Insertion Torque Research Articles

Ultrashort Implants, Alternative Prosthetic Rehabilitation in Mandibular Atrophies in Fragile Subjects: A Retrospective Study.

This study aimed to evaluate the effectiveness of using ultrashort implants in the rehabilitation of jaws of fragile patients. The aim of the study was to retrospectively evaluate the survival rate of full-arch prosthetic rehabilitation on ultrashort implants, length 4 mm, 4 mm in diameter in the premolar and canine area and 4.5 mm in diameter in the molar area, with the insertion torque of 60 Nw and immediate loading. Nineteen patients were evaluated for 3 years clinically and radiographically. The significant majority of the patients at the 3 year follow-up (T4) presented a stable and functional implant-supported prothesis, and the survival rate of the implants was 85%, with a loss of 16 implants on 114 implants. The combination of the innovative implant surfaces and the correct project of the prostheses, with the related implant connection, determined a different timing in the therapy, allowing to obtain an immediate loading, which is currently demanded by patients. This and recent reports on short and ultrashort implant usage in atrophic jaws offer a good solution in critical cases. In conclusion, within the limits of the study, the full-arch rehabilitation with immediate loading on ultrashort implants showed good results with few postoperative complications and related low biological cost.

Application of Inverse Neural Networks for Optimal Pretension of Absorbable Mini Plate and Screw System

Mandibular fractures are common facial lesions typically treated with titanium plate and screw systems; nevertheless, this material is associated with secondary effects. Absorbable material for implants is an alternative to titanium, but there are also problems such as incomplete screw insertion and screw breakage due to high pretension in the screw caused by the insertion torque. The purpose of this paper is to find the optimal screw pretension (SP) in absorbable plate and screw systems by means of artificial neural network (ANN) and its inverse (ANNi). This optimal SP must satisfy a desired maximum von Mises strain (MVMS). For training the ANN, a database was generated by means of a design of experiments (DOE). Each DOE configuration was solved by means of finite element method (FEM) calculations. To obtain the optimal value for (SP) in the mini absorbable screw for fracture fixation, a strategy to invert the ANN is developed. Using the ANN coefficients, a sensitive study was performed to identify the influence of the design parameters in the MVMS. The optimal SP obtained was 14.9742 N. The MVMS condition was satisfied with an error less than 1.1% in comparison with FEM and ANN results. The screw shaft length is the most influencing MVMS parameter.

Survival rate and potential risk indicators of implant loss in non-smokers and systemically healthy periodontitis patients: An up to 9-year retrospective study.

An increasing number of patients with chronic periodontitis (CP) have received implant restoration. However, very few studies have evaluated the probable risk indicators of implant loss in patients with CP. The aim of this study is to evaluate implant long-term survival rates in patients with CP. The results are analyzed to discern potential risk indicators of implant loss. A total of 1549 implants were inserted in 827 non-smokers and systemically healthy CP patients between March 2011 and March 2019. Clinical variables (age; sex; implant location; implant diameter; implant length; implant type; bone quality; bone graft, periodontal disease status, and insertion torque) were recorded. Kaplan-Meier survival curves illustrated the cumulative survival rate. The relationship between variables and implant loss was discerned by univariate analysis. Further multivariate Cox proportional hazard regression analysis was carried out for the variables with P<0.2. The cumulative survival rates were 98.8% after 3months, 97.9% after 6months, 97.7% after 1year, and 97.4% after 2 to 9years. After adjusting possible confounders, the multivariable Cox regression model revealed statistically significant influences of implant location, history of bone graft, and insertion torque on implant loss. Implants with history of bone graft were more likely to loss. Implants inserted in the anterior area had a higher implant loss risk; insertion torque of <15 Newton-centimeter (Ncm) showed a relatively high risk of being lost. The study represented public hospital insight into long-term implant results of patients with CP. Under the premise of strict periodontal control, patients with the history of CP exhibited relatively high implant survival rate. Anterior implant location, history of bone graft, and insertion torque <15Ncm are associated with a lower implant survival rate and could be considered at a higher risk of implant failure in patients with CP.

