scholarly journals Implant Stability in the Posterior Maxilla: A Controlled Clinical Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Raquel Zita Gomes ◽  
Mario Ramalho de Vasconcelos ◽  
Isabel Maria Lopes Guerra ◽  
Rute Alexandra Borges de Almeida ◽  
Antonio Cabral de Campos Felino

Aim. To evaluate the primary and secondary stability of implants in the posterior maxilla. Methods. Patients were allocated into three groups: (A) native bone, (B) partially regenerated bone, and (C) nearly totally regenerated bone. Insertion torque (IT) and implant stability quotient (ISQ) were measured at placement, to evaluate whether satisfactory high primary stability (IT ≥ 45 N/cm; ISQ ≥ 60) was achieved; ISQ was measured 15, 30, 45, and 60 days after placement, to investigate the evolution to secondary stability. Results. 133 implants (Anyridge®, Megagen) were installed in 59 patients: 55 fixtures were placed in Group A, 57 in Group B, and 21 in Group C. Fifty-two implants had satisfactory high primary stability (IT ≥ 45 N/cm; ISQ ≥ 60). A positive correlation was found between all variables (IT, ISQ at t = 0, t = 60), and statistically higher IT and ISQ values were found for implants with satisfactory high primary stability. Significant differences were found for IT and ISQ between the groups (A, B, and C); however, no drops were reported in the median ISQ values during the healing period. Conclusions. The evaluation of the primary and secondary implant stability may contribute to higher implant survival/success rates in critical areas, such as the regenerated posterior maxilla. The present study is registered in the ISRCTN registry with ID ISRCTN33469250.

Author(s):  
Luca Comuzzi ◽  
Margherita Tumedei ◽  
Ana Emilia Pontes ◽  
Adriano Piattelli ◽  
Giovanna Iezzi

Background: The aim of the present study was to compare, in low-density polyurethane blocks, the primary implant stability values (micromobility) and removal torque values of three different implant geometries in two different bone densities representing the structure of the human posterior jaws. Methods: A total of 60 implants were used in the present investigation: twenty implants for each of three groups (group A, group B, and group C), in both polyurethane 10 pcf and 20 pcf densities. The insertion torque, pull-out torque, and implant stability quotient (ISQ) values were obtained. Results: No differences were found in the values of Group A and Group B implants. In both these groups, the insertion torques were quite low in the 10 pcf blocks. Better results were found in the 20 pcf blocks, which showed very good stability of the implants. The pull-out values were slightly lower than the insertion torque values. High ISQ values were found in Group A and B implants. Lower values were present in Group C implants. Conclusions: The present investigation evaluated implants with different geometries that are available on the market, and not experimental implants specifically created for the study. The authors aimed to simulate real clinical conditions (poor-density bone or immediate post-extraction implants) in which knowledge of dental implant features, which may be useful in increasing the primary stability, may help the oral surgeon during the surgery planning.


2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
Fernanda Faot ◽  
Amália Machado Bielemann ◽  
Alessandra Julie Schuster ◽  
Raissa Micaella Marcello-Machado ◽  
Altair Antoninha Del Bel Cury ◽  
...  

Aim. To evaluate the influence of primary insertion torque (IT) values of narrow dental implants on the peri-implant health, implant stability, immunoinflammatory responses, bone loss, and success and survival rates. Methods. Thirty-one edentulous patients received two narrow implants (2.9x10mm, Facility NeoPoros) to retain mandibular overdentures. The implants were categorized in four groups according to their IT: (G1) IT > 10 Ncm; (G2) IT ≥ 10Ncm and ≤ 30 Ncm; (G3) IT >30Ncm and < 45Ncm; (G4) IT ≥ 45Ncm, and all implants were loaded after 3 months of healing. The following clinical outcomes were evaluated 1, 3, 6, and 12 months after implant insertion: (i) peri-implant tissue health (PH), gingival index (GI), plaque index (PI), calculus presence (CP), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ) by resonance frequency analysis; and (iii) IL-1β and TNF-α concentration in the peri-implant crevicular fluid. The marginal bone level (MBL) and changes (MBC) were evaluated. The Chi2 test, Kruskal-Wallis test, mixed-effects regression analysis, and the Kendall rank correlation coefficient were used for statistical analysis (α = 5%). Results. G1 presented the highest PD at all evaluated periods. G2 presented higher PI at month 6 and 12. G4 showed increased GI at month 3 and 12 and more CP at month 1 (p=.003). G2 and G4 had higher ISQ values over the study period, while those from G1 and G3 presented lower ISQ values. The IL-1β concentration increased until month 12 and was independent of IT and bone type; G4 had a higher IL-1β concentration in month 3 than the other groups (p=.015). The TNF-α release was negatively correlated with IT, and TNF-α release was highest in G1 at month 12. The MBL immediately after surgery and the MBC at month 12 were similar between the groups, and G4 presented a positive MBC at month 12. The survival and success rates were 75% for G1, 81.3% for G2, 64.3% for G3, and 95% for G4. Conclusion. The IT did not influence the clinical outcomes and the peri-implant immunoinflammatory responses and was weakly correlated with the narrow dental implants primary stability. The observed success rates suggest that the ideal IT for atrophic fully edentulous patients may deviate from the standardized IT of 32 Ncm.


