Mechanical stability and clinical applicability assessment of novel orthodontic mini-implant design

ABSTRACT Objective: To compare the stability and clinical applicability of a novel orthodontic mini-implant design (N2) with the most widely used commercially available (CA) design. Materials and Methods: Two groups of mini-implants were tested: a CA design (1.5-mm diameter, 6-mm length) and N2 (3-mm diameter, 2-mm length, tapered shape). Implants were inserted in bone blocks of cortical bone simulation with varying densities (20 pounds per cubic foot [pcf], 30 pcf, and 40 pcf). A torque test was used to measure maximum insertion torque (MIT) and maximum removal torque (MRT). Compression and tension force vectors were applied at angles of 10°, 20°, 30°, and 40° using customized load pins to determine primary stability. Results: Mean MIT and MRT were higher in the N2 than the CA design at all three cortical bone densities except MRT in 20 pcf bone (not statistically significant). The mean compression force required to displace the N2 at all distances and angulations was greater for the N2 than the CA design. At all displacement distances, the highest mean tension force required for N2 displacement was at 10° angulation, whereas at 30° and 40°, the mean tension force required to displace the CA design was greater. Conclusions: The primary stability of the N2 is superior to that of the CA design and is promising for both orthodontic and orthopedic clinical applicability, especially under compression force. The short length of the N2 reduces risk of damage to anatomic structures and root proximity during placement and orthodontic treatment. The stability of the N2 may be compromised in areas of high bone density and highly angulated tension force.

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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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Comparative In Vitro Evaluation of the Primary Stability in D3 Synthetic Bone of Two Different Shapes and Pitches of the Implant Threads

Applied Sciences ◽

10.3390/app11125612 ◽

2021 ◽

Vol 11 (12) ◽

pp. 5612

Author(s):

Stefano Fanali ◽

Margherita Tumedei ◽

Pamela Pignatelli ◽

Alessandra Lucchese ◽

Francesco Inchingolo ◽

...

Keyword(s):

Surgical Techniques ◽

Primary Stability ◽

Implant Design ◽

Insertion Torque ◽

Synthetic Bone ◽

One Stage ◽

Prosthetic Joint ◽

Joint Connection ◽

The One

Background: Implant primary stability can be affected by several factors related to implant macrogeometry, local anatomy, and surgical techniques. The aim of this research was to study primary stability on polyurethane foam sheets of wide-threaded implant design compared to narrow-threaded implants. Materials and methods: Two different implant designs were positioned on D3 density polyurethane blocks in a standardized environment: the wide-threaded implant and the narrow-threaded implant, for a total of 160 specimens. Moreover, for each group, two different sizes were considered: 3.8mm × 12mm and 4.8mm × 12 mm. The insertion torque (IT) values, the removal strength (RT), and the Periotest analyses were evaluated. Results: A significantly higher IT and RT was reported for wide-threaded implants and two-stage implants (p < 0.01), compared to the narrow-threaded implants. The diameters seemed to provide a significant effect on the primary stability for both implants’ geometry (p < 0.01). A higher mean of the one-stage implant was evident in the Periotest measurements (p < 0.01). Conclusions: Both of the implants showed sufficient stability in polyurethane artificial simulation, while the wide-threaded implant design showed a higher primary stability on alveolar cancellous synthetic bone in vitro. Additionally, the prosthetic joint connection seemed to have a determinant effect on Periotest analysis, and the one-stage implants seemed to provide a high stability of the fixture when positioned in the osteotomy, which could be important for the immediate loading protocol.

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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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Evaluation of the effect of force direction on stationary anchorage success of mini-implant with a lever-arm–shaped upper structure

The Angle Orthodontist ◽

10.2319/092810-566.1 ◽

2011 ◽

Vol 81 (5) ◽

pp. 776-782 ◽

Cited By ~ 5

Author(s):

Ki-Ho Park ◽

Eun-Man Lee ◽

Seung-il Shin ◽

Seong-Hun Kim ◽

Young-Guk Park ◽

...

