Evaluation of the insertion torque, implant stability quotient and drilled hole quality for different drill design: an in vitro Investigation

Gehrke, Sérgio Alexandre; Calvo-Guirado, José Luís; Bettach, Raphaèl; Fabbro, Massimo Del; Martı́nez, Carlos Pérez; Shibli, Jamil Awad

doi:10.1111/clr.12808

Cited by 38 publications

(36 citation statements)

References 31 publications

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“…This study did not investigate sites that required further preparation of the osteotomies. Regarding the models, one in vitro study was carried out in bone surrogates which is an often-used laboratory model for proof of concept implant testing [22][23][24] since it allows to perform the experiments under controlled parameters. Albeit bone surrogates do not fully replicate the mechanical properties of human bone, they are intended to provide consistent and uniform material with properties in the range of human cancellous bone [25].…”

Section: Discussionmentioning

confidence: 99%

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A New Site Preparation Protocol That Supports Bone Quality Evaluation and Provides Predictable Implant Insertion Torque

Velikov¹,

Susin

Heuberger³

et al. 2020

JCM

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When preparing an implant site, clinicians often base their assessment of the bone on subjective tactile and visual cues. This assessment is used to plan the surgical procedure for site preparation, including how many drilling steps will be used. The subjective nature of bone evaluation, consequently, results in poor reproducibility and may lead to under or over preparation of the site. Recently, an unconventional site preparation protocol was developed in which the decision of which instruments to use is dictated by insertion torque of the novel site preparation instrument (OsseoShaper ™ , Nobel Biocare AB, Gothenburg, Sweden). The aim of this study was to quantify the correlation of the site preparation torques of the new instrument with bone density and maximum implant insertion torques. In vitro and in vivo data showed strong linear correlation between site preparation torque and density and resulted in reliable implant insertion torques, respectively. From our analysis, we conclude that this new instrument and protocol has the potential to eliminate the need for additional intraoperative bone evaluation and may reduce the risk of inadequate preparation of the site due to the ability to serve as a predictor of the final implant insertion torque.profile combined with a cutting flute and unconventional site preparation protocol. Following the pilot drill, the osteotomy is shaped with an implant-specific single use instrument, OsseoShaper1 (OS1), without irrigation at low speed (25-100 rpm) using a motorized drill unit with a maximum torque setting of 40 Ncm (Figure 1). The OS1 torque, measured by a drill unit with real-time torque display, determines the workflow for implant placement. If the OS1 achieves the desired depth and position with less than 40 Ncm, the implant can be placed. If the OS1 torque reaches 40 Ncm before it reaches the planned position, the next instrument should be used to further shape the implant site.

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Section: Discussionmentioning

confidence: 99%

“…The data presented in this work was analyzed from independently performed in vitro (bone surrogate and bovine bone) and in vivo (animal and human) studies between 24 October, 2017 and 13 June, 2019, sponsored by Nobel Biocare. In vitro and preclinical animal studies were performed as performance verification studies.…”

Section: Methodsmentioning

confidence: 99%

A New Site Preparation Protocol That Supports Bone Quality Evaluation and Provides Predictable Implant Insertion Torque

Velikov¹,

Susin

Heuberger³

et al. 2020

JCM

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“…PS seemed to be closely correlated to bone quality and quantity, implant macrostructure, implant length and diameter, surgical technique, and the fitting of the implant into the site [17][18][19][20][21]. Bone density has been correlated to the amount of bone-to-implant contact (BIC) [19], and BIC to the PS [17]. Bone density has been measured with the use of different techniques: insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA), producing a value giving the implant stability quotient (ISQ) [22].…”

Section: Introductionmentioning

confidence: 96%

“…Primary dental implant stability (PS), i.e., an absence of micromotion of the implant immediately after implant placement, has been reported to have an important role in implant osseointegration [17][18][19]. PS seemed to be closely correlated to bone quality and quantity, implant macrostructure, implant length and diameter, surgical technique, and the fitting of the implant into the site [17][18][19][20][21]. Bone density has been correlated to the amount of bone-to-implant contact (BIC) [19], and BIC to the PS [17].…”

Section: Introductionmentioning

confidence: 99%

Short vs. Standard Length Cone Morse Connection Implants: An In Vitro Pilot Study in Low Density Polyurethane Foam

Comuzzi¹,

Tumedei

Piattelli

et al. 2019

Symmetry

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The aim of the investigation was to evaluate the insertion torque, pull-out torque and implant stability quotient (ISQ) of short implants (SI) and standard length implants (ST) inserted into linearly elastic and constitutive isotropic symmetry polyurethane foam blocks. Short dental titanium implants with a Cone Morse connection and a conical shape (test implants: Test Implant A—diameter 5.5 mm and length 6 mm) (Test Implant B—diameter 5.5 mm and length 5 mm) were used for the present in vitro investigation. ST implants (4 mm diameter and 10 mm length), with a Cone Morse connection and a conical shape, were used as Control Implant A and as Control Implants B. These two latter implants had a different macro design. A total of 20 implants (5 Test A, 5 Test B, 5 Control A and 5 Control B) were used for the present research. The results were similar when comparing the Test A and Test B implants. The test implants had very good stability in polyurethane 14.88–29.76 kgm3 density blocks. The insertion torque values were very high for both types of test implant (25–32 Ncm on 14.88 kgm blocks, and up to 45 Ncm in 29.76 kgm3 blocks). The pull-out test values were very similar to the insertion torque values. The ISQ values were significantly high with 75–80 in 14.88 kgm3 blocks, and 78–83 in 29.76 kgm3 blocks. No differences were found in the values of the Control A and Control B implants. In both these implants, the insertion torque was quite low in the 14.88 kgm3 blocks (16–28 Ncm). Better results were found in the 29.76 kgm3 blocks. The pull-out values for these control implants were slightly lower than the insertion torque values. High ISQ values were found in both control implants (57–80). When comparing SI and ST implants, the SI had a similar if not better performance in low quality polyurethane foam blocks (14.88–29.76 kgm), corresponding to D3 and D4 bone.

