Abstract
Insertion energy has been advocated as a novel measure for primary implant stability, but the effect of implant length, diameter, or surgical protocol remains unclear. Twenty implants from one specific bone level implant system were placed in layered polyurethane foam measuring maximum insertion torque, torque–time curves, and primary stability using resonance frequency analysis (RFA). Insertion energy was calculated as area under torque–time curve applying the trapezoidal formula. Statistical analysis was based on analysis of variance, Tukey honest differences tests and Pearson’s product moment correlation tests (α = 0.05). Implant stability (p = 0.01) and insertion energy (p < 0.01) differed significantly among groups, while maximum insertion torque did not (p = 0.17). Short implants showed a significant decrease in implant stability (p = 0.01), while reducing implant diameter did not cause any significant effect. Applying the drilling protocol for dense bone resulted in significantly increased insertion energy (p = 0.02) but a significant decrease in implant stability (p = 0.04). Insertion energy was not found to be a more reliable parameter for evaluating primary implant stability when compared to maximum insertion torque and resonance frequency analysis.
Highlights
Recent finite element analysis [1] and in-vitro experiments [2] have shown that trabecular bone definitely contributes to the insertion process and resulting implant stability
A potential paradigm shift in surgical implant placement appears evident, transitioning from high insertion torque values being considered beneficial for mechanical primary implant stability [7,23], to an altered osteotomy and implant installation protocol to provide for a biologically acceptable level of primary stability—a successful outcome that avoids damage to the jaw bone due to mechanical stress [10,11,12,13,24,25]
Insertion energy of a dental implant has been advocated as a relevant measure [17,18,19,20,21,22]
Summary
Recent finite element analysis [1] and in-vitro experiments [2] have shown that trabecular bone definitely contributes to the insertion process and resulting implant stability. Surgical technique should be customized based on the bone quality found in the specific site and with consideration of the impact of different drilling protocols, implant designs [3,4], and implant material [5]. Marin et al [10] demonstrated that under-sizing an implant osteotomy led to an increase in insertion torque and had no detrimental effect on osseointegration when compared to wider bone preparation, despite substantial differences in the healing mode.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call