Primary Stability of Short Implants Inserted Using Piezoelectric or Drilling Systems: An In Vitro Comparison

2019 ◽  
Vol 45 (4) ◽  
pp. 259-266
Author(s):  
Claudio Stacchi ◽  
Matteo De Biasi ◽  
Lucio Torelli ◽  
Massimo Robiony ◽  
Roberto Di Lenarda ◽  
...  

The primary objective of the present in vitro study was to evaluate the influence of implant site preparation technique (drills vs ultrasonic instrumentation) on the primary stability of short dental implants with two different designs inserted in simulated low-quality cancellous bone. Eighty implant sites were prepared in custom-made solid rigid polyurethane blocks with two different low cancellous bone densities (5 or 15 pounds per cubic foot [PCF]), equally distributed between piezoelectric (Surgysonic Moto, Esacrom, Italy) and conventional drilling techniques. Two short implant systems (Prama and Syra, Sweden & Martina) were tested by inserting 40 fixtures of each system (both 6.0 mm length and 5.0 mm diameter), divided in the four subgroups (drills/5 PCF density; drills/15 PCF density; piezo/5 PCF density; piezo/15 PCF density). Insertion torque (Ncm), implant stability quotient values, removal torque (Ncm), and surgical time were recorded. Data were analyzed by 3-way ANOVA and Scheffé's test (α = 0.05). With slight variations among the considered dependent variables, overall high primary implant stability was observed across all subgroups. Piezoelectric instrumentation allowed for comparable or slightly superior primary stability in comparison with the drilling procedures in both implant systems. The Prama implants group showed the highest mean reverse torque and Syra implants the highest implant stability quotient values. Piezoelectric implant site preparation took prolonged operative time compared to conventional preparation with drills; among the drilling procedures, Syra system required fewer surgical steps and shorter operative time.

Author(s):  
Bernardo Ferreira Lemos ◽  
Paula Lopez-Jarana ◽  
Carlos Falcao ◽  
Blanca Ríos-Carrasco ◽  
Javier Gil ◽  
...  

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.


2013 ◽  
Vol 39 (1) ◽  
pp. 52-57
Author(s):  
Philipp Kreißel ◽  
Felix Kölpin ◽  
Friedrich Graef ◽  
Manfred Wichmann ◽  
Matthias Karl

Achieving sufficient primary implant stability in poor-quality bone is difficult. Other than for conventional osteotomes, little is known about the effectiveness of screw-shaped spreaders in condensing bone and increasing primary stability. Therefore, implant stability quotient (ISQ) measurements of implants placed in bone surrogate models were conducted. Whereas bony microarchitecture had no effect on implant stability, initial bone density, presence of a cortical layer, and the use of screw-shaped spreaders significantly increased ISQ levels.


Author(s):  
Mariano Herrero-Climent ◽  
Bernardo Ferreira Lemos ◽  
Federico Herrero-Climent ◽  
Carlos Falcao ◽  
Helder Oliveira ◽  
...  

The aim of this study was to evaluate the effects of different implant sites an under-preparation sequence associated with two different implant designs on implant primary stability measured by two parameters: insertion torque (IT) and implant stability quotient (ISQ). It used two different implants: one cylindrical as a control and another one with a tapered design. The implants were inserted in type III fresh humid bovine bone and four drilling sequences were used: one control, the one proposed by the implant company (P1), and three different undersized (P2, P3 and P4). P2 was the same as P1 without the cortical drill, P3 was without the last pilot drill and P4 was without both of them. The sample size was n = 40 for each of the eight groups. Final IT was measured with a torquemeter and the ISQ was measured with Penguin resonance frequency analysis. Results showed that both ISQ and IT have a tendency to increase as the preparation technique reduces the implant site diameter when compared with the standard preparation, P1. The preparations without cortical drill, P2 and P4, showed the best results when compared with the ones with a cortical drill. Tapered implants always showed higher or the same ISQ and IT values when compared with the cylindrical implants. Giving the limitations of this study, it can be concluded that reducing implant preparation can increase IT and ISQ values. Removing the cortical drill and the use of a tapered design implant are also effective methods of increasing primary implant stability.


2014 ◽  
Vol 23 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Shweta A. Gandhi ◽  
Justin A. Baker ◽  
Latifa Bairam ◽  
Hyeong-Il Kim ◽  
Elaine L. Davis ◽  
...  

2020 ◽  
Vol 10 (24) ◽  
pp. 8909
Author(s):  
Alberto Rebaudi ◽  
Federico Rebaudi ◽  
Fabrizio Barberis ◽  
Gilberto Sammartino ◽  
Gaetano Marenzi

Background: The conventional drill technique is the most commonly used for the implant site preparation of the desired diameter and length. Ultrasonic implant site preparation (UISP) can also be used to perform an implant site preparation of the desired dimensions. Methods: Implant sites were prepared in fresh bone ribs with two different implant site preparation techniques: implant surgical drills and piezoelectric tips. Samples were analyzed with scanning electron microscopy (SEM) for evaluating the peri-implant bone damage. Result: In the surgical drills group, the cortical bone surface showed several cracks and the bone vascular canals were hidden by a dense smear layer. Cancellous bone showed large irregularities and trabecular fractures. The piezoelectric group showed a clean and smooth cortical bone surface with opened bone vascular canals; the cancellous bone presented a regular morphology, and the trabecular spaces, clearly visible, were free of debris. Conclusions: Ultrasonic implant site preparation showed cleaner bone surfaces and lower bone trauma compared with the preparation using implant surgical drills.


2018 ◽  
Vol 29 ◽  
pp. 297-297
Author(s):  
Alexandre Campos Montenegro ◽  
Mario Vieira Neto ◽  
Gonçalo Pimentel Neto ◽  
Silvana Pizzini Montenegro ◽  
Kamila Temponi ◽  
...  

2017 ◽  
Vol 43 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Yen-Ting Lin ◽  
Adrienne Hong ◽  
Ying-Chin Peng ◽  
Hsiang-Hsi Hong

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.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Michele Maglione ◽  
Lorenzo Bevilacqua ◽  
Federica Dotto ◽  
Fulvia Costantinides ◽  
Felice Lorusso ◽  
...  

Purpose. Recent advances show that ultrasonic implant site osteotomy is related to a decreased trauma and a better postoperative healing of the surgical site when compared to traditional drilling techniques. The micrometric bone cutting control and the operative advantages related to the piezoelectric approach are also characterized by a learning curve for the clinician in surgical practice and an increased operative duration of the procedure. The aim of this investigation is to compare the operative time, the postoperative pain, and the amount of painkillers taken by the patient during the healing period. Methods. A total of 65 patients were treated at the Unit of Oral Surgery (Department of Medical Sciences, Surgery and Health, University of Trieste, Italy) using a split mouth model: 75 drill-inserted implants (G1) and 75 piezoelectric device-inserted implants (G2) were placed. The Visual Analogue Scale (VAS) was performed to evaluate the postoperative pain at 15 days from surgery. The operative time and frequency of intake of painkillers were measured. Results. The G1 and G2 groups showed a significant difference with a higher use of painkillers observed for G1. The G2 patients showed a lower level of pain (VAS) at all experimental times between 8 hours to 7 days (p<0.01) postsurgery. At 15 days, the pain levels were similar for both groups. No differences were found in site preparation duration between the study groups. Conclusions. The evidence supports the application of the piezoelectric approach compared to the drill’s osteotomy as a useful technique for implant site preparation. This trial is registered with NCT03978923.


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