2016 ◽  
Vol 42 (1) ◽  
pp. 17-25 ◽  
Author(s):  
David E. Simmons ◽  
Archontia Palaiologou ◽  
Austin G. Teitelbaum ◽  
Susan Billiot ◽  
Lomesh J. Popat ◽  
...  

This investigation was undertaken to determine if multithreaded implants partially coated with plasma-sprayed hydroxyapatite (HA) could be effectively loaded earlier than 3–6 months after placement. Forty-eight patients (22 men, 26 women) were enrolled in the study and received 48 implants. The population was divided into 2 groups: A implants (n = 23) were loaded immediately on the day of surgery and group B implants (n = 19) were loaded 3 weeks after surgery. Cone beam computerized tomography (CBCT) scans were taken preoperatively to aid in treatment planning. Bone density was evaluated by tactile feedback during surgery. Insertion torque was recorded at time of implant placement. Resonance frequency analysis, performed on the day of surgery, at the time of loading, and at 6, 12, and 24 months, was used to record implant stability according to the unit's implant stability quotient (Osstell ISQ). Standardized radiographs were taken at time of implant placement and at 6, 12, and 24 months to measure crestal bone stability. Bone level changes were measured by software (Image J). Bone quality was judged as either type 1 (n = 1), 2 (n = 31), 3 (n = 15), or 4 (n = 1). There were no failures in the group A (survival = 100%, n = 23/23) and 1 failure in group B (survival = 94.7%, n = 18/19). After 2 years in function, cumulative mean radiographic bone loss was 0.75 ± 0.50mm (maxillae: 0.92 ± 0.49 mm, n = 14; mandibles: 0.67 ± 0.49 mm, n = 28). No differences in bone levels were noted between implants placed in previously augmented and nonaugmented sites, and there were no periodontal or soft tissue complications. After 2 years in function, implants partially coated with plasma-sprayed and hydrothermally treated HA were clinically predictable when restored in occlusion immediately after or within 3 weeks of implant placement.


2021 ◽  
Vol 23 (05) ◽  
pp. 392-411
Author(s):  
Dr. Ali Nahi Hamdi ◽  
◽  
Dr. Shehab Ahmed Hemd ◽  

Dental implants are considered the first choice to replace lost or non-restorable teeth. However, the posterior maxilla remains a challenge in its management because of the quality of bone in the posterior maxilla. Osseo densification (OD) concept has been proposed in the literature to improve primary implant stability, which is an important aspect of osseointegration. Densah bur is novel drills specially designed to enhance a bone density by Osseo densification, which in turn increases primary stability. This present study was conducted to assess crestal sinus floor elevation by osteotome in comparison to Densah bur in the posterior atrophic maxilla. This was a randomized controlled clinical trial conducted on 20 patients to evaluate available crestal bone height loss, implant stability after implant placement in healed posterior maxillary alveolar ridge, whole bone height, Schneiderian membrane trauma, and post-operative complication.