Influence of the dental implant macrogeometry and threads design on primary stability: an in vitro simulation on artificial bone blocks

The implant macrogeometry and thread profile represent one of the most important factors for a successful achievement of primary stability during the positioning procedure. The aim of the present investigation was to evaluate the insertion torque (IT), removal torque (RT) and Implant stability Quotient (ISQ) of two different implant macrogeometry and thread profile on solid rigid polyurethane model. Two different implants macrogeometries were tested: K2 (Group I) with 11° angle, 1.17 mm pitch and self-cutting V thread profile and K3 (Group II) implants with 30° angle, 0.71 mm pitch and spyral thread profile. A total of 120 specimens (n = 60 for each group) were positioned into different conditions of solid rigid polyurethane blocks. The insertion torque (IT), removal torque (RT) and ISQ were measured for each specimen. All specimens achieved the positioning into solid rigid polyurethane blocks for both of groups with no loss of stability. A significantly higher IT, RT and ISQ were detected in Group II (p < 0.05). In both groups the mean values for IT, RT and ISQ appeared promising from a clinical point of view. In spite of different macrogeometry and thread profile, both implant types achieved high primary stability on solid rigid polyurethane block to support the functional loading for a clinical application.

Evaluation of Biomechanical and Stress Distribution of Different Dental Implant Designs: Primary Stability and Photoelastic Analysis

ObjectivesThis study aimed to evaluate and compare the stress distribution and primary stability of three different designs of dental implants. Material and Methods24 implants Neodent® were used (n=8): G1 – Alvim CM; G2 – Drive CM; G3 – Facility, submitted to insertion torque (IT) and pullout test, on 20 PCF (0.24 g/cm3) and 40 PCF (0.64 g/cm3) polyurethane blocks. For the stress distribution, by means of photoelasticity, axial and oblique loads (model at 30° inclination) of 100 N were performed, for reading and quantifying the fringe orders. According to the distribution data, a parametric or non-parametric analysis was performed (α=0.05). ResultsThe IT was lower in G3 (p<0.05) compared to G1 and G2, in 20 and 40 PCF polyurethanes. In the pullout, no difference (p>0.05) was observed between G1 and G2, in both 20 and 40 PCF polyurethanes. In the comparisons between polyurethanes, higher values (p<0.05) were obtained in the 40 PCF for IT and pullout. In the axial loading, lower stresses were observed in the cervical third and higher stresses in the middle and apical third of the implants. With the oblique inclination of the models, higher stresses were generated in the opposite side of the load, in the cervical third of G1, followed by G3 and G2. ConclusionThe results allow to affirm that G1 and G2 exhibit high primary stability and satisfactory stress distribution. Although G3 generates stresses comparable to other implants, its indication is limited in low density bones.

Effect of hypothyrodism’s medication (T4) on implant osstointegration: A case series and literature search

IntroductionHypothyroidism reduces the recruitment, maturation, and activity of bone cells, decreasing bone resorption and formation. Several investigations have reported that T4 replacement therapy is associated with a significant decrease in bone mineral density in various skeletal parts, while others have failed to corroborate these results. The present study describes both a literature review and our own experience with dental implants in patients with hypothyroidism undergoing T4 replacement therapy. Case presentationThe study included two parts: a literature review and case series. The literature review included 12 articles documenting the success rate of osseointegrated dental implants in patients with hypothyroidism. The clinical cases were chosen from King Saud University Dental College, Riyadh. The patients’ identity was only available to the main researcher. The inclusion criteria for the clinical cases were: T4-treated hypothyroidism, age 20–60 years, and use of dental implants with a follow-up period of 6–12 months after loading. The exclusion criteria were: any other medical condition alongside hypothyroidism, syndromic hypothyroidism, pregnancy, current smoking, bruxism, and hypothyroidism caused by surgical excision combined with radiotherapy. The following parameters were assessed: insertion torque (IT), crestal bone height (CBH), mesial bone width (MBW), and distal bone width (DBW) at different time points, probing depth, and signs of infection. DiscussionSeventeen dental implants placed in patients with T4-treated hypothyroidism showed median IT success (42.4 N⋅cm; range: 35–45 N⋅cm). The median crestal bone loss was measured at 6–12 months after loading was 0.6 mm (range: 0.5–0.7. mm). Conversely, the median bone loss differences in MBW and DBW at 6–12 months after loading were 0.3 mm and 0.2 mm, respectively. ConclusionAfter a 1-year follow-up, patients with T4-treated hypothyroidism who had received dental implants fulfilled the criteria for successful implants.

