Keywords
How to Cite
Abstract
Aim: This study evaluated the influence of surgical undersized drilling on insertion torque of an implant system at low bone density. Methods: Implant site preparations were made in two polyurethane foam blocks with different densities, where two preparation techniques were considered: Control group (C): conventional drilling, following the manufacturer’s instructions; and Group (E): undersized drilling, experimental technique using a final surgical drill with reduced diameter. The artificial bone blocks were selected based on density: D1 (0.64 g/cm3) and D2 (0.32 g/cm3). Three groups were considered according to the preparation technique and bone density used (n=10): CD1 – conventional drilling technique in artificial bone with higher density; CD2 – conventional drilling technique in artificial bone with lower density; and ED2 – undersized drilling in artificial bone with lower density. Externalhexagon implants (11 × 4 mm) were inserted and the insertion torque values were measured using a digital torque-meter. Data were submitted to one-way ANOVA followed by Tukey’s test (α=0.05). Results: The results showed significant statistical differences between groups (p<0.001), where the highest insertion torque was found for the Group CD1 (48.9 Ncm) followed by Group ED2 (22.6 Ncm) and Group CD2 (11.7 Ncm). Conclusions: The undersized drilling technique for implant site preparation leads to increased insertion torque on low bone density.
References
Heinemann F, Hasan I, Bourauel C, Biffar R, Mundt T. Bone stability around dental implants: Treatment related factors. Ann Anat. 2015 May;199:3-8. doi: 10.1016/j.aanat.2015.02.004.
Javed F, Ahmed HB, Crespi R, Romanos GE. Role of primary stability for successful osseointegration of dental implants: Factors of influence and evaluation. Interv Med Appl Sci. 2013 Dec;5(4):162-7. doi: 10.1556/IMAS.5.2013.4.3.
Chong L, Khocht A, Suzuki JB, Gaughan J. Effect of implant design on initial stability of tapered implants. J Oral Implantol. 2009;35(3):130-5. doi: 10.1563/1548-1336-35.3.130. doi: 10.1563/1548-1336-35.3.130.
Mohlhenrich SC, Heussen N, Elvers D, Steiner T, Holzle F, Modabber A. Compensating for poor primary implant stability in different bone densities by varying implant geometry: a laboratory study. Int J Oral Maxillofac Surg. 2015 Dec;44(12):1514-20. doi: 10.1016/j. ijom.2015.08.985.
Trisi P, Berardi D, Paolantonio M, Spoto G, D’Addona A, Perfetti G. Primary stability, insertion torque, and bone density of conical implants with internal hexagon: is there a relationship. J Craniofac Surg. 2013 May;24(3):841-4. doi: 10.1097/SCS.0b013e31827c9e01.
Ostman PO, Hellman M, Wendelhag I, Sennerby L. Resonance frequency analysis measurements of implants at placement surgery. Int J Prosthodont. 2006 Jan-Feb;19(1):77-83.
Akkocaoglu M, Uysal S, Tekdemir I, Akca K, Cehreli MC. Implant design and intraosseous stability of immediately placed implants: a human cadaver study. Clin Oral Implants Res. 2005 Apr;16(2):202-9.
Jemt T, Stenport V. Implant treatment with fixed prostheses in the edentulous maxilla. Part 2: prosthetic technique and clinical maintenance in two patient cohorts restored between 1986 and 1987 and 15 years later. Int J Prosthodont. 2011 Jul-Aug;24(4):356-62.
Jemt T, Stenport V, Friberg B. Implant treatment with fixed prostheses in the edentulous maxilla. Part 1: implants and biologic response in two patient cohorts restored between 1986 and 1987 and 15 years later. Int J Prosthodont. 2011 Jul-Aug;24(4):345-55.
Shibli JA, Mangano C, Mangano F, Rodrigues JA, Cassoni A, Bechara K, et al. Bone-to-implant contact around immediately loaded direct laser metal-forming transitional implants in human posterior maxilla. J Periodontol. 2013 Jun;84(6):732-7. doi: 10.1902/jop.2012.120126.
Friberg B, Ekestubbe A, Sennerby L. Clinical outcome of Branemark System implants of various diameters: a retrospective study. Int J Oral Maxillofac Implants. 2002 Sep-Oct;17(5):671-7.
Irinakis T, Wiebe C. Initial torque stability of a new bone condensing dental implant. A cohort study of 140 consecutively placed implants. J Oral Implantol. 2009;35(6):277-82. doi: 10.1563/AAIDJOI-D-09-00020.1.
Tabassum A, Meijer GJ, Wolke JG, Jansen JA. Influence of surgical technique and surface roughness on the primary stability of an implant in artificial bone with different cortical thickness: a laboratory study. Clin Oral Implants Res. 2010 Feb;21(2):213-20. doi: 10.1111/j.16000501.2009.01823.x.
