Abstract
Background To date, insertion torque value (ITV) and implant stability quotient (ISQ) obtained by the Osstell instrument are common clinical methods to assess the initial stability of an implant for a predictable loading procedure. The aim of this current study is to evaluate the ITV and ISQ as stability parameters as part of the decision-making protocol in the adoption of immediate loading in fresh extraction sockets. Materials and Methods A total of 41 tapered implants were allocated into two groups: the test group (n = 11; 3 males and 8 females; mean age: 62.8 ± 10.7) which received 18 implants as type 1 fresh extraction sockets after teeth removal and the control group (n = 7; 4 males and 3 females; mean age: 65.4 ± 9.7) which received 23 implants placed in healed sockets for a period of at least 3 months. Both the ITV and ISQ data were recorded at the time of insertion (t0). Since ITV (test group) and ITV/ISQ (control group) values were useful for the immediate loading protocol, a screw-retained temporary crown was immediately loaded. ISQ values were recorded after a healing period of 4 months (t1). Results ITV mean values at t0 in test and control groups were, respectively, 48.61 ± 15.39 and 70.47 ± 14.71, whereas ISQ mean values were 57.55 ± 1.93 and 72.86 ± 5.25, respectively, showing a statistically significant difference (p value < 0.001). ISQ mean values at t1 in either the test or the control group were 68.68 ± 4.20 and 74.54 ± 4.17, not showing a statistical difference. The implant survival rate was 100% in both groups, and no surgical and prosthetic complications were reported during the study. Conclusion In conclusion, this study remarked the presence of a residual gap that influenced the ISQ during implant insertion in fresh extraction sockets making this parameter not sufficient for a conclusive decision in the immediate loading, whereas the ITV alone showed to be the best parameter for a final substantial decision.
Highlights
Insertion torque value (ITV) and implant stability quotient (ISQ) obtained by the Osstell instrument are common clinical methods to assess the initial stability of an implant for a predictable loading procedure. e aim of this current study is to evaluate the insertion torque value (ITV) and ISQ as stability parameters as part of the decision-making protocol in the adoption of immediate loading in fresh extraction sockets
Mean ISQ values recorded after a healing period of 4 months (t1) (68.66 ± 4.20) showed a statistically significant difference compared to the same values measured at t0 (p value < 0.0005)
Current protocols strongly suggest the use of ITV, ISQ, and resonance-frequency analysis (RFA) methodologies, in order to make a solid decision towards the immediate loading procedure, this study showed that the ITV alone could be enough in the decision-making process. e outcomes, though still low in number, clearly showed that ISQ values recorded at the time of implant placement are not sufficient as a conclusive parameter for an immediate loading protocol after extraction socket since the ISQ may give either incorrect values or incongruence data because of the presence of a residual gap in extraction sockets
Summary
Implantology is a field of dentistry that has been practiced since many years, thanks to the biological osteointegration principles of Branemark’s protocol [1]. e osteointegration, defined as “a direct structural and functional connection between the living bone and the surface of the load-carrying implant,” depends on an atraumatic surgery with the use of BioMed Research International surgical motors with speed and torque control, sterile saline solution for irrigation, titanium biocompatibility, and implant primary stability [2].In 1973, Cameron et al specified that the micromovements at the bone/implant interface could be tolerated up to a certain threshold between 50 and 150 μm [3]. erefore, it was common opinion that the micromotions produced by early loading could affect bone healing and induce fibrous tissue encapsulation instead of osteointegration. Erefore, it was common opinion that the micromotions produced by early loading could affect bone healing and induce fibrous tissue encapsulation instead of osteointegration For this reason, according to the original Branemark’s protocol, a no-loaded healing period of 3–6 months following implant placement was essential to achieve adequate implant stability before functional loading [4]. A total of 41 tapered implants were allocated into two groups: the test group (n 11; 3 males and 8 females; mean age: 62.8 ± 10.7) which received 18 implants as type 1 fresh extraction sockets after teeth removal and the control group (n 7; 4 males and 3 females; mean age: 65.4 ± 9.7) which received 23 implants placed in healed sockets for a period of at least 3 months Both the ITV and ISQ data were recorded at the time of insertion (t0). This study remarked the presence of a residual gap that influenced the ISQ during implant insertion in fresh extraction sockets making this parameter not sufficient for a conclusive decision in the immediate loading, whereas the ITV alone showed to be the best parameter for a final substantial decision
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