Clinical Assessment of Dental Implants Placed in Low-Quality Bone Sites Prepared for the Healing Chamber with Osseodensification Concept: A Double-Blind, Randomized Clinical Trial

The present study aimed to compare the stability of dental implants placed in low-quality bone prepared for the healing chamber with osseodensification technique and a standard undersized drilling. Sixteen subjects presenting D3 or D4 bone density according to Misch’s classification were randomly distributed to receive dental implants following either osseodensification (G1: n = 29) or standard undersized drilling (G2: n = 26) preparation techniques. Implant insertion torque (IT) and implant stability quotient (ISQ) were measured immediately after implant placement. Implant survival and secondary stability (ISQ) were evaluated after six months. The G1 group showed higher IT (39.0 ± 6.4 Ncm) than G2 (32.0 ± 3.4 Ncm) (p &lt; 0.001). ISQ values were similar (p &gt; 0.05) at the implant insertion (67.1 ± 3.2 and 65.5 ± 2.7 for G1 and G2, respectively). After six months healing, implant survival was equally comparable in both groups (p &gt; 0.05), and ISQ values were higher than those of implant insertion (p &lt; 0.001) but similar (p &gt; 0.05) for both groups (74.0 ± 3.6 and 73.3 ± 3.2 for G1 and G2, respectively). Within the limitations of this study, the present RCT demonstrated that a wider surgical bed prepared by osseodensification instrumentation allowed for the bone healing-chamber concept in low-quality bone without any reduction in implant stability and success rate.

Factors Affecting Implant Stability Quotients at Immediately and Conventionally Loaded Implants in the Posterior Maxilla: A Split-Mouth Randomized Controlled Trial.

To assess primary and secondary stability of variable-thread tapered implants in the posterior maxilla and analyze the impact of various factors on implant stability quotients (ISQs). Twenty-six subjects received 3-4 adjacent implants in the maxillary premolar-molar sextants to replace bilateral tooth loss. The implants on one side were immediately loaded with a provisional fixed prosthesis regardless of their primary stability. The contralateral control implants were conventionally loaded. Bone quality was subjectively recorded and primary stability was assessed by means of insertion torque values (ITVs) and ISQs in 4 directions. Secondary stability was measured by ISQ at definitive prosthesis delivery (3-3.5 months postoperatively), and 12 months after definitive loading. The impact of measurement direction, loading protocol, time, site-related (bone quality, implant position, crestal buccal bone thickness, apical cortical anchorage), and implant-related (implant dimensions, abutment height) variables on ISQs was assessed. For logistic reasons, ISQs were obtained for only 18 patients with 60 test and 60 control implants. Most of the implants (82%) at baseline had their lowest ISQ on the buccal aspect. There were no significant differences between ISQs measured in the buccal and palatal directions, or between ISQs in the mesial and distal directions. The mean of buccal and palatal ISQs was significantly lower than the mean of the 2 interproximal measurements at all evaluation periods. ISQs were not significantly different between the 2 loading groups at any time point. All implants showed a time-dependent increase in ISQs. Baseline ISQ correlated weakly with bone quality and ITV. None of the variables had a significant impact on baseline ISQs, except for implants in second molar sites which showed poorer primary stability than first premolars. Measurement direction and time are the most significant parameters affecting ISQs of variable-thread tapered implants in the posterior maxilla.

How Do Parameters of Implant Primary Stability Correspond with CT-Evaluated Bone Quality in the Posterior Maxilla? A Correlation Analysis.

The aim of the present study was to evaluate correlations between bone density and implant primary stability, considering various determinants such as age, gender, and geometry of implants (design, diameter). Bone density of edentulous posterior maxillae was assessed by computed tomography (CT)-derived Hounsfield units, and implant primary stability values were measured with insertion torque and resonance frequency analysis (RFA). A total of 60 implants in 30 partially edentulous patients were evaluated in the posterior maxilla with two different types of dental implants. The bone density evaluated by CT-derived Hounsfield units showed a significant correlation with primary stability parameters. The bone quality was more influenced by gender rather than age, and the type of implant was insignificant when determining primary stability. Such results imply that primary stability parameters can be used for objective assessment of bone quality, allowing surgical modifications especially in sites suspected of poor bone quality.

