Effect of Rotating Osteotomes on Primary Implant Stability—An In Vitro Investigation

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.

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

Journal of Oral Implantology ◽

10.1563/aaid-joi-18-00157 ◽

2019 ◽

Vol 45 (4) ◽

pp. 259-266

Author(s):

Claudio Stacchi ◽

Matteo De Biasi ◽

Lucio Torelli ◽

Massimo Robiony ◽

Roberto Di Lenarda ◽

...

Keyword(s):

Cancellous Bone ◽

Operative Time ◽

Primary Stability ◽

Site Preparation ◽

Preparation Technique ◽

Implant Stability ◽

Implant Stability Quotient ◽

Custom Made ◽

Implant Site Preparation

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.

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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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In Vitro Investigation of the Dependency Between Abutment Length and Implant Stability Quotient (ISQ) for Stability Measurements on Bone Anchored Hearing Implant Systems

Otology & Neurotology ◽

10.1097/mao.0000000000002620 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Morten Høgsbro ◽

Andreas Agger ◽

Lars Vendelbo Johansen ◽

Michael Gaihede

Keyword(s):

Implant Stability ◽

Implant Stability Quotient ◽

In Vitro Investigation ◽

Stability Measurements

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An In Vitro Evaluation of Primary Stability Values for Two Differently Designed Implants to Suit Immediate Loading in Very Soft Bone

Dentistry Journal ◽

10.3390/dj9010005 ◽

2021 ◽

Vol 9 (1) ◽

pp. 5

Author(s):

Dirk Krischik ◽

Selen Ergin Tokgöz ◽

Andreas van Orten ◽

Anton Friedmann ◽

Hakan Bilhan

Keyword(s):

Dental Implants ◽

Primary Stability ◽

Poor Quality ◽

Immediate Loading ◽

Standard Protocol ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Sufficient Stability ◽

Implant Bed

The achievement of sufficient implant stability in poor quality bone seems to be a challenge. Most manufacturers develop special dental implants, which are claimed to show higher stability even in very soft bone. The aim of this experimental study was to compare two recently introduced dental implants with differing thread designs. A total of 11 implants of each group were inserted in the part of the fresh bovine ribs, corresponding to very soft bone. The primary stability was measured with resonance frequency analysis (RFA) and Periotest; the average of two measurements for each method and for each implant was taken and statistical analysis was applied. The highest stability values were obtained with the ICX Active Master implants, followed by the Conelog® Progressive-Line implants placed with the very soft bone protocol. The primary stability values of the Conelog® Progressive-Line implants inserted by the very soft bone protocol and the ICX Active Master implants placed with the standard protocol showed sufficient stability for immediate loading in low-density bone. Within the limitations of this study, the thread design of the implants and underdimensioned implant bed preparation seem to be effective for better primary stability in cancellous bone.

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Relative Contribution of Trabecular and Cortical Bone to Primary Implant Stability: An In Vitro Model Study

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-14-00322 ◽

2016 ◽

Vol 42 (2) ◽

pp. 145-152 ◽

Cited By ~ 6

Author(s):

Russell Wang ◽

Steven J. Eppell ◽

Christian Nguyen ◽

Nathan Morris

Keyword(s):

Trabecular Bone ◽

Cortical Bone ◽

Quantitative Information ◽

Cortical Layer ◽

Insertion Torque ◽

Implant Stability ◽

Relative Contribution ◽

Primary Implant ◽

Torque Values

The specific aim of this study was to examine the relative contributions to the implant insertion torque value (ITV) by cortical and trabecular components of an in vitro bone model. Simulated bone blocks of polyurethane were used with 2 densities of foam (0.08 g/cm3 to mimic trabecular bone and 0.64 g/cm3 to mimic cortical bone). We have developed a new platform technology to collect data that enables quantitative evaluation of ITV at different implant locations. Seven groups were used to model varying thicknesses of cortical bone over a lower-quality trabecular bone that have clinical significance: a solid 0.08 g/cm3 block; 1 mm, 2 mm, and 3 mm thick 0.64 g/cm3 sheets with no underlayer; and 1 mm, 2 mm, and 3 mm thick 0.64 g/cm3 sheets laminated on top of a 4 cm thick 0.08 g/cm3 block. The ITVs were recorded as a function of insertion displacement distance. Relative contributions of ITV ranged from 3% to 18% from trabecular bone, and 62% to 74% from cortical bone depending on the thickness of the cortical layer. Inserting an implant into 2-mm and 3-mm cortical layers laminated atop trabecular blocks had a synergistic effect on ITVs. Finally, an implant with a reverse bevel design near the abutment showed final average torque values that were 14% to 34% less than their maximum torque values. This work provides basic quantitative information for clinicians to understand the influence of composite layers of bone in relation to mechanical torque resistances during implant insertion in order to obtain desired primary implant stability.