Keyword(s):

Primary Stability ◽

The Other ◽

Control Group ◽

Removal Torque ◽

Lever Arm ◽

Mini Implants ◽

Force Direction ◽

The Mean ◽

The Stability ◽

Experimental Group

Abstract Objective: To compare the effect of clockwise and counterclockwise torque on the primary stability of a mini-implant with a lever-arm–shaped upper structure. Materials and Methods: Twenty-four white rabbits were used for this study. Two screw-type mini-implants were placed in each tibia. In all, 96 screws were inserted. Two weeks later, a 2-N force was applied to the mini-implants without an upper structure in eight rabbits (control group). The mini-implants of the other 16 rabbits were loaded with an upper structure (experimental group). In the experimental group, the two left mini-implants were loaded in a clockwise direction (CW group) and the two right implants were loaded in a counterclockwise direction (CCW group). The rabbits were sacrificed at 1 week or 8 weeks after loading in both control and experimental groups. The removal torque value (RTV) was measured in 15 of 16 mini-implants in each group and the remaining implant was processed for histologic examination. Results: At 1 week there were no significant differences in the mean RTV between the control, CW, and CCW groups. At 8 weeks, the RTV was higher in the control and experimental groups than in the respective 1-week groups. At 8 weeks, there were no significant differences in the RTV between the control and CW groups, but the CCW group showed a lower RTV. Conclusions: CCW torque can decrease the stability of a mini-implant, whereas a CW torque has no effect.

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Effects of Intrabony Length and Cortical Bone Density on the Primary Stability of Orthodontic Miniscrews

Materials ◽

10.3390/ma13245615 ◽

2020 ◽

Vol 13 (24) ◽

pp. 5615

Author(s):

Jie Jin ◽

Gi-Tae Kim ◽

Jae-Sung Kwon ◽

Sung-Hwan Choi

Keyword(s):

Bone Density ◽

Cortical Bone ◽

Primary Stability ◽

Insertion Torque ◽

Low Density ◽

Horizontal Resistance ◽

Cortical Bone Density ◽

Temporary Anchorage Devices ◽

Implantation Depth ◽

Maximum Removal

Miniscrews have gained recent popularity as temporary anchorage devices in orthodontic treatments, where failure due to sinus perforations or damage to the neighboring roots have increased. Issues regarding miniscrews in insufficient interradicular space must also be resolved. This study aimed to evaluate the primary stability of miniscrews shorter than 6 mm and their feasibility in artificial bone with densities of 30, 40, and 50 pounds per cubic foot (pcf). The primary stability was evaluated by adjusting the intrabony miniscrew length, based on several physical properties: maximum insertion torque (MIT), maximum removal torque (MRT), removal angular momentum (RAM), horizontal resistance, and micromotion. The MIT and micromotion results demonstrated that the intrabony length of a miniscrew significantly affected its stability in low-density cortical bone, unlike cases with a higher cortical bone density (p < 0.05). The horizontal resistance, MRT, and RAM were affected by the intrabony length, regardless of the bone density (p < 0.05). Thus, the primary stability of miniscrews was affected by both the cortical bone density and intrabony length. The effect of the intrabony length was more significant in low-density cortical bone, where the implantation depth increased as more energy was required to remove the miniscrew. This facilitated higher resistance and a lower risk of falling out.

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Influence of Orthodontic Anchor Screw Anchorage Method on the Stability of Artificial Bone: An In Vitro Study

Materials ◽

10.3390/ma13143205 ◽

2020 ◽

Vol 13 (14) ◽

pp. 3205 ◽

Cited By ~ 2

Author(s):

Seen-Young Kang ◽

Ji-Min Yu ◽

Hyoung-Sik Kim ◽

Jun-Seok Lee ◽

Chan-Mi Yeon ◽

...

Keyword(s):

In Vitro Study ◽

Automatic Device ◽

Insertion Torque ◽

Artificial Bone ◽

Artificial Bones ◽

Significant Difference ◽

The Mean ◽

The Stability ◽

Torque Values

This study aims to compare the torque values for various lengths of the titanium-based orthodontic anchor screw (OAS), different anchorage methods and varying artificial bone densities after predrilling. Furthermore, the effects of these parameters on bone stability are evaluated. A total of 144 OASs were prepared with a diameter of 1.6 mm and heights of 6, 8 and 10 mm. Artificial bones were selected according to their density, corresponding to Grades 50, 40 and 30. Torque values for the automatic device and manual anchorage methods exhibited a statistically significant difference for the same-sized OAS, according to the bone density of the artificial bones (p < 0.05). However, when insertion torque was at the maximum rotations, there was no significant difference in the torque values for the Grade 30 artificial bone (p > 0.05). When the torque values of both anchorage methods were statistically compared with the mean difference for each group, the results of the manual anchorage method were significantly higher than those of the automatic device anchorage method (p < 0.05). A statistically significant difference was observed in the bone stability resulting from different OAS anchorage methods and artificial bone lengths. These findings suggest that the automatic anchorage method should be used when fixing the OAS.

