Integrative Performance Analysis of a Novel Bone Level Tapered Implant

Abstract

Primary mechanical stability, as measured by maximum insertion torque and resonance frequency analysis, is generally considered to be positively associated with successful secondary stability and implant success. Primary implant stability can be affected by several factors, including the quality and quantity of available bone, the implant design, and the surgical procedure. The use of a tapered implant design, for instance, has been shown to result in good primary stability even in clinical scenarios where primary stability is otherwise difficult to achieve with traditional cylindrical implants-for example, in soft bone and for immediate placement in extraction sockets. In this study, bone-type specific drill procedures are presented for a novel Straumann bone level tapered implant that ensure maximum insertion torque values are kept within the range of 15 to 80 Ncm. The drill procedures are tested in vitro using polyurethane foam blocks of variable density, ex vivo on explanted porcine ribs (bone type 3), and finally in vivo on porcine mandibles (bone type 1). In each test site, adapted drill procedures are found to achieve a good primary stability. These results are further translated into a finite element analysis model capable of predicting primary stability of tapered implants. In conclusion, we have assessed the biomechanical behavior of a novel taper-walled implant in combination with a bone-type specific drill procedure in both synthetic and natural bone of various types, and we have developed an in silico model for predicting primary stability upon implantation.

Effect of implant neck design on primary and secondary implant stability in the posterior maxilla: A prospective randomized controlled study

“…Mean insertion torque of Ti‐Unite Branemark III implants placed in the posterior maxilla was 22 Ncm in type III bone and 17 Ncm in type IV bone (Alsaadi, Quirynen, Komárek, & Steenberghe, ); other studies in the posterior maxilla also reported low mean insertion torques between 10 and 30 Ncm (Alsaadi et al, ; Beer, Gahleitner, Holm, Tschabitscher, & Homolka, ). It is accepted that the insertion torque of tapered implants is superior to paralleled‐wall implants (Dard et al, ; Javed et al, ). Comparing these data seems to confirm that implant design plays a critical role when a threshold insertion torque is aimed at a demanding bony environment.…”

Comparison between tapered and cylindrical implants in the posterior regions of the mandible: A prospective, randomized, split‐mouth clinical trial focusing on implant stability changes during early healing

“…In low-density bone sites, the dental implant macrodesign needs to guarantee an acceptable primary stability 2,6,10,[22][23][24]30 ; and stability tends to increase with length and width, so long and wide implants are still preferable. However, their installation requires sufficient thickness of the alveolar crest.…”

“…Currently, clinical data related to the healing process such as implant stability quotient (ISQ) values and peri‐implant health are not present in literature. In addition, in vitro studies comparing the performance of tapered and cylindrical implants yielded variable and inconsistent results …”

“…In addition, in vitro studies comparing the performance of tapered and cylindrical implants yielded variable and inconsistent results. 12,[24][25][26] Some in vitro studies showed that the effects of macrogeometry effect were more prominent when insertion torque (IT) values were used as indicators of primary stability (PS). Using an under-dimensioned drilling procedure 27 or a treated surface, 12 tapered implants yield higher IT and primary stability values compared to cylindrical implants.…”

Clinical Relevance of Integrated Developmental Research for Dental Implants

“…The fourth publication, by Dard et al (2016), defends the concept of integrative performance analysis applied to a novel bone-level tapered implant. They propose successively conducting bone type-specific drill procedures that ensure maximum insertion torque values within the range of 15 to 80 N•cm when measured by maximum insertion torque and resonance frequency analysis.…”