The effect of sandblasting and acid etching on survival rate of orthodontic miniscrews: a split-mouth randomized controlled trial

BackgroundThe aim of this study was to investigate the effect of surface roughening and acid etching on clinical success rate and removal and insertion torque of orthodontic miniscrews.Materials and methodsSixty-two orthodontic miniscrews (Jail Medical Corporation, Seoul, Korea) with the same design and dimensions (10-mm length, 2-mm diameter) are divided into two (sandblasted and acid-etched versus control) groups. The sample of the study was 31 patients whose miniscrews were needed for en masse retraction of the upper six anterior teeth. In this split-mouth study, the miniscrews were placed in the attached gingiva between the second premolar and the first molar. The side (left or right) was selected randomly. The miniscrews were loaded 6 weeks after insertion, and the patients were followed up after 3, 6, 10, 14, and 18 weeks and then for 4 weeks interval. Chi-square, correlation, and independent t tests were done using SPSS ver24 to interpret the data.ResultsThe survival rate was 90.3% and 83.9% for the sandblasted and acid-etched versus the control group, respectively. The difference in survival rate was not statistically significant (p > 0.05). Removal torque was higher for the sandblasted group (p < 0.05). Younger patients showed less survival rate (p < 0.05) in both groups. Insertion side, namely, left or right, was not statistically significant.ConclusionsAlthough sandblasting increased removal torque, it did not influence the survival rate of orthodontic miniscrews significantly.

Observational study on primary and secondary stability of two current bone level implant designs.

Objective: Achieving high levels of primary implant stability is considered to be desirable, despite some studies warning of the risk of bone damage. It was the goal of this observational clinical study to compare two current bone level implant systems with respect to primary and secondary stability. Method and materials: Data on bone quality, insertion torque, implant stability at insertion and after healing, as well as number of implants lost during healing were obtained from two centers either placing BLT (Bone Level Tapered, Straumann) or Nobel Parallel CC (Nobel Biocare) implants. Statistical analysis was based on Spearman rank correlation tests, analysis of variance, and t tests with the level of significance set at α = .05. Results: A total of 312 BLT and 92 Nobel Parallel CC implants were placed. Ten BLT and two Nobel Parallel CC implants failed resulting in survival rates of 96.79% and 97.83%, respectively. Mean insertion torque recorded in the different bone classes showed large standard deviations, and only torque values for BLT implants recorded in type 3 bone differed significantly from type 2 bone and type 1 bone (P = .024). For BLT implants, bone quality and insertion torque correlated (Spearman rho = -.3326; P = .0023) as did ISQ at insertion (Spearman rho = -.2241; P = .0429). Implant diameter significantly affected primary (P = .0013) and secondary (P = .0050) stability of Nobel Parallel CC implants while for BLT implants a significant effect was only seen for secondary stability (P = .0000). Bone quality had a significant effect on implant insertion torque for BLT implants (P = .0059). Bone quality had no general effect on ISQ changes during healing but 3.3-mm BLT implants showed significantly (P = .0005) lower stability after healing. Conclusion: Huge variation with respect to primary and secondary stability seems to exist among similar looking implant systems clinically used for identical indications.

Maximum Insertion Torque, Stress, and Strain in Bone during Insertion of Three Dental Implants with Different Macroscopic Designs: A Dynamic Finite-Element Analysis

Using finite element analysis, this study assesses maximum insertion torque, stress, and strain in bone during insertion of three dental implant types with different macroscopic designs. We model a bone block including cancellous and cortical bones and an osteotomy hole matching the size of the final implant drill. We then model three implants of the same length and diameter but with different thread and body designs. Model I has a conical body with greater apical region tapering and specifically designed threads, model II has wedge-shaped threads and a conical body, and model III is a conical implant with progressive threads. We place models into the bone block at 30 rounds/min and evaluate the implant insertion process in three equal phases of apical, middle, and coronal thirds. We record mean maximum von Mises stress, strain, and insertion torque at 10 points in each third of the osteotomy hole (total of 30 points). In all three implant models, increasing fixture insertion depth into the osteotomy hole results in augmented maximum von Mises stress, strain, and insertion torque in bone. Maximum values are recorded in model I, whereas minimum values are recorded in model III. The dental implant model with crestal microthread design shows maximum von Mises stress, strain, and insertion torque, whereas the model with progressive thread design and absence of coronal threads shows minimum stress, strain, and torque.

Effect of undersized drilling on the stability of immediate tapered implants in the anterior maxillary sector. A randomized clinical trial.

