Effects of Different Undersizing Site Preparations on Implant Stability.

Bernardo Ferreira Lemos,Carlos Falcao,José Vicente Ríos-Santos,Javier Gil,Paula Lopez-Jarana,Blanca Ríos-Carrasco,Mariano Herrero-Climent

doi:10.3390/ijerph17238965

Abstract

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant (p < 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully.

Highlights

The primary stability of dental implants is a key element in obtaining successful osseointegration [1].It is described as the frictional force of contact between the implant surface and the drill bone preparation after its insertion [2]; it is a mechanical concept
For implants with a diameter of 4 mm, the insertion torque (IT) values were higher in those sequences in which underpreparation was performed without the use of the cortical drill (P2 and P4)
The results show that when the implant site was undersized, there was an increase in the resonance frequency analysis (RFA) values, so micromovements of the implant were decreased and higher primary implant stability was obtained

Summary

Introduction

The primary stability of dental implants is a key element in obtaining successful osseointegration [1]. It is described as the frictional force of contact between the implant surface and the drill bone preparation after its insertion [2]; it is a mechanical concept. It is defined as the non-existence of mobility, where the implant stays in the desired final position. Recent research showed that primary stability could be affected by several factors: the macro-implant design, bone quality, implant size, osseous morphology of the surgical site, drilling protocol technique [5] or surgeon’s skills.

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Conclusion