Bilhan H, Geckili O, Mumcu E, Bozdag E, Sunbuloglu E, Kutay O. Influence of surgical technique, implant shape and diameter on the primary stability in cancellous bone. J Oral Rehabil. 2010 Dec;37(12):900-7. doi: 10.1111/j.1365-2842.2010.02117.x.
Mohlhenrich SC, Modabber A, Steiner T, Mitchell DA, Holzle F. Heat generation and drill wear during dental implant site preparation: systematic review. Br J Oral Maxillofac Surg. 2015 Oct;53(8):679-89. doi: 10.1016/j.bjoms.2015.05.004.
Mohlhenrich SC, Heussen N, Loberg C, Goloborodko E, Holzle F, Modabber A. Three-Dimensional Evaluation of Implant Bed Preparation and the Influence on Primary Implant Stability After Using 2 Different Surgical Techniques. J Oral Maxillofac Surg. 2015 Sep;73(9):1723-32. doi: 10.1016/j.joms.2015.03.071.
Wu SW, Lee CC, Fu PY, Lin SC. The effects of flute shape and thread profile on the insertion torque and primary stability of dental implants. Med Eng Phys. 2012 Sep;34(7):797-805. doi: 10.1016/j. medengphy.2011.09.021.
Hsu JT, Huang HL, Chang CH, Tsai MT, Hung WC, Fuh LJ. Relationship of three-dimensional bone-to-implant contact to primary implant stability and peri-implant bone strain in immediate loading: microcomputed tomographic and in vitro analyses. Int J Oral Maxillofac Implants. 2013 Mar-Apr;28(2):367-74. doi: 10.11607/ jomi.2407.
Wang TM, Lee MS, Wang JS, Lin LD. The effect of implant design and bone quality on insertion torque, resonance frequency analysis, and insertion energy during implant placement in low or low- to mediumdensity bone. Int J Prosthodont. 2015 Jan-Feb;28(1):40-7. doi: 10.11607/ijp.4063.
Hsu JT, Fuh LJ, Tu MG, Li YF, Chen KT, Huang HL. The effects of cortical bone thickness and trabecular bone strength on noninvasive measures of the implant primary stability using synthetic bone models. Clin Implant Dent Relat Res. 2013 Apr;15(2):251-61. doi: 10.1111/j.1708-8208.2011.00349.x.
Suer BT, Yaman Z, Buyuksarac B. Correlation of Fractal Dimension Values with Implant Insertion Torque and Resonance Frequency Values at Implant Recipient Sites. Int J Oral Maxillofac Implants. 2016 Jan-Feb;31(1):55-62. doi: 10.11607/jomi.3965.
Wang R, Eppell SJ, Nguyen C, Morris N. Relative contribution of trabecular and cortical bone to primary implant stability: an in vitro model study. J Oral Implantol. 2015 Apr;42(2):145-52. doi: 10.1563/ aaid-joi-D-14-00322.
Magno Filho LC, Cirano FR, Hayashi F, Feng HS, Conte A, Dib LL, et al. Assessment of the correlation between insertion torque and resonance frequency analysis of implants placed in bone tissue of different densities. J Oral Implantol. 2014 Jun;40(3):259-62. doi: 10.1563/AAID-JOI-D-11-00183.
Herekar M, Sethi M, Ahmad T, Fernandes AS, Patil V, Kulkarni H. A correlation between bone (B), insertion torque (IT), and implant stability (S): BITS score. J Prosthet Dent. 2014 Oct;112(4):805-10. doi: 10.1016/j.prosdent.2014.02.011.
Degidi M, Daprile G, Piattelli A. Primary stability determination by means of insertion torque and RFA in a sample of 4,135 implants. Clin Implant Dent Relat Res. 2012 Aug;14(4):501-7. doi: 10.1111/j.17088208.2010.00302.x.
Coelho PG, Marin C, Teixeira HS, Campos FE, Gomes JB, Guastaldi F, et al. Biomechanical evaluation of undersized drilling on implant biomechanical stability at early implantation times. J Oral Maxillofac Surg. 2013 Feb;71(2):e69-75. doi: 10.1016/j.joms.2012.10.008.
Al-Marshood MM, Junker R, Al-Rasheed A, Al Farraj Aldosari A, Jansen JA, Anil S. Study of the osseointegration of dental implants placed with an adapted surgical technique. Clin Oral Implants Res. 2011 Jul;22(7):753-9. doi: 10.1111/j.1600-0501.2010.02055.x.
Fanuscu MI, Chang TL, Akça K. Effect of surgical techniques on primary implant stability and peri-implant bone. J Oral Maxillofac Surg. 2007;65 (12):2487–91.
Dos Santos MV, Elias CN, Cavalcanti Lima JH. The effects of superficial roughness and design on the primary stability of dental implants. Clin Implant Dent Relat Res. 2011 Sep;13(3):215-23. doi: 10.1111/j.1708-8208.2009.00202.x.
The Brazilian Journal of Oral Sciences uses the Creative Commons license (CC), thus preserving the integrity of the articles in an open access environment.
Downloads