Background To evaluate the effect of undersized drilling on the primary and secondary stability of immediate implants placed in the anterior maxilla. Material and Methods A comparative randomized clinical trial was carried out in 30 healthy adults. Thirty tapered implants, 16 involving conventional drilling and 14 undersized drilling, were placed immediately after anterior maxillary tooth removal. Insertion torque and implant stability assessed by resonance frequency analysis (RFA) were evaluated at three different timepoints: at implant placement and 6 and 12 weeks post-implantation. The results were compared using parametric statistical tests. Results All implants showed adequate stability during follow-up. At implant placement, the undersized drilling group exhibited greater insertion torque values than the conventional drilling group, but stability assessed by RFA showed greater mean values in the conventional group. After 6 and 12 weeks of follow-up, both groups showed improved stability, though the RFA values remained comparatively higher in the conventional group. The differences were not statistically significant. Conclusions Based on the results obtained, undersized drilling does not appear to afford significantly improved stability of immediate implants placed in the anterior zone of the maxilla during the osseointegration period. Key words:Insertion torque, RFA, undersized drilling, immediate implants, primary stability, secondary stability.

Miniscrew-assisted rapid palatal expansion (MARPE): how to achieve greater stability. In vitro study.

ABSTRACTObjective: Assess the influence of mono- and bicortical anchorage and diameter of mini-implants (MIs) on the primary stability of these devices. Methods: 60 self-drilling MIs were distributed in six groups according to diameter (1.5mm, 1.8mm or 2.0mm) and type of anchorage (monocortical and bicortical) in bovine rib. The primary stability was evaluated by insertion torque, micromobility and pull-out strength tests. ANOVA and/or Tukey analysis were used to conduct intergroup comparisons (p< 0.05). Non-parametric statistics (Kruskal-Wallis and Mann-Whitney) were performed when normality was not found (p< 0.05). Results: MIs with larger diameters and bicortical anchorage showed greater primary stability regarding insertion torque (p< 0.05) and micromobility (p< 0.05). Only MI diameter had an effect on the pull-out strength test. Larger diameter MIs presented better retention in pull-out strength tests (p< 0.001), regardless of mono- or bicortical anchorage. Conclusions: MI primary stability is dependent on its diameter and type of anchorage. Bicortical anchorage showed greater stability when compared with monocortical anchorage, independently of other variables.

Stability of immediately loaded 3 mm long miniscrew implants: a feasibility study.

ABSTRACTIntroduction: Shorter miniscrew implants (MSIs) are needed to make orthodontics more effective and efficient. Objective: To evaluate the stability, insertion torque, removal torque and pain associated with 3 mm long MSIs placed in humans by a novice clinician. Methods: 82 MSIs were placed in the buccal maxillae of 26 adults. Pairs of adjacent implants were immediately loaded with 100g. Subjects were recalled after 1, 3, 5, and 8 weeks to verify stability and complete questionnaires pertaining to MSI-related pain and discomfort. Results: The overall failure rate was 32.9%. The anterior and posterior MSIs failed 35.7% and 30.0% of the time, respectively. Excluding the 10 MSIs (12.2%) that were traumatically dislodged, the failure rates in the anterior and posterior sites were 30.1% and 15.2%, respectively; the overall primary failure rate was 23.6%. Failures were significantly (p= 0.010) greater (46.3% vs 19.5%) among the first 41 MSIs than the last 41 MSIs that were placed. Excluding the traumatically lost MSIs, the failures occurred on or before day 42. Subjects experienced very low pain (2.2% of maximum) and discomfort (5.5% of maximum) during the first week only. Conclusions: Shorter 3 mm MSIs placed by a novice operator are highly likely to fail. However, failure rates can be substantially decreased over time with the placement of more MSIs. Pain and discomfort experienced after placing 3 mm MSIs is minimal and temporary.

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

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.

Lag Screw Trajectory in Supination-External Rotation Fractures: Does the Direction of the Fibula Lag Screw Have an Effect?

