Effect of implantoplasty on the elastic limit of dental implants of different diameters

Abstract

Background Implantoplasty reduces both implant diameter and the thickness of its walls, subsequently reducing the ability of the implant to resist fracture in response to functional load. In combination with an increase in the crown-implant ratio due to bone loss, this could increase the lever effect, which in presence of high masticatory forces or parafunctional habits, could lead to complications such as fracture of the implant or loosening of the prosthetic screw. Objectives To determine the elastic limits of internal connection, dental implants of different designs and diameters after an implantoplasty. Materials and methods This in vitro study included 315 tapered internal connection titanium dental implants, the threads of which were removed with an industrial milling machine—for standardized implantoplasty (IMP1; n = 105)—or with the conventional approach—manually, using high-speed burs (IMP2; n = 105). The remaining 105 implants were used as controls. The final implant diameters were recorded. The quality of the newly polished surfaces was assessed by scanning electron microscopy. All implants were subjected to a mechanical pressure resistance test. A Tukey’s test for multiple comparisons was used to detect differences in the elastic limit and final implant diameters between the implant groups. Results There were statistically significant differences in the elastic limit between the IMP1, IMP2, and control groups (p < 0.05). Furthermore, the implant diameter was significantly smaller in the IMP1 and IMP2 groups (p < 0.05). Scanning electron microscopy revealed smooth implant surfaces in the IMP1 and IMP2 groups, with some titanium particles visible in the IMP1 group. Conclusions Implantoplasty significantly decreased the elastic limit of internal connection titanium dental implants, especially in those with a smaller diameter (3-3.5 mm).

In vitro pilot study comparing a novel implantoplasty sonic instrumentation protocol with a conventional protocol using burs

“…All IP procedures in this study were performed under copious water irrigation (Camps-Font et al, 2020;Costa-Berenguer et al, 2018;Dieguez-Pereira et al, 2021;Ramel et al, 2016) because IP increases the temperature of the surrounding tissue regardless of the type of burr used (de Souza Junior et al, 2016;Sharon et al, 2013).…”

“…Volumetric analysis of modified implants after in vitro IP has been performed using various methods, including radiographs from different directions and distances (Jorio et al., 2021), a long‐cone paralleling technique (Camps‐Font et al., 2020), a digital reader (Quadra‐Chek 200) connected to a profile projector (Costa‐Berenguer et al., 2018), a micrometric precision caliper (Dieguez‐Pereira et al., 2021), and micro‐CT (Sivolella et al., 2021). In this study, material loss was measured by successive 3D scans as previously described (Sahrmann et al., 2019).…”

“…In the present study, the maximum compression force of the implants was analyzed using a compression test based on ISO 14801 (Bertl et al., 2021; Camps‐Font et al., 2020; Costa‐Berenguer et al., 2018; Dieguez‐Pereira et al., 2021; Sivolella et al., 2021) except that 4 mm of the implant body was exposed rather than 3 mm as described by the standard protocol. These standard test parameters can simulate worse‐case clinical scenarios where implants are loaded 30° off‐axis with significant bone loss.…”

Effect of Implantoplasty on Roughness, Fatigue and Corrosion Behavior of Narrow Diameter Dental Implants

“…Aside from the macroscopical changes, other factors can also influence the mechanical behavior of dental implants: the implant material [ 47 ], the implant-abutment connection design [ 48 , 49 ], implant diameter [ 15 , 18 , 50 , 51 ], crown to implant ratio [ 43 ], crown height [ 52 ], and nominal bone level 34. This is the reason why we selected a worst-case scenario involving commercially pure titanium narrow diameter (<3.5 mm) implants, with an internal connection and thin walls, an unfavorable crown-to-implant ratio, and with a significant loss of supporting bone.…”

Implantoplasty and the risk of fracture of narrow implants with advanced bone loss: A laboratory study

“…This discussion is pertinent, since narrow implants seem to be relevant alternatives to standard implants for an extended array of indications (Schiegnitz & Al‐Nawas, 2018), reducing the need for bone augmentation procedures (Roccuzzo et al, 2021). However, there is currently relatively limited and conflicting information on the possible impact of IP on the strength of narrow implants in the available laboratory studies (Bertl et al, 2021; Camps‐Font et al, 2020, 2023; Diéguez‐Pereira et al, 2021; Leitão‐Almeida et al, 2020, 2021), and especially regarding the possible clinical relevance of the findings. For instance, in one study IP did not result in a significant weakening of narrow bone‐level (BL) implants with an external hexagon connection (Leitão‐Almeida et al, 2021), while in another study, IP had a significant negative impact on maximum failure strength of narrow tissue‐level (TL) implants but not on BL implants, both with an internal connection (Bertl et al, 2021).…”