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

Abstract

(1) Background: Primary implant stability is vital for successful implant therapy. This study explores the influence of implant shape, length, and diameter on primary stability in different bone qualities. (2) Methods: Three implant systems (two parallel-walled and one tapered) with various lengths and diameters were inserted into polyurethane foam blocks of different densities (35, 25, 15, and 10 PCF) using standard drilling protocols. Primary stability was assessed through insertion torque (IT) and resonance frequency analysis (RFA). Optimal ranges were defined for IT (25 to 50 Ncm) and RFA (ISQ 60 to 80). A comparison of implant groups was conducted to determine adherence to the optimal ranges. (3) Results: Implant macro-design, -length, and -diameter and bone block density significantly influenced IT and RFA. Optimal IT was observed in 8/40 and 9/40 groups for the parallel-walled implants, while the tapered implant achieved optimal IT in 13/40 groups (within a 25–50 Ncm range). Implant diameter strongly impacted primary stability, with sufficient stability achieved in only one-third of cases despite the tapered implant’s superiority. (4) Conclusions: The findings highlight the need to adapt the drilling protocol based on diverse bone qualities in clinical practice. Further investigations should explore the impact of these adapted protocols on implant outcomes.

The Effectiveness of Osseodensification Drilling versus the Conventional Surgical Technique on Implant Stability: A Clinical Trial

“…The ISQ value range from 1 to100. A value of ISQ < 60 represents low stability, ≥60 ISQ ≤ 69 represents medium stability and ISQ ≥ 70 high stability [16,18]. According to our results, there was a progressive increase in IT and ISQ over time, regardless of the technique used, SD or OD.…”

“…The IT, initially developed by Johansson and Strid, is applied with a torque wrench, and is the measure of the frictional resistance obtained at the time of implant placement [17,18]. The maximum value of the insertion torque was recorded in Newton centimeter (Ncm) [16,18].…”

A New Approach to Implant Stability Using a Flexible Synthetic Silicate-Additive Beta-Tricalcium Phosphate-Poly(D,L-lactide-co-caprolactone) Bone Graft: An In Vitro Study

“…Comuzzi et al compared polyurethane blocks of different densities and reported that implant insertion and removal torques increased with increasing density [ 43 ]. Similarly, Stoilov et al found that polyurethane blocks used in relation to different densities affected the ITs of the implants, with higher ITs being achieved with higher densities [ 44 ]. According to these studies, the use of polyurethane blocks for comparison between the ITs obtained from different sockets is considered appropriate.…”

Influence of implant shape and prosthetic platform on cervical bone resorption: A systematic review

“…The mechanical and behavioral factors of stress (amplitude, direction, rate, and frequency) affect bone remodeling, particularly in the neck region (Cehreli et al, 2004). Thus, cylindrical implants may require a higher insertion torque to achieve primary stability, and if exceeded by 50 Ncm may potentiate MBL (Nandini, et al, 2022;Stoilov, et al, 2023). , demonstrated that cylindrical implants showed a slight increase in MBL compared to conical implants, but not in a statistically significant way.…”