The 6-mm implants supporting single crowns performed well, but the mandible shows a higher risk of failure. The time and clinical C/I ratio are predictors for bone loss.
The biomechanical stability of the implant-abutment connection is critical for the success of implant-supported restorations. This study investigated the effect of a positioning index on the abutment screw preload values of tapered connection implants. Twenty Morse taper implants presenting an internal locking hex received 10 solid and 10 straight screw retained abutments for cemented single-crown restorations. Ten abutments had a positioning index to fit the internal locking hex of the implant (straight), and 10 were locked only by the implant taper (solid). The preload values for each abutment screw after a tightening torque were registered by strain gauges. Prosthetic crowns were placed on each abutment and subjected to mechanical cycling. Detorque forces were applied to each abutment and compared with the initial torque values. Data were statistically analyzed using Kolmogorov-Smirnov and Student t tests. The nonindexed group presented higher initial preload (6.05 N ± 0.95 N) compared with the indexed group (4.88 N ± 0.92 N; P < .05). After cycling, the nonindexed group exhibited less reduction of preload (13.84% ± 6.43%) compared with the indexed group (52.65% ± 14.81%; P < .01). Indexed tapered abutments for single-crown restorations might represent greater biomechanical risk under function.
Within the limitations of this study, the results suggest that clinical success is associated to framework design with retention pins equal or longer than 4 mm. Quality of life improved with IFCD treatment, even in patients with mechanical complications.
Background
This study assessed the relationship between insertion torque and bone quality evaluated during surgery and in preoperative computed tomographic (CT) images analyzed either visually or by rescaled mean gray values (MGVs). The study also tested the correlation between the clinical and radiographic measures of bone quality.
Methods
The consecutive sample was composed of 45 short implants (4.1 × 6 mm) placed in the posterior region of 20 patients. Intra-surgical tactile bone quality, based on the classification of bone types by Lekholm and Zarb, and insertion torque were recorded during the implant placement. Visual bone quality and normalized MGV were assessed in standardized axial, coronal, and sagittal sections of preoperative CT images. Data were analyzed by ANOVA and Spearman correlation (alpha = 0.05).
Results
Insertion torque was associated with all assessment methods of bone quality (tactile, CT visual, MGV). A moderate correlation was found among all methods of bone quality, except for CT visual assessment and tactile evaluation. MGVs varied as a function of arch, dental region, insertion torque, and bone types.
Conclusions
The results suggest that bone quality measures affect primary stability as recorded by insertion torque, and the assessment methods are consistently related.
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