Relation Between Insertion Torque and Implant Stability Quotient: A Clinical Study

Abstract Objectives This study aimed to assess the relation between the insertion torque and implant stability quotient (ISQ recorded immediately and 6 months after implant placement). Materials and Methods Twenty-five patients over the age of 18 years were selected for this study. One implant was placed per patient after tooth extraction. The implant site needed 15 mm in height and 8 mm in width. All implants had the same size (11.5 × 3.75 mm) and brand (Hexagonal Morse cone, DSP Biomedical). The insertion torque (Ncm) and resonance frequency analysis (ISQ value) (Osstell Mentor) were used to assess the primary stability (on the day of surgery). After 6 months, ISQ value was used to assess the secondary stability of each implant. Statistical Analysis The insertion torque data were correlated with ISQ measurements by using Pearson’s correlation. The significance level was 5%. Results There was a positive correlation between insertion torque and initial ISQ (correlation: 0.457; p = 0.022); however, no correlation was found between insertion torque and final ISQ (p = 0.308). Conclusion The present study demonstrated that there is a positive correlation between the insertion torque and the initial ISQ. Therefore, the higher the insertion torque, the higher the initial ISQ (or vice versa).

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Assessment of Dental Implant Stability in Areas Previously Submitted to Maxillary Sinus Elevation

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-17-00094 ◽

2018 ◽

Vol 44 (2) ◽

pp. 109-113 ◽

Cited By ~ 1

Author(s):

Karine Câmara Silva ◽

Elton Gonçalves Zenóbio ◽

Paulo Eduardo Alencar Souza ◽

Rodrigo Villamarim Soares ◽

Maurício Greco Cosso ◽

...

Keyword(s):

Resonance Frequency ◽

Maxillary Sinus ◽

Frequency Analysis ◽

Insertion Torque ◽

Sinus Lift ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Air Motor ◽

Implant Stability Quotient ◽

Secondary Stability

This study aimed to compare the primary and secondary stability, measured by resonance frequency analysis (RFA), in implants of different lengths installed in areas submitted to maxillary sinus lift. Correlation between RFA and implant insertion torque was also assessed. Twenty implants of 9 and 11 mm were inserted in areas submitted to maxillary sinus lift. The insertion torque was measured by the Bien Air motor. Osstell, through RFA, determined the implant stability quotient (ISQ) 2 times: the day of implant installation (T1) and 90 days after implant installation (T2). No differences were observed in the ISQ between T1 and T2 when the 20 implants were grouped, nor when the 9 mm implants were evaluated separately. In contrast, when the 11 mm values were evaluated separately, the ISQ was significantly higher in T2 than in T1 (P < .05). In T1, 9 mm implants had a higher ISQ than 11 mm ones (P < .05), whereas in T2, the implants of 11 mm showed a higher ISQ than did the 9 mm implants (P < .05). There was no difference in insertion torque between 9 and 11 mm implants (P > .05), nor was there a correlation between ISQ and insertion torque (P > .05). In conclusion, longer implants (11 mm) presented a significant increase in ISQ values during the healing period when installed in areas previously submitted to maxillary sinus lift. This phenomenon was not observed for shorter implants (9 mm). Finally, no correlation was observed between ISQ and insertion torque.

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Influence of Implant Dimensions and Position on Implant Stability: A Prospective Clinical Study in Maxilla Using Resonance Frequency Analysis

Applied Sciences ◽

10.3390/app9050860 ◽

2019 ◽

Vol 9 (5) ◽

pp. 860 ◽

Cited By ~ 4

Author(s):

Antonio Nappo ◽

Carlo Rengo ◽

Giuseppe Pantaleo ◽

Gianrico Spagnuolo ◽

Marco Ferrari

Keyword(s):

Resonance Frequency ◽

Dental Implant ◽

Frequency Analysis ◽

Primary Stability ◽

Prospective Clinical Study ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Implant Stability Quotient ◽

Implant Placement ◽

Implant System

Implant stability is relevant for the correct osseointegration and long-term success of dental implant treatments. The aim of this study has been to evaluate the influence of implant dimensions and position on primary and secondary stability of implants placed in maxilla using resonance frequency analysis. Thirty-one healthy patients who underwent dental implant placement were enrolled for the study. A total of 70 OsseoSpeed TX (Astra Tech Implant System—Dentsply Implants; Mölndal, Sweden) implants were placed. All implants have been placed according to a conventional two-stage surgical procedure according to the manufacturer instructions. Bone quality and implant stability quotient were recorded. Mean implant stability quotient (ISQ) at baseline (ISQ1) was statistically significant lower compared to 3-months post-implant placement (ISQ2) (p < 0.05). Initial implant stability was significantly higher with 4 mm diameter implants with respect to 3.5 mm. No differences were observed within maxilla regions. Implant length, diameter and maxillary regions have an influence on primary stability.