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“…1,8,[12][13][14] Bu yöntem, in-vitro çalışmalarda ise genellikle belirli bir implant tasarımının, farklı kemik kalitesi ve kalınlığının "primer stabilite" üzerine etkisinin incelenmesi amacıyla kullanılmıştır. [15][16][17][18] Fonksiyonel oklüzal yüklerin ve protetik üst yapının implant stabilitesi üzerine etkisi üzerine bilgiye rastlanmamıştır.…”

Section: Gġrġġunclassified

Termomekani̇k Yaşlandirmanin Farkli Serami̇k Abutmentlara Sahi̇p İmplantlarin Stabi̇li̇tesi̇ne Etki̇si̇

Güngör¹,

Nemli²,

Bağkur³

et al. 2019

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

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Bu çalışmanın amacı, 3 farklı seramik abutment kullanılarak restore edilen dental implantların termomekanik yaşlandırma öncesinde ve sonrasında stabilitelerinin Rezonans Frekans Analizi yöntemi ile değerlendirilmesidir. Gereç ve Yöntem: Bu çalışmada, Lityum disilikat abutment, Prefabrike zirkonya abutment ve Zirkonya abutment olmak üzere üç çalışma grubu (n=5) oluşturuldu. Lityum disilikat ve zirkonya abutment gruplarında, deney örneklerinin elde edilmesi amacıyla, model üzerinde üst sağ birinci kesici diş boşluğuna yerleştirilen implantın, komşu dişlerin ve kapanış ilişkisinin dijital ölçüsü alındı. Sanal modeller üzerinde abutment ve lityum disilikat kron restorasyonları tasarlandı ve üretildi. Prefabrike zirkonya abutment grubunda ise, firma tarafından üretilen hazır zirkonya abutment üzerine lityum disilikat kron restorasyonları tasarlanarak üretildi. Abutmentimplant bağlantısı sağlanan tüm örnekler, sıcaklığı 5 0 C-55 0 C olan suda 1000 kez ısı döngüsüne ve 50 N'luk kuvvet ile 200000 mekanik siklusa maruz bırakıldı. Yaşlandırma sonrasında, abutment ve kronlar çıkarıldı. Ġmplantların üzerine üretici firmaya ait Smartpeg'ler yerleştirildi. Ġmplant stabilite katsayısı (ISQ) değerleri, yaşlandırma öncesi ve sonrasında dört farklı bölgeden (bukkal, palatal, mezial ve distal) ölçülerek kaydedildi. ISQ değerlerinin karşılaştırılması için iki-faktörlü tekrarlanan ölçümlü varyans analizi kullanıldı. Hesaplama ve yorumlamalarda % 5'lik önem düzeyi dikkate alındı. Bulgular: Varyans analizi sonucunda materyalxtermomekanik yaşlandırma interaksiyonunun istatistiksel olarak önemli olmadığı (P>.05), materyal ve termomekanik yaşlandırma faktörlerinin ise istatistiksel olarak önemli olduğu bulundu (P<.05). ISQ değerleri termomekanik yükleme sonrası önemli derecede azaldı (P<.05). Bonferroni testi sonuçları incelendiğinde; Prefabrike zirkonya abutment grubunun Lityum disilikat abutment grubundan anlamlı derecede yüksek ISQ ortalamasına sahip olduğu görüldü (P<.05). Sonuç: Ġmplantların yükleme sonrasında stabilitelerindeki değişimi gösteren ISQ değerlerinin azalması, implant ve kemik ara yüzünün sağlamlığında azalmaya işaret olabilir. Ancak bu çalışmada elde edilen sonuçlar yorumlanırken, implantı çevreleyen akrilik rezin materyalinin canlı kemik dokudan farklı özellikler gösterdiği göz önüne alınmalıdır.

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Evaluation of the insertion torque, implant stability quotient and drilled hole quality for different drill design: an in vitro Investigation

Abstract: Within the limitations of the study, the results suggest that the hole quality, in addition to the insertion torque, may significantly affect implant primary stability.

Cited by 38 publications

References 31 publications

A New Site Preparation Protocol That Supports Bone Quality Evaluation and Provides Predictable Implant Insertion Torque

A New Site Preparation Protocol That Supports Bone Quality Evaluation and Provides Predictable Implant Insertion Torque

Short vs. Standard Length Cone Morse Connection Implants: An In Vitro Pilot Study in Low Density Polyurethane Foam

Termomekani̇k Yaşlandirmanin Farkli Serami̇k Abutmentlara Sahi̇p İmplantlarin Stabi̇li̇tesi̇ne Etki̇si̇

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