rough surface implants were placed in bovine bone (type II and III). The implants were divided into groups, according to its design. Once the implants were in place, the exact insertion torque was registered. Then, primary stability was measured by means of the resonance frequency analysis with the PenguinRFA and the Osstell ISQ devices. In each implant two transducers of each device were used. Three measurements were obtained with each transducer. Results The mean ISQ (implant stability quotient) of the whole sample is 67,70 ± 5,51. The Intraclass Correlation Coefficient (ICC) is 0,933 and 0,944 for transducers 1 and 2 respectively. The reproducibility is 0,906. The mean insertion torque is 24,54 ± 8,96N. The correlation between the ISQ and the insertion torque is 0,507 p<0,000 (MultiPeg 1) and 0,468 p<0,000 (MultiPeg 2) for bone type II and 0,533 p<0,801 (MultiPeg 1) and 0,193 p<0,140 (MultiPeg 2) for bone type III. Conclusions The results of the present trial suggest that the PenguinRFA presents excellent reproducibility and repeatability, so it could be very useful in the monitoring of the stability of implants over time. Additionally, according to the results, the correlation between the IT and the RFA is low and there are no statistically significant differences in between implant types. Key words:Implant stability, insertion torque, ISQ, osseointegration, implant-supported dental prostheses, immediate dental implant loading.
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Affiliation(s)
- M-C Díaz-Castro
- Facultad de Odontología, Universidad de Sevilla, C/ Avicena S/N, 41009 Sevilla, (Spain),
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Dayan C, Geckili O, Bural C. The Influence of Implant Shape on Primary Stability of Implants With a Thread Cutting and Forming Design: An Ex Vivo Study. J ORAL IMPLANTOL 2019; 45:181-185. [PMID: 30702967 DOI: 10.1563/aaid-joi-d-18-00158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The design of an implant has a great effect on primary stability. The purpose of this study was to determine the differences in primary stability between straight and tapered Neoss ProActive implants in type I and type III bones using resonance frequency analysis (RFA) and electronic percussive testing (EPT) methods. Fresh cow vertebrae and pelvis were used as models of type III and type i bone, respectively. Implants of 2 different designs-straight and tapered Neoss ProActive implants with a thread cutting and forming (TCF) design, both 3.5-mm wide and 11-mm long-were placed in both types of bone (n = 60). The primary stability of all implants was measured by an experienced clinician blinded to the study protocol using the EPT and RFA devices. No statistically significant difference was found between the implant stability quotients and the percussive test values of straight and tapered implants in either bone type. Within the limitations of this ex vivo study, it may be concluded that the shape of an implant with a TCF design does not affect primary stability.
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Affiliation(s)
- Cagatay Dayan
- 1 Program of Dental Technicians, Istanbul Cerrahpasa University, Istanbul, Turkey
| | - Onur Geckili
- 1 Program of Dental Technicians, Istanbul Cerrahpasa University, Istanbul, Turkey.,2 Department of Prosthodontics, Istanbul University, Faculty of Dentistry, Istanbul, Turkey
| | - Canan Bural
- 2 Department of Prosthodontics, Istanbul University, Faculty of Dentistry, Istanbul, Turkey
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Sciasci P, Casalle N, Vaz LG. Evaluation of primary stability in modified implants: Analysis by resonance frequency and insertion torque. Clin Implant Dent Relat Res 2018; 20:274-279. [DOI: 10.1111/cid.12574] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Plínio Sciasci
- Department of Diagnosis and Surgery; Araraquara Dental School, Unesp - Univ Estadual Paulista; Araraquara São Paulo Brazil
| | - Nicole Casalle
- Department of Dental Materials and Prosthodontics; Araraquara Dental School, Unesp - Univ Estadual Paulista; Araraquara São Paulo Brazil
| | - Luís Geraldo Vaz
- Department of Dental Materials and Prosthodontics; Araraquara Dental School, Unesp - Univ Estadual Paulista; Araraquara São Paulo Brazil
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Cobo-Vázquez C, Reininger D, Molinero-Mourelle P, González-Serrano J, Guisado-Moya B, López-Quiles J. Effect of the lack of primary stability in the survival of dental implants. J Clin Exp Dent 2018; 10:e14-e19. [PMID: 29670710 PMCID: PMC5899809 DOI: 10.4317/jced.54441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/18/2017] [Indexed: 11/22/2022] Open
Abstract
Background The survival of dental implants has been linked to primary stability. The aim of this study is to analyse the factors that influence the survival of dental implants placed without primary stability. Material and Methods A cohort study of implants placed without primary stability was carried out between September 2011 and July 2016. All cases with registered information on the patient and surgical intervention were used. Cases that did not have a 12-month follow-up after implant placement were excluded. Results Out of 2,400 analysed implants, 92 were placed without primary stability. The absence of primary stability was classified as B in 49 cases, C in 38 cases and D in 5 cases. No statistically significant influence of the patient’s age, primary stability, brand, or implant size in terms of implant survival was established. A tendency towards greater early implant loss was observed in implants whose absence of primary stability was classified as C. Conclusions Poor primary stability is not statistically significant in the loss of dental implants of the characteristics studied. Any of the factors studied are related with early implant loss as a main factor. Key words:Primary stability, survival, dental implants.
