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

2016 ◽  
Vol 42 (2) ◽  
pp. 145-152 ◽  
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.

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

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.

scholarly journals Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique

2020 ◽  
Vol 10 (23) ◽  
pp. 8623
Author(s):  
Alessandro Antonelli ◽  
Francesco Bennardo ◽  
Ylenia Brancaccio ◽  
Selene Barone ◽  
Felice Femiano ◽  
...  
Keyword(s):  
Cancellous Bone ◽  
Biological Response ◽  
In Vivo Studies ◽  
Insertion Torque ◽  
Clinical Settings ◽  
Implant Stability ◽  
Primary Implant ◽  
Significant Difference

Background: This study aims to analyze bone compaction and osseodensification techniques and to investigate how cancellous bone compaction could influence primary implant stability (PS). Methods: Two different surgical protocols (bone compactors—BC; osseodensification drills—OD) were compared by placing 20 implants into 20 fresh pig ribs for each procedure. Peak insertion torque (PIT) and peak removal torque (PRT) were investigated using an MGT-12 digital torque gauge, and implant stability quotient (ISQ) was analyzed using an Osstell® Beacon device. Results: Analysis of our data (T-test p < 0.05) evidenced no statistically significant difference between BC and OD in terms of PIT (p = 0.33) or ISQ (p = 0.97). The comparison of PRT values showed a statistically significant difference between BC and OD protocols (p = 0.009). Conclusions: Cancellous bone compaction seems to improve PS, preserving a significant amount of bone and evenly spreading trabeculae on the entire implant site. Although the PIT and ISQ values obtained are similar, the PRT values suggest a better biological response from the surrounding bone tissue. Nevertheless, a larger sample and further in vivo studies are necessary to validate the usefulness of this protocol in several clinical settings.

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

2013 ◽  
Vol 39 (1) ◽  
pp. 52-57
Author(s):  
Philipp Kreißel ◽  
Felix Kölpin ◽  
Friedrich Graef ◽  
Manfred Wichmann ◽  
Matthias Karl
Keyword(s):  
Bone Density ◽  
Primary Stability ◽  
Surrogate Models ◽  
Poor Quality ◽  
Cortical Layer ◽  
Implant Stability ◽  
Implant Stability Quotient ◽  
Primary Implant ◽  
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.

scholarly journals An In Vitro Analysis on Polyurethane Foam Blocks of the Insertion Torque (IT) Values, Removal Torque Values (RTVs), and Resonance Frequency Analysis (RFA) Values in Tapered and Cylindrical Implants

2021 ◽  
Vol 18 (17) ◽  
pp. 9238
Author(s):  
Luca Comuzzi ◽  
Margherita Tumedei ◽  
Camillo D’Arcangelo ◽  
Adriano Piattelli ◽  
Giovanna Iezzi
Keyword(s):  
Dental Implants ◽  
Frequency Analysis ◽  
Primary Stability ◽  
Cortical Layer ◽  
Insertion Torque ◽  
Low Density ◽  
Resonance Frequency Analysis ◽  
Removal Torque ◽  
Torque Values

Background: Several different dental implant microgeometries have been investigated in the literature for use in low-density bone sites. The polyurethane solid rigid blocks represent an optimal in vitro study model for dental implants, because their composition is characterized by symmetrical linear chains of monomers of hexa-methylene sequences producing a self-polymerization process. The aim of the present investigation was to evaluate the primary stability of cylindrical and tapered implants positioned into low-density polyurethane solid rigid blocks. Materials and Methods: Two different macrogeometries, cylindrical (4 mm diameter and 10 mm length) and tapered dental implants (4.20 mm diameter and 10 mm length), were investigated in the present study. The implants were inserted into 10 PCF and 20 PCF polyurethane blocks, with and without an additional cortical layer. The insertion torque (IT) values, the removal torque values (RTVs), and the resonance frequency analysis (RFA) values were measured and recorded. Results: A total of 80 sites were tested, and a significant increased primary stability (PS) was detected in favour of tapered dental implants when compared to cylindrical implants in all experimental conditions (p < 0.05). Higher IT, RT, and RFA values were measured in tapered implants in 10 and 20 PCF polyurethane blocks, both with and without the additional cortical layer. Conclusions: Both implants showed sufficient primary stability in poor density substrates, while, on the other hand, the tapered microgeometry showed characteristics that could also lead to clinical application in low-density posterior maxillary sites, even with a drastically decreased bone cortical component.

scholarly journals Influence of Cortical Layer and Surgical Techniques on the Primary Implant Stability in Low-density Bone:An In Vitro Study

2021 ◽  
Vol 22 (2) ◽  
pp. 146-151
Author(s):  
Sampathkumar JayaKrishnaKumar ◽  
Rahmath S Shafiullah ◽  
Ramasubramanian Hariharan ◽  
Chitra S Krishnan ◽  
Navarasampatti S Azhagarasan ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
In Vitro Study ◽  
Cortical Layer ◽  
Vitro Study ◽  
Low Density ◽  
Implant Stability ◽  
Primary Implant

scholarly journals Bone Damage during Dental Implant Insertion: A Pilot Study Combining Strain Gauge and Histologic Analysis