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Comparison of Implant Stability between Regenerated and Non-Regenerated Bone. A Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10153220 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3220

Author(s):

Marta Vallecillo-Rivas ◽

Candela Reyes-Botella ◽

Cristina Vallecillo ◽

María Jesús Lisbona-González Manuel Vallecillo-Capilla ◽

María Victoria Olmedo-Gaya

Keyword(s):

Cohort Study ◽

Bone Quality ◽

Frequency Analysis ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Native Bone ◽

Time Points ◽

Implant Stability Quotient ◽

Implant Placement ◽

Secondary Stability

Implant stability is one of the main indicators of successful osseointegration. Although it has been measured in numerous studies, there has been little research on implant stability in regenerated bone. The study compares primary and secondary stability between implants placed in regenerated versus native bone and evaluates the influence of bone quality on the results. Sixty implants were placed in 31 patients: 30 implants inserted in native bone (non-regenerated) after a healing period of at least 6 months post-exodontia and 30 inserted in regenerated bone at 6 months after grafting with xenograft. Resonance frequency analysis (RFA) was used to obtain implant stability quotient (ISQ) values at baseline (implant placement), 8 weeks, and 12 weeks. Statistically significant differences were found between implants placed in regenerated bone and those placed in native bone at all measurement time points (p < 0.05). ISQ values were significantly influenced by bone quality at baseline (p < 0.05) but not at 8 or 12 weeks. Greater stability was obtained in implants placed in native bone; however, those placed in regenerated bone showed adequate primary and secondary stability for prosthetic loading. Bone quality influences the primary but not secondary stability of the implants in both native and regenerated bone.

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Developing Stability of Posterior Mandibular Implants Placed With Osteotome Expansion Technique Compared With Conventional Drilling Techniques

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-16-00101 ◽

2017 ◽

Vol 43 (2) ◽

pp. 131-138 ◽

Cited By ~ 1

Author(s):

Yen-Ting Lin ◽

Adrienne Hong ◽

Ying-Chin Peng ◽

Hsiang-Hsi Hong

Keyword(s):

Bone Density ◽

Surgical Techniques ◽

Primary Stability ◽

Conventional Technique ◽

Implant Stability ◽

Implant Stability Quotient ◽

Expansion Technique ◽

The Stability ◽

Conventional Drilling ◽

Secondary Stability

Clinical decisions regarding the stability and osseointegration of mandibular implants positioned using the bone expansion techniques are conflicting and limited. The objective was to evaluate the stability of implants placed using 2 surgical techniques, selected according to the initial width of the mandibular posterior edentulous ridge, with D3 bone density, during a 12-week period. Fifty-eight implants in 33 patients were evaluated. Thirty-two implants in 24 patients were positioned using the osteotome expansion technique, and 26 fixtures in 17 patients were installed using the conventional drilling technique. The implant stability quotient values were recorded at weeks 0, 1, 2, 3, 4, 6, 8, 10, and 12 postsurgery and evaluated using analysis of variance, independent, and paired t tests. Calibrated according to the stability reading of a 3.3-mm diameter implant, the osteotome expansion group was associated with a lower bone density than the conventional group (64.96 ± 6.25 vs 68.98 ± 5.06, P = .011). The osteotome expansion group achieved a comparable primary stability (ISQb-0, P = .124) and greater increases in secondary stability (ISQb-12, P = .07) than did the conventional technique. A D3 quality ridge with mild horizontal deficiency is expandable by using the osteotome expansion technique. Although the 2 groups presented similar implant stability quotient readings during the study period, the osteotome expansion technique showed significant improvement in secondary stability. The healing patterns for these techniques are therefore inconsistent.

