How does dental implant macrogeometry affect primary implant stability? A narrative review

Abstract

Purpose The macrogeometry of a dental implant plays a decisive role in its primary stability. A larger diameter, a conical shape, and a roughened surface increase the contact area of the implant with the surrounding bone and thus improve primary stability. This is considered the basis for successful implant osseointegration that different factors, such as implant design, can influence. This narrative review aims to critically review macro-geometric features affecting the primary stability of dental implants. Methods For this review, a comprehensive literature search and review of relevant studies was conducted based on formulating a research question, searching the literature using keywords and electronic databases such as PubMed, Embase, and Cochrane Library to search for relevant studies. These studies were screened and selected, the study quality was assessed, data were extracted, the results were summarized, and conclusions were drawn. Results The macrogeometry of a dental implant includes its surface characteristics, size, and shape, all of which play a critical role in its primary stability. At the time of placement, the initial stability of an implant is determined by its contact area with the surrounding bone. Larger diameter and a conical shape of an implant result in a larger contact area and better primary stability. But the linear relationship between implant length and primary stability ends at 12 mm. Conclusions Several factors must be considered when choosing the ideal implant geometry, including local factors such as the condition of the bone and soft tissues at the implant site and systemic and patient-specific factors such as osteoporosis, diabetes, or autoimmune diseases. These factors can affect the success of the implant procedure and the long-term stability of an implant. By considering these factors, the surgeon can ensure the greatest possible therapeutic success and minimize the risk of implant failure. Graphical Abstract

Primary and Secondary Stability Assessments of Dental Implants According to Their Macro-Design, Length, Width, Location, and Bone Quality

“…Many factors can affect the success of implant therapy, but patient-related factors and implant-related factors are perhaps the two most important variables to consider [26,27]. Achieving primary stability in implant surgery is one of the many desired outcomes for clinicians [28,29], and it is reported to depend mainly on bone density and implant macro geometry [30]. Research relating to insertion torque and implant success is becoming increasingly frequent.…”

Influence of Implant Macro-Design, -Length, and -Diameter on Primary Implant Stability Depending on Different Bone Qualities Using Standard Drilling Protocols—An In Vitro Analysis

“…In addition to the abovementioned prerequisites for immediate implant placement and immediate loading, the achievement of sufficient primary implant stability also plays a decisive role regarding success. For this purpose, implant manufacturers offer various macro-designs of implants, most of which feature a tapered implant geometry and/or progressive thread configurations [ 24 ]. In addition to the macro-design of implants, other factors also play an important role in the primary stability of implants: bone density, implant length and diameter, and the precision of implant bed preparation [ 52 , 68 ].…”

“…In addition to the macro-design of implants, other factors also play an important role in the primary stability of implants: bone density, implant length and diameter, and the precision of implant bed preparation [ 52 , 68 ]. While bone density cannot be influenced in advance, the practitioner can influence primary stability through the choice of implant (macro-design, -length, and -diameter), as well as through the drilling protocol [ 24 , 69 , 70 ].…”

“…Primary stability is predominantly influenced by the implant design, the surface treatment, the specific properties of the implant site, and the surgical technique used for preparation [ 22 , 23 ]. In addition, implant diameter and length are positively correlated with primary implant stability [ 24 ].…”

Toward Digital Twin Development for Implant Placement Planning Using a Parametric Reduced-Order Model

“…Dental implants are used in dental treatment to replace the teeth of partially and completely edentulous patients [7]. The implant placement process involves placing an implant in the jawbone, combining the implant with a small metal pillar, and inserting a tooth-shaped prosthesis into the oral cavity [8,9]. The 10-year survival rate of implants is more than 90%, and with proper management, they can be used for decades or more [10].…”