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Romasco T, De Bortoli Jr N, Paulo De Bortoli J, Jorge Jayme S, Piattelli A, Di Pietro N. Primary stability evaluation of different morse cone implants in low-density artificial bone blocks: A comparison between high-and low-speed drilling. Heliyon 2024; 10:e35225. [PMID: 39170202 PMCID: PMC11336439 DOI: 10.1016/j.heliyon.2024.e35225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 08/23/2024] Open
Abstract
This study aimed to evaluate various biomechanical parameters associated with the primary stability of Maestro and Due Cone implants placed in low-density artificial bones, prepared using high-speed drilling with irrigation and low-speed drilling without irrigation. The insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ) values were recorded for Maestro and Due Cone implants placed in low-density polyurethane blocks (10 and 20 pounds per cubic foot (PCF) with and without a cortical layer) prepared using high-speed and low-speed with or without irrigation using a saline solution, respectively. A three-way ANOVA model and Tukey's post-hoc test were conducted, presenting data as means and standard deviations. P-values equal to or less than 0.05 were considered statistically significant. No statistically significant differences in IT, RT, and ISQ between drilling speeds were observed. However, Maestro implants exhibited lower IT and RT values after high- and low-speed drilling across almost all polyurethane blocks, significantly evident in the 20 PCF density block for IT and in the 20 PCF density block with the cortical layer for the RT with low-speed drilling (IT: 47.33 ± 10.02 Ncm and 16.00 ± 12.49 Ncm for Due Cone and Maestro implants, respectively, with p < 0.01; RT: 44.67 ± 22.81 Ncm and 20.01 ± 4.36 Ncm for Due Cone and Maestro implants, respectively, with p < 0.05) and among the same implant types inserted in different bone densities. Additionally, the study found that for all bone densities and drilling speeds, both implants registered ISQ values exceeding 60, except for the lowest-density polyurethane block. Overall, it can be inferred that low-speed drilling without irrigation achieved biomechanical parameters similar to conventional drilling with both implant types, even with lower IT values in the case of Maestro implants. These findings suggest a promising potential use of low-speed drilling without irrigation in specific clinical scenarios, particularly when focusing on preparation depth or when ensuring proper irrigation is challenging.
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Affiliation(s)
- Tea Romasco
- Center for Advanced Studies and Technology-CAST, “G. D'Annunzio” University of Chieti-Pescara, Via Luigi Polacchi 11, 66100, Chieti, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D'Annunzio” University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
| | - Nilton De Bortoli Jr
- Department of Oral Implantology, Associação Paulista Dos Cirurgiões Dentistas-APCD, São Bernardo Do Campo, 02011-000, Brazil
| | - Joao Paulo De Bortoli
- Biomaterials Division, New York University College of Dentistry, New York, 10010, NY, USA
| | - Sergio Jorge Jayme
- Department of Dental Materials and Prosthetics, School of Dentistry of Ribeirão Preto, University of São Paulo, 14040-904, Ribeirão Preto, SP, Brazil
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International, University of Health and Medical Sciences, Via di Sant’Alessandro 8, 00131, Rome, Italy
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, Av. de Los Jerónimos 135, 30107, Guadalupe de Maciascoque, Spain
| | - Natalia Di Pietro
- Center for Advanced Studies and Technology-CAST, “G. D'Annunzio” University of Chieti-Pescara, Via Luigi Polacchi 11, 66100, Chieti, Italy
- Department of Medical, Oral and Biotechnological Sciences, “G. D'Annunzio” University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
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Jar C, Archibald A, Gibson M, Westover L. Evaluation of a vibration modeling technique for the in-vitro measurement of dental implant stability. J Mech Behav Biomed Mater 2024; 154:106537. [PMID: 38588632 DOI: 10.1016/j.jmbbm.2024.106537] [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: 02/07/2024] [Revised: 03/06/2024] [Accepted: 04/01/2024] [Indexed: 04/10/2024]
Abstract
The Advanced System for Implant Stability Testing (ASIST) is a device currently being developed to noninvasively measure implant stability by estimating the mechanical stiffness of the bone-implant interface, which is reported as the ASIST Stability Coefficient (ASC). This study's purpose was to determine whether changes in density, bonding, and drilling technique affect the measured vibration of a dental implant, and whether they can be quantified as a change in the estimated BII stiffness. Stability was also measured using RFA, insertion torque (IT) and the pullout test. Bone-level tapered implants (4.1 mm diameter, 10 mm length) were inserted in polyurethane foam as an artificial bone substitute. Samples were prepared using different bone densities (20, 30, 40 PCF), drilling sequences, and superglue to simulate a bonded implant. Measurements were compared across groups at a significance level of 0.05. The ASC was able to indicate changes in each factor as a change in the interfacial stiffness. IT and pullout force values also showed comparable increases. Furthermore, the relative difference in ISQ values between experimental groups was considerably smaller than the ASC. While future work should be done using biological bone and in-vivo systems, the results of this in-vitro study suggest that modelling of the implant system with a vibration-based approach may provide a noninvasive method of assessing the mechanical stability of the implant.
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Affiliation(s)
- Chester Jar
- University of Alberta, Department of Mechanical Engineering, Edmonton, Alberta, T6G 2R3, Canada.
| | - Andrew Archibald
- University of Alberta, Department of Medicine, Edmonton, Alberta, T6G 2R3, Canada.
| | - Monica Gibson
- University of Alberta, Department of Dentistry, Edmonton, Alberta, T6G 2R3, Canada.
| | - Lindsey Westover
- University of Alberta, Department of Mechanical Engineering, Edmonton, Alberta, T6G 2R3, Canada; University of Alberta, Department of Biomedical Engineering, Edmonton, Alberta, T6G 2R3, Canada.
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Can the design of the instruments used for undersized osteotomies influence the initial stability of implants installed in low-density bone? An in vitro pilot study. PLoS One 2021; 16:e0257985. [PMID: 34618848 PMCID: PMC8496820 DOI: 10.1371/journal.pone.0257985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/14/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives The aims of this study were to compare the initial implant stability obtained using four different osteotomy techniques in low-density synthetic bone, to evaluate the instrument design in comparison to the implant design, and to determinate a possible correlation between the insertion torque and initial stability quotient (ISQ). Materials and methods Four groups were identified in accordance with the osteotomy technique used (n = 10 implants per group): group G1, osteotomy using the recommended drilling sequence; group G2, osteotomy using an undersized compactor drill; group G3, osteotomy using an undersized drill; and group G4, osteotomy using universal osseodensification drills. Two polyurethane blocks were used: block 1, with a medullary portion of 10 pounds per cubic foot (PCF 10) and with a 1 mm cortical portion of PCF 40, and block 2, with a medullary of PCF 15 and with a 2 mm cortical portion of PCF 40. Tapered implants of 4 mm in diameter and 11 mm in length were used. The insertion torque (IT) and ISQ were measured. The dimensions of the final instrument used in each group and the dimensions of the implant were used to calculate the total area of each part, and these data were compared. Results Differences between the four groups were found for IT and ISQ values depending on the technique used for the osteotomy in the two synthetic bone models (p < 0.0001). All groups showed lower values of initial stability in block 1 than in block 2. Conclusions Undersized osteotomies with instruments designed according to the implant body significantly increased the initial stability values compared to beds prepared with universal drills and using the drilling sequence standardized by the manufacturer.
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