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New Implant Design with Midcrestal and Apical Wing Thread for Increased Implant Stability in Single Postextraction Maxillary Implant

Case Reports in Dentistry ◽

10.1155/2019/9529248 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Antonio Scarano ◽

Bartolomeo Assenza ◽

Francesco Inchingolo ◽

Filiberto Mastrangelo ◽

Felice Lorusso

Keyword(s):

Cortical Bone ◽

Dental Implant ◽

Alveolar Bone ◽

Primary Stability ◽

Implant Design ◽

Insertion Torque ◽

Fixture Design ◽

Implant Stability ◽

Implant Placement ◽

Immediate Placement

Background. The immediate placement of a dental implant could represent an option treatment for the rehabilitation of a postextractive missing tooth socket to replace compromised or untreatable teeth, with the advantage of single-session surgery. In this way, the anatomy of the alveolar bone defect, the preservation of the buccal cortical bone, and the primary stability of the fixture represent the critical factors that consent a precise implant placement. Objective. This case report describes a novel fixture design for postextractive alveolar socket immediate implant. Methods. Two patients (25 and 31 years old) were treated for postextractive dental implant placement to replace both central upper incisor teeth with four implants. The residual bone implant gap was not filled with graft or bone substitute. The restoration was provided following a standard loading protocol by a cement-sealed prosthetic abutment. Results. Clinically, all implants positioned showed an excellent insertion torque. No postoperative complications were reported. At 6 months of healing, the buccal cortical bone and the implant stability were present and well maintained. Conclusion. The evidence of this study allows us to underline the possible advantages of this new fixture design for postextractive implant technique.

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Relevant Design Aspects to Improve the Stability of Titanium Dental Implants

Materials ◽

10.3390/ma13081910 ◽

2020 ◽

Vol 13 (8) ◽

pp. 1910 ◽

Cited By ~ 4

Author(s):

M. Herrero-Climent ◽

P. López-Jarana ◽

B. F. Lemos ◽

F. J. Gil ◽

C. Falcão ◽

...

Keyword(s):

Primary Stability ◽

Insertion Torque ◽

Bovine Bone ◽

Resonance Frequency Analysis ◽

Everyday Clinical Practice ◽

Implant Stability Quotient ◽

The Stability ◽

The One ◽

Implant System ◽

Titanium Dental Implants

Post-extractional implants and immediate loading protocols are becoming much more frequent in everyday clinical practice. Given the existing literature about tapered implants, the objective of this paper was to understand whether implant shape had a direct influence on the results of the insertion torque (IT) and implant stability quotient (ISQ). Seven tapered implant prototypes were developed and distributed into three groups and compared with a control cylindrical implant—VEGA by Klockner Implant System. The implants were inserted into bovine bone type III according to Lekholm and Zarb Classification. The sample size was n = 30 for the three groups. Final IT was measured with a torquemeter, and the ISQ was measured with Penguin Resonance Frequency Analysis (RFA). Modifications done to the Prototype I did not reveal higher values of the ISQ and IT when compared to VEGA. In the second group, when comparing the five prototypes (II–VI) with VEGA, it was seen that the values of the ISQ and IT were not always higher, but there were two values of the ISQ that were statistically significantly higher with the 4.0 mm diameter Prototypes II (76.3 ± 6.1) and IV (78 ± 3.7). Prototype VII was the one with higher and significant values of the ISQ and IT. In both diameters and in both variables, all differences were statistically significant enough to achieve the higher values of primary stability values (IT and ISQ). Given the limitations of this study, it can be concluded that when there is an increase of the diameter of the implant and body taper, there is an increase of the ISQ and IT, showing that the diameter of the implant is an important criteria to obtain higher values of primary stability.

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Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients

Applied Sciences ◽

10.3390/app10228084 ◽

2020 ◽

Vol 10 (22) ◽

pp. 8084

Author(s):

Andreas Vollmer ◽

Babak Saravi ◽

Gernot Lang ◽

Nicolai Adolphs ◽

Derek Hazard ◽

...

Keyword(s):

Risk Stratification ◽

Predictive Factors ◽

Healing Time ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Implant Stability Quotient ◽

Primary Implant ◽

Preoperative Risk Stratification ◽

Implant Length ◽

Secondary Stability

The success rate of dental implants depends on primary and secondary stability. We investigate predictive factors for future risk stratification models. We retrospectively analyze 272 patients with a total of 582 implants. Implant stability is measured with resonance frequency analysis and evaluated based on the implant stability quotient (ISQ). A linear regression model with regression coefficients (reg. coeff.) and its 95% confidence interval (95% CI) is applied to assess predictive factors for implant stability. Implant diameter (reg. coeff.: 3.28; 95% CI: 1.89–4.66, p < 0.001), implant length (reg. coeff.: 0.67, 95% CI: 0.26–1.08, p < 0.001), and implant localization (maxillary vs. mandibular, reg. coeff.: −7.45, 95% CI: −8.70–(−6.20), p < 0.001) are significant prognostic factors for primary implant stability. An increase in ISQ between insertion and exposure is significantly correlated with healing time (reg. coeff.: 0.11, 95% CI: 0.04–0.19). Patients with maxillary implants have lower ISQ at insertion but show a higher increase in ISQ after insertion than patients with mandibular implants. We observe positive associations between primary implant stability and implant diameter, implant length, and localization (mandibular vs. maxillary). An increase in implant stability between insertion and exposure is significantly correlated with healing time and is higher for maxillary implants. These predictive factors should be further evaluated in prospective cohort studies to develop future preoperative risk-stratification models.

