Clinical effect of the high insertion torque on dental implants: A systematic review and meta-analysis

Lemos, Caa; Verri, Fellippo Ramos; Neto, Olavo Barbosa de Oliveira; Cruz, Raimundo Leite; Gomes, Jml; Casado, Bruno Gustavo da Silva; Pellizzer, Eduardo Piza

doi:10.1016/j.prosdent.2020.06.012

Cited by 30 publications

(25 citation statements)

References 29 publications

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“…Furthermore, other studies have shown that drilling speed does not affect the initial stability parameters of implants 43 , 44 . However, different results were found in the literature with regards to the healing behavior of peri-implant crestal tissues in relation to insertion torque effects 45 – 48 . On the other hand, a study by our research group was recently published where surgical trauma during maneuvers for implant placement, in this case bone tissue drilling, can influence the healing response of the bone 49 .…”

Section: Discussionmentioning

confidence: 95%

Effects of insertion torque values on the marginal bone loss of dental implants installed in sheep mandibles

Gehrke

Júnior

Treichel

et al. 2022

Sci Rep

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The aim of the present in vivo study was to analyze and compare the effects on the crestal bone healing of two different implant macrogeometries installed in fresh socket areas and in normal bone areas with different insertion torque values. Two implant macrogeometries were used in the present study, DuoCone implant (DC) and Maestro implant (MAE), forming four groups: group DCws, in which the implants were installed in healing bone (without a socket); group DCfs, in which the implants were installed in post-extraction areas (fresh sockets); group MAEws, in which the implants were installed in healing bone (without a socket); group MAEfs, in which the implants were installed in post-extraction areas (fresh sockets). After 30 and 90 days of implantations in the bilateral mandibles of 10 sheep, eighty implants were evaluated through digital X-ray images and histologic slices. The crestal bone position in relation to the implant platform shoulder was measured and compared. The measured insertion torque was 47.2 ± 4.69 Ncm for the DCws group, 43.4 ± 4.87 Ncm for the DCfs group, 29.3 ± 3.16 Ncm for the MAEws group, and 27.7 ± 4.41 Ncm for the MAEfs group. The radiographic mesio-distal and histological bucco-lingual analyses showed significantly greater vertical bone loss in the implants installed with high torque (DC groups) in comparison to the implants installed with a low torque (MAE groups) (p < 0.05), at both evaluation times. In general, low insertion torque values (Maestro implants) showed better results of MBL when compared to implants installed with higher torque values (Duo Cone implants). Moreover, our results showed that the implants installed in the sites without sockets showed a less MBL in comparison with the implants installed in sites of fresh sockets.

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Section: Discussionmentioning

confidence: 95%

Effects of insertion torque values on the marginal bone loss of dental implants installed in sheep mandibles

Gehrke

Júnior

Treichel

et al. 2022

Sci Rep

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“…They also pointed out that, at implant sites where the cortical bone was more represented (mandible), the use of high IT produced the worst clinical effects. However, recent systematic reviews on this subject underline that studies concerning the association between high IT and marginal bone loss are still inconclusive, and more research is recommended on the matter [ 46 , 47 , 48 ].…”

Section: Measurements For Stability Of Dental Implantsmentioning

confidence: 99%

Stability of Dental Implants and Thickness of Cortical Bone: Clinical Research and Future Perspectives. A Systematic Review

et al. 2021

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Dental surgery implantation has become increasingly important among procedures that aim to rehabilitate edentulous patients to restore esthetics and the mastication ability. The optimal stability of dental implants is correlated primarily to the quality and quantity of bone. This systematic literature review describes clinical research focusing on the correlation between cortical bone thickness and primary/secondary stability of dental fixtures. To predict successful outcome of prosthetic treatment, quantification of bone density at the osteotomy site is, in general, taken into account, with little attention being paid to assessment of the thickness of cortical bone. Nevertheless, local variations in bone structure (including cortical thickness) could explain differences in clinical practice with regard to implantation success, marginal bone resorption or anchorage loss. Current knowledge is preliminarily detailed, while tentatively identifying which inconclusive or unexplored aspects merit further investigation.

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“…Animal studies [8,9] have observed an increased predictability of implant treatment when the insertion resulted in an insertion torque ≥ 32 Ncm; however, there are conflicting opinions in literature on the limits of this value [10]. A high insertion torque (greater than 50 or 70 Ncm) has been shown to lead to the formation of microfractures, damage to microcirculation leading to bone necrosis especially in cortical or bicortical bones, alterations to the prosthetic connection, and changes in the surface roughness and microtopography of implants [5,11,12].…”

mentioning

confidence: 99%

Clinical effects of conventional and underprepared drilling preparation of the implant site based on bone density: A systematic review and meta-regression

Antonacci¹,

Fabbro

Bollero

et al. 2023

J Prosthodont Res

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Currently, one of the most important challenges in dental implant surgery is the optimization of techniques to obtain a high grade of stability. This is a key factor for survival and long-term predictability, especially in immediate loading procedures [1]. Implant stability can be classified as primary and secondary, which represent the mechanical retention of the bone at the time of implant insertion and the formation of biologically stable bone around the fixture, respectively [2,3].A commonly used surgical protocol to obtain increased primary stability consists of under-dimensioning the preparation of the site, especially in the case of low-density bone. With this technique, also called underpreparation or underized drilling, an implant is inserted in a substantially smaller osteotomy than its diameter, and is typically obtained by skipping the use of the last drill from the drilling protocol. This leads to an immediate direct contact of the implant surface with the bone, which promotes primary stability, and is clinically perceived as insertion torque (ITQ) [4]. The initial bone-toimplant contact then undergoes a major change during the healing period and while functioning. The increased lateral compression induced by underpreparation might affect the local microcirculation and bone cellular responses, leading to bone compression necrosis [5]. A review by Insua et al. [6] clarified the bases of bone metabolism during implant healing and the processes that can lead to peri-implant bone loss. The review consistently demonstrated, from a cel-J Prosthodont Res. 2022; **(**):

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Clinical effect of the high insertion torque on dental implants: A systematic review and meta-analysis

Cited by 30 publications

References 29 publications

Effects of insertion torque values on the marginal bone loss of dental implants installed in sheep mandibles

Effects of insertion torque values on the marginal bone loss of dental implants installed in sheep mandibles

Stability of Dental Implants and Thickness of Cortical Bone: Clinical Research and Future Perspectives. A Systematic Review

Clinical effects of conventional and underprepared drilling preparation of the implant site based on bone density: A systematic review and meta-regression

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