Clinical Considerations of Adapted Drilling Protocol by Bone Quality Perception

Toia, Marco; Stocchero, Michele; Cecchinato, Francesca; Corrà, Enrico; Jimbo, Ryo; Cecchinato, Denis

doi:10.11607/jomi.5881

Cited by 35 publications

(32 citation statements)

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“…Abbreviations: L&Z, Lekholm & Zarb classification; Min, Minimum; Max, Maximum; N, Frequency; S, S‐A, S‐B, S‐X‐B (Drilling protocol: S = step drill; A = cortical drill; B = cortical drill; X = body drill).…”

Section: Resultsmentioning

confidence: 99%

“…Patients rinsed chlorexidine 0.2% for 1 minute prior to surgery and local anesthesia was induced. After a crestal incision, a full thickness flap was elevated and 2, 3, or 4 implants (OsseoSpeed EV Astra Tech Implant System, Dentsply Sirona Implants, Mölndal, Sweden) were placed in each patient according to the drilling protocol described by Toia et al, using a two‐stage procedure. The implant bone site was classified according to Lekholm and Zarb classification (L&Z) and insertion torque value (ITV) was registered using SA‐310 W&H Elcomed implant unit (W&H, Burmoos, Austria).…”

Section: Methodsmentioning

confidence: 99%

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Implant vs abutment level connection in implant supported screw‐retained fixed partial dentures with cobalt‐chrome framework: 1‐year interim results of a randomized clinical study

Toia

Stocchero

Becktor

et al. 2019

Clin Implant Dent Rel Res

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Background Screw‐retained fixed partial dentures (FPD) have shown a lower incidence of biologic complications and an easier retrievability compared with cemented FPD. Purpose To compare the marginal bone loss at conical connection implant restored with a screw retained cobalt‐chrome FPD in an implant‐level (IL) or an abutment‐level (AL) setup. Materials and Methods Patients with at least two adjacent missing teeth were randomly allocated to be restored with IL or AL FPD. Periapical radiographs and clinical examination were taken at implant placement, prosthetic connection, 6 and 12 months to evaluate marginal bone loss (MBL), and soft tissue conditions. Complications were used to calculate prognostic indexes. Results Fifty patients were treated with 50 FPD supported by 119 implants. The difference of MBL between the IL and AL groups was statistically significant (P = 0.003). At 1 year, MBL was 0.086 ± 0.313 mm and 0.005 ± 0.222 mm in the IL and AL groups, respectively. The presence of BoP increased with time in IL, whereas it decreased in AL group (P < 0.001). A minor complication was encounted in one FPD. Conclusions A low grade of MBL was present after 1 year. IL showed greater amount of MBL and soft tissue inflammation indexes than AL. In FPD, AL may be a safer procedure than IL setup in order to preserve a healthy periimplant tissue.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Implant vs abutment level connection in implant supported screw‐retained fixed partial dentures with cobalt‐chrome framework: 1‐year interim results of a randomized clinical study

Toia

Stocchero

Becktor

et al. 2019

Clin Implant Dent Rel Res

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“…Even if the primary stability of dental implants is controversially discussed as a decisive parameter for successful masticatory functional rehabilitation in the context of two-stage loading concepts and oversized drilling protocols are also employed, the development of alternative loading concepts (i.e., transgingival healing, immediate loading) showed the need as well as the importance of primary stability [ 27 ]. It has been repeatedly found in the literature that the final osteotomy position for the preparation of the implant bed should be determined by adapted drilling in order to achieve an individual and variable degree of bone compression [ 35 ]. In this context, several modifications of surgical techniques have been proposed, which include undersized drilling protocols, bone condensation, and/or bicortical fixation [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Does the Modification of the Apical Geometry of a Dental Implant Affect Its Primary Stability? A Comparative Ex Vivo Study

et al. 2021

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(1) Background: Primary stability—one fundamental criterion for the success of dental implants—is influenced by implant geometry even if the effect of apical shape modifications on implant primary stability has not yet been examined. Therefore, the aim of the ex vivo study was to compare primary stability of implants differing in apically located screw threads (J-line) or a flat tip (K-line) only. (2) Methods: 28 implants of each group of the same diameter (4.3 mm) were randomly inserted into porcine bone blocks. The first group (9, 11 and 13 mm) was inserted into “hard”, the second (11 mm) into “soft” bone, here using a normal and an undersized drilling protocol. Insertion torque (Ncm), Periotest® value, resonance frequency (implant stability coefficient, ISQ) and push-out force (N) were measured. (3) Results: In “hard” bone, primary stability increased with increasing length in both groups but it was significantly higher in J-line (p < 0.03). An undersized preparation of the implant bed in “soft” bone resulted in a significant increase in primary stability in both groups. Here, J-line also showed a significantly increased primary stability when compared to equally prepared K-line (insertion torque: 37 Ncm vs. 26 Ncm; Periotest®: −6.5 vs. −4.3; push-out force: 365 N vs. 329 N; p < 0.05 each). (4) Conclusions: Primary stability is significantly higher with increasing implant length and apically located screw threads as well as with undersized drilling protocols. When preparing the implant site and subsequently selecting the implant system, modifying factors such as implant geometry (also at the tip) should be taken into account.

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“…The proper final osteotomy dimension should be determined based on the bone characteristics via so-called adapted drilling; that is, when selecting the final osteotomy dimension, a different degree of bone compression and primary stability at implant placement can be obtained [26].…”

Section: Introductionmentioning

confidence: 99%

Effects of Different Undersizing Site Preparations on Implant Stability

Lemos

López-Jarana²,

Falcão

et al. 2020

IJERPH

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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.

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Clinical Considerations of Adapted Drilling Protocol by Bone Quality Perception

Cited by 35 publications

References 0 publications

Implant vs abutment level connection in implant supported screw‐retained fixed partial dentures with cobalt‐chrome framework: 1‐year interim results of a randomized clinical study

Implant vs abutment level connection in implant supported screw‐retained fixed partial dentures with cobalt‐chrome framework: 1‐year interim results of a randomized clinical study

Does the Modification of the Apical Geometry of a Dental Implant Affect Its Primary Stability? A Comparative Ex Vivo Study

Effects of Different Undersizing Site Preparations on Implant Stability

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