Incomplete Implant Insertion Due to the Use of A Non-dynamometric Torque Wrench: A Case Report

Abstract

A case is reported in which the use of a non- dynamometric torque wrench could be the cause of incomplete implant insertion. A woman, 73-year-old, visited the dentist in March 2021 for oral rehabilitation due to the absence of teeth in the left mandibular area. A Galimplant IPX 4.5 x 8 implant (internal hex connection) (Sarria, Spain) was placed in position 36. Bone drilling was performed correctly in width and depth, however, insertion of the implant was difficult due to the hardness of the cortical bone. New drillings were made in the bone with insertion and removal of the implant on three occasions. On the third occasion, the implant was threaded to a depth of 7 mm. At that time, the thread that the implant had carved in the bone had been lost and the implant did not advance until 8 mm in depth, nor could it go back to remove it and continue drilling the bone. We estimate that a dynamometric torque wrench should have been used during implant insertion, to provide adequate torque and not cause the loss of the thread that the implant had carved into the bone. The use of a non-dynamometric torque wrench does not allow a precise insertion torque. If excessive torque is applied, the thread carved by the implant in the bone can be lost and this finally causes an incomplete insertion of the same.