2021 ◽  
Vol 12 (1) ◽  
pp. 291
Author(s):  
Virgilia Klär ◽  
Matthias Karl ◽  
Tanja Grobecker-Karl
Keyword(s):  
Trabecular Bone ◽  
Cortical Bone ◽  
Bone Quality ◽  
Alveolar Bone ◽  
Insertion Torque ◽  
Surgical Trauma ◽  
Implant Stability ◽  
Strain Development ◽  
Bone Damage ◽  
Bone To Implant Contact

Besides alveolar bone quality, the drilling protocol applied in conjunction with the design of an implant are the major determinants of primary implant stability. Surgical trauma and bone compression resulting from implant insertion may constitute one cause for marginal bone resorption. Inserting two current bone-level implant designs (Astra; Straumann; n = 5) in bovine ribs, primary stability, strain development on the buccal bone plate and histologic signs of bone damage were recorded. Besides comparing the implant designs (Welch t-tests), all measurement parameters were checked for potential correlations (Pearson product moment correlation coefficients) with the level of significance set at α = 0.05. Considerable numbers of crack formation and plastic deformation of bone were observed after implant insertion. Straumann implants showed slightly greater values for insertion torque (p = 0.772), strain development (p = 0.893) and implant stability (p = 0.642). Significantly greater bone to implant contact (cortical p = 0.014; trabecular p = 0.016) was observed in Straumann implants, while Astra implants caused a significantly greater number of microcracks in cortical bone (p = 0.020). In Straumann implants, insertion torque correlated with bone to implant contact in the cortical area (p = 0.029) and the number of macrocracks in trabecular bone correlated with bone to implant contact (p = 0.029). In Astra implants, insertion torque and bone to implant contact in the trabecular area correlated (p = 0.007) as well as the number of macrocracks in trabecular bone and implant stability (p = 0.016). Additionally, in the area of cortical bone, the number of macrocracks correlated with bone to implant contact (p = 0.019). Implant placement results in bone damage of varying magnitude, which is governed by the drill protocol, implant macrodesign and bone quality.

scholarly journals Does the manual insertion torque of smartpegs affect the outcome of implant stability quotients (ISQ) during resonance frequency analysis (RFA)?

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Ingrid Kästel ◽  
Giles de Quincey ◽  
Jörg Neugebauer ◽  
Robert Sader ◽  
Peter Gehrke
Keyword(s):  
Resonance Frequency ◽  
Frequency Analysis ◽  
Insertion Torque ◽  
Resonance Frequency Analysis ◽  
Implant Stability ◽  
Reliable Determination ◽  
Torque Values ◽  
Finger Pressure

Abstract Background There is disagreement about the optimal torque for tightening smartpegs for resonance frequency analysis (RFA). Subjective finger pressure during hand tightening could affect the reliability of the resulting values. The aim of the current study was therefore to assess whether or not the insertion torque of a smartpeg magnetic device influences the implant stability quotient (ISQ) value during RFA. Methods Thirty self-tapping screw implants (XiVE S, Dentsply Sirona Implants, Bensheim, Germany) with a diameter of 3.8 mm and a length of 11 mm were inserted in three cow ribs with a bone quality of D1. The RFA value of each implant was measured (Ostell, FA W&H Dentalwerk, Bürmoos, Austria) in two orthogonal directions (mesial and buccal) after tightening the corresponding smartpeg type 45 with a mechanically defined value of 5 Ncm (Meg Torq device, Megagen, Daegu, South Korea) (test). Additionally, 4 different examiners measured the RFA after hand tightening the smartpegs, and the results were compared (control). Insertion torque values were determined by measuring the unscrew torque of hand seated smartpegs (Tohnichi Manufacturing Co. Ltd, Tokyo, Japan). Results The ISQ values varied from 2 to 11 Ncm by hand tightening and from 2 to 6 Ncm by machine tightening. The comparison of hand and machine tightening of smartpegs displayed only minor differences in the mean ISQ values with low standard deviations (mesial 79.76 ± 2,11, buccal 77.98 ± 2,) and no statistical difference (mesial p = 0,343 and buccal p = 0,890). Conclusions Manual tightening of smartpeg transducers allows for an objective and reliable determination of ISQ values during RFA.

scholarly journals Correction: Antonelli, A., et al. Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique. Applied Sciences 2020, 10, 8623

2021 ◽  
Vol 11 (8) ◽  
pp. 3427
Author(s):  
Alessandro Antonelli ◽  
Francesco Bennardo ◽  
Ylenia Brancaccio ◽  
Selene Barone ◽  
Felice Femiano ◽  
...  
Keyword(s):  
Applied Sciences ◽  
Comparative Study ◽  
Implant Stability ◽  
Primary Implant

The author wishes to make the following corrections to this paper [...]

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

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
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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