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Effects of Different Undersizing Site Preparations on Implant Stability

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238965 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8965

Author(s):

Bernardo Ferreira Lemos ◽

Paula Lopez-Jarana ◽

Carlos Falcao ◽

Blanca Ríos-Carrasco ◽

Javier Gil ◽

...

Keyword(s):

Primary Stability ◽

Immediate Loading ◽

Insertion Torque ◽

Bovine Bone ◽

Preparation Technique ◽

Standard Protocol ◽

Implant Stability ◽

Implant Stability Quotient ◽

Surgical Preparation ◽

Implant System

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant (p < 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully.

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Does the Osseodensification Technique Allow for the use of a Healing Chamber with Primary Stability in Low-Density Bone? An in Vivo Study

10.21203/rs.3.rs-462910/v1 ◽

2021 ◽

Author(s):

Rafael Coutinho Mello-Machado ◽

Suelen Cristina Sartoretto ◽

Jose Mauro Granjeiro ◽

José Albuquerque Calasans-Maia ◽

Marcelo Jose Guedes Pinheiro Uzeda ◽

...

Keyword(s):

Bone Remodeling ◽

Bone Growth ◽

Primary Stability ◽

Insertion Torque ◽

Low Density ◽

Implant Stability ◽

Bone Implant ◽

Implant Stability Quotient ◽

Implant Bed

Abstract This study aimed to investigate in vivo the hypothesis that the osseodensification technique, through a wider osteotomy, produce healing chambers at the implant-bone interface with no impact on primary stability osseointegration in low-density bone. Twenty implants (3.5 x 10 mm) presenting nanohydroxyapatite (nHA) surface were inserted in the ilium of ten sheep, after preparation of a 2.7-mm wide implant bed with conventional subtractive drilling (SCD) or a 3.8-mm wide implant bed with an osseodensification bur system (OBS) (n = 5/group/period). The final insertion torque (IT) and implant stability quotient (ISQ) evaluated the primary implant stability. After 14 and 28 days, the bone samples containing the implants were processed for histological and histomorphometric evaluation of bone implant contact (BIC) and bone area fraction occupancy (BAFO). No significant differences occurred between the implant bed preparations regarding IT and ISQ (P > 0.05). Histological analysis showed bone remodeling, and bone growth in all samples with no inflammatory infiltrate. BIC values were higher for SCD after 14 and 28 days (p < 0.05), however BAFO values were similar on both groups (p > 0.05). It was possible to conclude that the osseodensification technique allowed a wider implant bed preparation with no prejudice on primary stability and bone remodeling.

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Evaluation of Insertion Energy as Novel Parameter for Dental Implant Stability

Journal of Clinical Medicine ◽

10.3390/jcm9092977 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2977

Author(s):

Tanja Grobecker-Karl ◽

Anthony Dickinson ◽

Siegfried Heckmann ◽

Matthias Karl ◽

Constanze Steiner

Keyword(s):

Resonance Frequency ◽

Frequency Analysis ◽

Primary Stability ◽

Insertion Torque ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Time Curve ◽

Trapezoidal Formula ◽

Primary Implant ◽

Reliable Parameter

Insertion energy has been advocated as a novel measure for primary implant stability, but the effect of implant length, diameter, or surgical protocol remains unclear. Twenty implants from one specific bone level implant system were placed in layered polyurethane foam measuring maximum insertion torque, torque–time curves, and primary stability using resonance frequency analysis (RFA). Insertion energy was calculated as area under torque–time curve applying the trapezoidal formula. Statistical analysis was based on analysis of variance, Tukey honest differences tests and Pearson’s product moment correlation tests (α = 0.05). Implant stability (p = 0.01) and insertion energy (p < 0.01) differed significantly among groups, while maximum insertion torque did not (p = 0.17). Short implants showed a significant decrease in implant stability (p = 0.01), while reducing implant diameter did not cause any significant effect. Applying the drilling protocol for dense bone resulted in significantly increased insertion energy (p = 0.02) but a significant decrease in implant stability (p = 0.04). Insertion energy was not found to be a more reliable parameter for evaluating primary implant stability when compared to maximum insertion torque and resonance frequency analysis.

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