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Affiliation(s)
- Carlos Cobo-Vázquez
- DDS, MS, Clinical Assistant Professor, Department of Medicine and Oral Surgery, Faculty of Dentistry, Complutense University of Madrid
| | - David Reininger
- DDS, MS, Clinical Assistant Professor, Department of Medicine and Oral Surgery, Faculty of Dentistry, Complutense University of Madrid
| | - Pedro Molinero-Mourelle
- DDS, MS, PhD Student, Department of Orofacial Prosthetics. Faculty of Dentistry, Complutense University of Madrid
| | - José González-Serrano
- DDS, MS, Master's Student, Department of Medicine and Oral Surgery, Faculty of Dentistry, Complutense University of Madrid
| | - Blanca Guisado-Moya
- MD, DDS, PhD, Professor of Oral Surgery, Department of Medicine and Oral Surgery, Faculty of Dentistry, Complutense University of Madrid
| | - Juan López-Quiles
- MD, DDS, PhD, Professor of Oral Surgery, Department of Medicine and Oral Surgery, Faculty of Dentistry, Complutense University of Madrid
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Ayranci F, Sivrikaya EC, Omezli MM. Is bone density or implant design more important in implant stress formation in patients with bruxism? BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1376597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ferhat Ayranci
- Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey,
| | - Efe Can Sivrikaya
- Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey,
| | - M. Melih Omezli
- Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey,
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Relationship between implant stability on the abutment and platform level by means of resonance frequency analysis: A cross-sectional study. PLoS One 2017; 12:e0181873. [PMID: 28742164 PMCID: PMC5526494 DOI: 10.1371/journal.pone.0181873] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 07/07/2017] [Indexed: 12/03/2022] Open
Abstract
Resonance frequency analysis (RFA) has become the main tool used to assess the osseointegration of dental implants. The objective of this study was to verify the relationship between the ISQ values with different prosthetic abutments and with the implant platform. The hypothesis was that ISQ values changes according to the abutment height. Twelve patients were included, whose contribution to the study was 31 dental implants (external hexagon connection implants, 4.1x10 mm). The temporary implant-supported crown and prosthetic components were removed and the following smartpegs were inserted, one at a time: type 1, in the implant platform (G1); type A3, in the microunit component with 1mm transmucosal height (G2) and type A3, in the microunit component with 5mm transmucosal height (G3). In all the smartpegs, RFA measurements were taken on mesial, distal, buccal and lingual surfaces. All evaluations were performed by a single calibrated examiner (ICC = 0.989). Data were analyzed by Friedman and Spearman correlation tests and log-linear marginal regression (p<0.05). The mean age of participants was 52.83 (± 3.77) years. There was statistically significant difference (p<0.001) among the mean ISQ of G1 (88.27 ±5.70); G2 (72.75 ±4.73) and G3 (66.33 ±3.67). There was statistically significant negative correlation between the ISQ and the measurement distance (rs:-0.852; p<0.001; R2:0.553). Measurement distance was significantly associated (p<0.001) with ISQ value in the log-linear regression. The abutment height has a significant impact on resonance frequency analysis measurements. The higher the transmucosal abutment height, the lower the implant stability quotient value. Clinically, the ISQ measured on the abutment cannot be compared with values measured on the implant platform.
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Simmons DE, Maney P, Teitelbaum AG, Billiot S, Popat LJ, Palaiologou AA. Comparative evaluation of the stability of two different dental implant designs and surgical protocols-a pilot study. Int J Implant Dent 2017; 3:16. [PMID: 28466248 PMCID: PMC5411487 DOI: 10.1186/s40729-017-0078-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/22/2017] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols. Methods Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long. Group A received 10 tapered implants (OSPTX) (Astra Tech OsseoSpeed TX™) using the soft bone surgical protocol (TXSoft). Group B received 10 tapered implants (OSPTX) (AstraTech OsseoSpeedTX™) using the standard surgical protocol (TXStd). Group C received 10 parallel wall implants (OSP) (AstraTech OsseoSpeed™) using the standard surgical protocol (OStd). All implants were placed in the posterior maxilla in areas with a minimum of 8-mm crestal bone height. Resonance frequency measurements (implant stability quotient (ISQ)) and torque values were recorded to determine initial implant stability. All implants were uncovered 6 weeks after placement and restored with a functionally loaded resin provisional screw-retained crown. Resonance frequency measurements were recorded at the time of implant placement, at 6 weeks and 6 and 12 months. Twelve months after implant placement, the stability of the implants was recorded and the final restorations were placed using custom CAD/CAM fabricated abutments and cement-retained PFM DSIGN porcelain crowns. After implant restoration, bone levels were measured at 6 and 12 months with standardized radiographs. Results Radiographic mean bone loss was less than 0.5 mm in all groups, with no statistically significant differences between the groups. Implant survival rate at 1 year was 93.3%, with 2/30 implants failing to integrate prior to functional loading at 6 weeks. No statistically significant difference was found between ISQ measurements between the three groups at all time intervals measured. Strong positive correlations were found between overall bone loss at 6 months and insertion torque at time of placement. A very weak correlation was found between insertion torque and ISQ values at time of implant placement. Conclusions Survival and stability of OSPTX and OSP implants is comparable. Osteotomy preparation by either standard or soft bone surgical protocol presented no significant effect on implant survival and stability for the specific implant designs.
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Affiliation(s)
- David E Simmons
- Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA
| | - Pooja Maney
- Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA
| | - Austin G Teitelbaum
- Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA
| | - Susan Billiot
- Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA
| | - Lomesh J Popat
- Tulane University SPHTM, 1440 Canal St, Suite 2001, New Orleans, LA, 70130, USA
| | - A Archontia Palaiologou
- Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA.
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