BackgroundThe fracture obliquity of supination-external rotation injury of the fibula is often amenable to lag screw insertion. The purpose of the study was to determine whether biomechanical differences exist between lag screws inserted from an anterior to posterior direction and from a posterior to anterior direction and the thickness of the anterior and posterior fibular cortices were correlated with biomechanical testing.MethodsTen cadaver fibulae were harvested and submitted to material testing following 3.5-mm cortical screw insertion from either an anterior to posterior direction or a posterior to anterior direction. Screw torsional insertion strength and axial pullout strength were measured. Computed tomography images of 40 consecutive patients undergoing preoperative planning for fractures excluding the fibula were examined to define fibular cortical thickness and correlate anatomic findings with the biomechanical testing.ResultsThe axial pullout strength of lag screws inserted from posterior to anterior was significantly greater than that of lag screws inserted from anterior to posterior (p < 0.05). Screw insertion torque measurements demonstrated a similar trend although the data did not reach statistical significance (p = 0.056). The anterior cortex of the distal fibula exhibited a radiographically greater thickness than that of the posterior cortex at the same level (p < 0.001).ConclusionsFor oblique fractures of the distal fibula, posterior to anterior lag screw insertion exhibited improved biomechanical properties when compared with a similar screw inserted from anterior to posterior. These results correlated with the thicker cortical bone present along the anterior fibula.

Dental implants in aesthetic zone – cases report

Placement of dental implants in the aesthetic zone needs to be planned to consider both atraumatic tooth extraction and the preservation of the socket. The authors presented two clinical cases of patients with indication of dental extraction of the upper central incisor which was planned to use a two-armed lever as atraumatic alveolar preservation technique and managed in two different ways. Case one referred to a traditional approach that included dental extraction, guided bone regeneration, and provisionalization, with a period of healing of 6 months to enable the bone regeneration. Subsequently, it was placed a dental implant TSV 3.7*13 mm (Zimmer Dental). Five months after of clinical and radiographic controls, the second phase was started with the rehabilitation. The second case was about a patient who required dental extractions of maxillary left central incisor due to a fracture of the crown with a poor prognosis, in which the dental extraction was planned to use a two-armed lever. After reclassifying the fresh socket, a dental implant TSV of 3.7 x 13 mm (Zimmer Dental) was placed with modified drilling technique, implant placement resulted in primary fixation with insertion torque level lower than 30 Ncm so the immediate load was not performed. Both patients received a ceramic crown with functional and esthetic results after 16 months of continuous checks and controls. It was concluded that the alveolar preservation in the aesthetic zone is a strategy that starts from the extraction technique. The authors recommend the two-armed lever as atraumatic alveolar preservation technique and different ways to place dental implants.

Prediction of screw loosening: Is it possible via measuring the insertion torque? An in vitro study

Prediction of screw loosening: Is it possible via measuring the insertion torque? An in vitro study

Early Loading of Posterior Nonsubmerged Titanium Implants with a Modified Sandblasted and Acid-Etched Surface: A Prospective Case Series with Up to 149 Months of Follow-up.

The purpose of this prospective study was to evaluate the success rates and prosthetic complications of implants with a modified sandblasted and acid-etched (SLA) surface inserted for posterior single-implant crown restorations. Final crowns were placed 3 to 4 weeks after surgery, and patient follow-up spanned 10 years in a private practice setting. A total of 22 patients (8 women, 14 men) with 25 posterior implants placed (16 mandible, 9 maxilla) were selected, including only implants for posterior single-implant crowns with insertion torque values of ≥ 35 Ncm at placement. Twenty-one implants passed the reverse torque test at 3 to 4 weeks after implant placement, and final restorations were placed. Three patients (4 implants) had "spinners," and there was one patient dropout after completion of the final restoration. All patients were recalled for clinical exams, digital periapical radiographs, and clinical photos at short-term (≤ 5 years) and long-term (> 5 years) follow-up appointments. The Community Periodontal Index of Treatment Needs was also determined at the initial and follow-up visits. Crestal bone level was measured at crown placement (T1), short-term follow-up (T2; mean: 29.4 months), and long-term follow-up appointments (T3; mean: 114.4 months). Twenty patients (23 implants) returned for examination at T2, and 15 (18 implants) were available at T3. For the 17 implants available at all evaluations, statistically significant bone loss was found from T1 to T2 (0.23 ± 0.30 mm), and the mean crestal bone level appeared stable from T2 to T3. Based on clinical and radiographic findings, the success rate for the implants and restorations at T2 and T3 was graded as 100%. Therefore, it can be stated that an early loading protocol of 3 to 4 weeks using a modified SLA surface at premolar/molar single-tooth locations can result in favorable clinical and radiographic long-term results.