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Does Implant Design Affect Implant Primary Stability? A Resonance Frequency Analysis–Based Randomized Split-Mouth Clinical Trial

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-13-00294 ◽

2015 ◽

Vol 41 (6) ◽

pp. e281-e286 ◽

Cited By ~ 16

Author(s):

Sergio Alexandre Gehrke ◽

Ulisses Tavares da Silva ◽

Massimo Del Fabbro

Keyword(s):

Standard Deviation ◽

Resonance Frequency ◽

Frequency Analysis ◽

Primary Stability ◽

Implant Design ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

The Mean ◽

Group 2 ◽

Group 1

The purpose of this study was to assess implant stability in relation to implant design (conical vs. semiconical and wide-pitch vs narrow-pitch) using resonance frequency analysis. Twenty patients with bilateral edentulous maxillary premolar region were selected. In one hemiarch, conical implants with wide pitch (group 1) were installed; in the other hemiarch, semiconical implants with narrow pitch were installed (group 2). The implant allocation was randomized. The implant stability quotient (ISQ) was measured by resonance frequency analysis immediately following implant placement to assess primary stability (time 1) and at 90 days after placement (time 2). In group 1, the mean and standard deviation ISQ for time 1 was 65.8 ± 6.22 (95% confidence interval [CI], 55 to 80), and for time 2, it was 68.0 ± 5.52 (95% CI, 57 to 77). In group 2, the mean and standard deviation ISQ was 63.6 ± 5.95 (95% CI, 52 to 78) for time 1 and 67.0 ± 5.71 (95% CI, 58 to 78) for time 2. The statistical analysis demonstrated significant difference in the ISQ values between groups at time 1 (P = .007) and no statistical difference at time 2 (P = .54). The greater primary stability of conical implants with wide pitch compared with semiconical implants with narrow pitch might suggest a preference for the former in case of the adoption of immediate or early loading protocols.

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Evaluation of Implants with Different Macrostructures in Type I Bone—Pre-Clinical Study in Rabbits

Materials ◽

10.3390/ma13071521 ◽

2020 ◽

Vol 13 (7) ◽

pp. 1521

Author(s):

Amanda de Carvalho Silva Leocádio ◽

Matusalém Silva Júnior ◽

Guilherme José Pimentel Lopes de Oliveira ◽

Gustavo da Col Santos Pinto ◽

Rafael Silveira Faeda ◽

...

Keyword(s):

Clinical Study ◽

Cortical Bone ◽

Histological Analysis ◽

Primary Stability ◽

The Other ◽

Insertion Torque ◽

Type I ◽

Bone Implant ◽

Tibial Metaphysis ◽

Bone Implant Contact

The objective of this study was to assess the primary stability and the osseointegration process in implants with different macrostructures (Cylindrical vs. Hybrid Conical) in rabbit tibiae. Twenty-four (24) rabbits were used, divided into 3 experimental periods (2, 4 and 8 weeks) with 8 animals each. Each animal bilaterally received 2 implants from each group in the tibial metaphysis: Cylindrical Implant (CI) and Hybrid Conical Implant (HCI). All implants were assessed for insertion torque. After the experimental periods, one of the implants in each group was submitted to the removal counter-torque test and descriptive histological analysis while the other implant was used for microtomographic and histometric analysis (%Bone-Implant Contact). HCI implants showed higher insertion torque (32.93 ± 10.61 Ncm vs. 27.99 ± 7.80 Ncm) and higher % of bone-implant contact in the 8-week period (79.08 ± 11.31% vs. 59.72 ± 11.29%) than CI implants. However, CI implants showed higher values of removal counter-torque than HCI implants in the 8-week period (91.05 ± 9.32 Ncm vs. 68.62 ± 13.70 Ncm). There were no differences between groups regarding microtomographic data. It can be concluded that HCI implants showed greater insertion torque and bone-implant contact in relation to CI implants in the period of 8 weeks when installed in cortical bone of rabbits.