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Bone Density and Implant Primary Stability. A Study on Equine Bone Blocks

Dentistry Journal ◽

10.3390/dj7030073 ◽

2019 ◽

Vol 7 (3) ◽

pp. 73 ◽

Cited By ~ 2

Author(s):

Francesco Orlando ◽

Federico Arosio ◽

Paolo Arosio ◽

Danilo Alessio Di Stefano

Keyword(s):

Mechanical Properties ◽

Bone Density ◽

Alveolar Bone ◽

Linear Regression Analysis ◽

Primary Stability ◽

Insertion Torque ◽

Implant Stability ◽

Primary Implant ◽

Physical Density ◽

Equine Bone

Previous results on synthetic blocks mimicking bone indicate that bone density can be measured by the friction encountered by a rotating probe while it descends into bone, and that primary implant stability may be measured through the integral (I) of the torque–depth curve at implant insertion. This study aims to repeat those tests on collagen-preserving equine bone blocks as they better reproduce the mechanical properties of natural bone. Fifteen cancellous equine blocks had their density measured using a measuring probe. This was compared to their known physical density through linear regression analysis. Implant placement was carried out into six cancellous equine blocks and primary stability was measured using (I), as well as the insertion torque (IT), the implant stability quotient (ISQ), and the reverse torque (RT). The relation between (I), (IT), (ISQ), and (RT) was investigated by correlation analysis. Bone density measured using the probe correlated significantly with actual density, both with (r = 0.764) and without irrigation (r = 0.977). (I) correlated significantly with IT and RT under all irrigation conditions, and with ISQ only without irrigation (r = 0.886). The results suggest that the probe provides actual bone density measurements. They also indicate that (I) measures primary implant stability and is more sensitive to density variations than IT, RT, and ISQ. Results are consistent with those obtained on synthetic blocks but suggest that equine bone blocks may better reproduce the mechanical properties of human cancellous alveolar bone. This should be the subject of additional studies.

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Insertion torque/time integral as a measure of primary implant stability

Biomedical Engineering / Biomedizinische Technik ◽

10.1515/bmt-2020-0039 ◽

2020 ◽

Vol 65 (6) ◽

pp. 729-733

Author(s):

Tanja Grobecker-Karl ◽

Matthias Karl ◽

Constanze Steiner

Keyword(s):

Cortical Layer ◽

Implant Design ◽

Insertion Torque ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Time Integral ◽

Primary Implant ◽

Medium Quality ◽

Bone Level

AbstractThe goal of this in vitro study was to determine the insertion torque/time integral for three implant systems. Bone level implants (n = 10; BLT – Straumann Bone Level Tapered 4.1 mm × 12 mm, V3 – MIS V3 3.9 mm × 11.5 mm, ASTRA – Dentsply-Sirona ASTRA TX 4.0 mm × 13 mm) were placed in polyurethane foam material consisting of a trabecular and a cortical layer applying protocols for medium quality bone. Besides measuring maximum insertion torque and primary implant stability using resonance frequency analysis (RFA), torque time curves recorded during insertion were used for calculating insertion torque/time integrals. Statistical analysis was based on ANOVA, Tukey’s honest differences test and Pearson product moment correlation (α = 0.05). Significantly greater mean maximum insertion torque (59.9 ± 4.94 Ncm) and mean maximum insertion torque/time integral (961.64 ± 54.07 Ncm∗s) were recorded for BLT implants (p < 0.01). V3 showed significantly higher mean maximum insertion torque as compared to ASTRA (p < 0.01), but significantly lower insertion torque/time integral (p < 0.01). Primary implant stability did not differ significantly among groups. Only a single weak (r = 0.61) but significant correlation could be established between maximum insertion torque and insertion torque/time integral (p < 0.01) when all data from all three implant groups were pooled. Implant design (length, thread pitch) seems to affect insertion torque/time integral more than maximum insertion torque.

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