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Comparative assessment of the primary stability of Straumann® BLX implant design using an in-vitro sinus lift-simultaneous implant insertion model

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-20-00411 ◽

2021 ◽

Author(s):

Marie Emmert ◽

Johannes Spille ◽

Eleonore Behrens ◽

Mustafa Ayna ◽

Fatih Karayurek ◽

...

Keyword(s):

Primary Stability ◽

Implant Design ◽

Control Group ◽

Study Group ◽

Sinus Lift ◽

Wide Diameter ◽

Resonance Frequence ◽

The Stability ◽

Standard Implant

Straumann ® BLX is a novel implant system, which has been proclaimed to provide an ideal primary stability in all types of bone. In the current study, the primary stability of Straumann ® BLX implant systems with Straumann ® tapered effect (TE) implants have been comparatively assessed in bovine ribs by using a simultaneous sinus elevation and implant insertion model. In the study group, BLX (4.0 x 12 mm), TE (4.1 x 12 mm), BLX (4,5 x 12 mm) and TE (4.8 x 12 mm) were placed in each bony window, which resembles sinus maxillaris. As a control, BLX and TE implants with same sizes were inserted into the proximal diaphysis of the bovine ribs. A total of 40 implant insertions were performed. The stability was measured with resonance frequence analysis. In the study group, TE implants of 4.8 mm showed significantly higher values compared to 4.5 mm BLX implants (p=0.116). However, BLX implants of 4.0 mm in the control group showed higher stability compared to TE with 4.0 mm diameter. (p=0.014). The primary stability of BLX implants in the control group was significantly higher compared to the experimental group in both widths (p=0.018 for BLX 4.0 and p=0.002 for BLX 4.5 respectively). The use of TE design with wide diameter in simultaneous implant placement with sinus lift could present higher ISQ values and might be more appropriate option for implant recipient sites with poor bone volume and quality. However, the advantage of BLX design in standard implant insertion protocols could be precious.

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A One-year Follow-up Study of a Tapered Hydrophilic Implant Design Using Various Placement Protocols in the Maxilla

The Open Dentistry Journal ◽

10.2174/1874210601610010680 ◽

2016 ◽

Vol 10 (1) ◽

pp. 680-691 ◽

Cited By ~ 4

Author(s):

Jakob Zwaan ◽

Leonardo Vanden Bogaerde ◽

Herman Sahlin ◽

Lars Sennerby

Keyword(s):

Survival Rate ◽

Bone Loss ◽

Implant Design ◽

Insertion Torque ◽

Daily Routine ◽

High Survival ◽

Marginal Bone Loss ◽

The Mean ◽

One Year

Purpose: To study the clinical/radiographic outcomes and stability of a tapered implant design with a hydrophilic surface when placed in the maxilla using various protocols and followed for one year. Methods: Ninety-seven consecutive patients treated as part of daily routine in two clinics with 163 tapered implants in healed sites, in extraction sockets and together with bone augmentation procedures in the maxilla were evaluated after one year in function. Individual healing periods varying from 0 to 6 months had been used. Insertion torque (IT) and resonance frequency analysis (RFA) measurements were made at baseline. Follow-up RFA registrations were made after 6 and 12 months of loading. The marginal bone levels were measured in intraoral radiographs from baseline and after 12 months. A reference group consisting of 163 consecutive straight maxillary implants was used for the comparison of baseline IT and RFA measurements. Results: Five implants failed before loading, giving an implant survival rate of 96.9% and a prosthesis survival rate of 99.4% after one year. The mean marginal bone loss after one year was 0.5 mm (SD 0.4). The mean IT was statistically significantly higher for tapered than for straight reference implants (41.3 ± 12.0 Ncm vs 33.6 ± 12.5 Ncm, p < 0.001). The tapered implants showed a statistically insignificantly higher mean ISQ value than the straight references implants (73.7 ± 6.4 ISQ vs 72.2 ± 8.0 ISQ, p=0.119). There was no correlation between IT and marginal bone loss. There was a correlation between IT and RFA measurements (p < 0.001). Conclusion: The tapered implant showed a high survival rate and minimal marginal bone loss after one year in function when using various protocols for placement. The tapered implant showed significantly higher insertion torque values than straight reference implants.

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