Author(s):  
Javier Badenes ◽  
Antonio Pallarés

While many studies have related smoking to periimplantitis and marginal bone loss, little is known of its potential impact upon dental implant osseointegration. The present clinical study explores the influence of smoking upon secondary stabilization based on radiofrequency analysis. A total of 194 implants in 114 patients were included. Implant stability was evaluated on the day of surgery and a minimum of 90 days after implantation, when osseointegration is considered to have been completed. The evolution of implant stability was compared between two groups: smokers versus non-smokers. The following variables were also analyzed: implant brand, model, length and diameter, insertion torque, bone density according to the Misch classification, location of the implant, and patient age and gender. The results showed that smoking does not affect primary stability of the implant, though it was associated to a marked decrease in secondary stability. The non-smokers showed a gain of 2.69 points (95%CI: 1.529 to 3.865) in the osseointegration process with respect to the smokers (p&lt;0.001). Among the latter, implant stability was seen to decrease 0.91 points (95%CI: -3.424 to 1.600) (p&lt;0.004), generating a difference of 3.61 points between smokers and non-smokers. Smoking is thus concluded to be an important factor that must be taken into account when seeking good implant osseointegration outcomes.


Crystals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 308
Author(s):  
Stefano Fanali ◽  
Margherita Tumedei ◽  
Pamela Pignatelli ◽  
Morena Petrini ◽  
Adriano Piattelli ◽  
...  

The implant geometry provides a key role in the osseointegration process and is able to improve the mechanical interaction and primary stability into the bone tissue. The aim of the present investigation was to compare different implant profiles to evaluate their influence on the primary stability on high-density polyurethane block. Methods: A total of 100 implants were used on 20 pcf polyurethane density in the present investigation, i.e., 20 implants for each of 5 groups (A, B, C, D, and E), characterized by different thread pitch and geometry. The insertion torque (IT), and Periotest mean values were recorded during the implant positioning. Results: Mean values for insertion torque values were higher for the group C and group E implant profiles when compared to all other groups (p < 0.01). No significant differences were detected between these two groups (p < 0.05). Lower IT (<20 Ncm2) were presented by groups A, B, and D (p < 0.05). All groups showed negative Periotest values. Group C implants showed the lowest level of Periotest values (p < 0.05). No significant Periotest differences were found between group B and group D and between group A and group E (p > 0.05). Conclusions: Implants with a wider and V-thread profile and a round apex showed a higher stability in a standardized polyurethane foam. Their use could be suggested in high-density bone in clinical practice.


2014 ◽  
Vol 71 (5) ◽  
pp. 451-461 ◽  
Author(s):  
Rafael Delgado-Ruíz ◽  
Aleksa Markovic ◽  
Luís Calvo-Guirado ◽  
Zoran Lazic ◽  
Adriano Piattelli ◽  
...  

Background/Aim. The modification of implant surfaces could affect mechanical implant stability as well as dynamics and quality of peri-implant bone healing. The aim of this 3-month experimental study in dogs was to investigate implant stability, marginal bone levels and bone tissue response to zirconia dental implants with two laser-micro-grooved intraosseous surfaces in comparison with nongrooved sandblasted zirconia and sandblasted, high-temperature etched titanium implants. Methods. Implant surface characterization was performed using optical interferometric profilometry and energy dispersive X-ray spectroscopy. A total of 96 implants (4 mm in diameter and 10 mm in length) were inserted randomly in both sides of the lower jaw of 12 Fox Hound dogs divided into groups of 24 each: the control (titanium), the group A (sandblasted zirconia), the group B (sandblasted zirconia plus microgrooved neck) and the group C (sandblasted zirconia plus all microgrooved). All the implants were immediately loaded. Insertion torque, periotest values, radiographic crestal bone level and removal torque were recorded during the 3-month follow-up. Qualitative scanning electon micro-scope (SEM) analysis of the bone-implant interfaces of each group was performed. Results. Insertion torque values were higher in the group C and control implants (p < 0.05). Perio-test values increased in all the periods in proportion to the ex-tent of microgrooving as follows: the group C > the control > the group B > the group A (p < 0.05). Radiographic measurements showed minimal crestal bone loss at 3 months for microgrooved zirconia implants (groups C and B) and control implants compared with the group A implants (p < 0.05). The removal torque values increased with time for all the groups as follows: the group C > the control > the group B > the group A (p < 0.05). SEM showed that implant surfaces of the groups B and C had an extra bone growth inside the microgrooves that corresponded to the shape and direction of the microgrooves. Conclusion. The addition of micro-grooves to the entire intraosseous surface of zirconia dental implants enhances primary and secondary implant stability, promotes bone tissue ingrowth and preserves crestal bone levels.


Author(s):  
André Moreira ◽  
◽  
José Rosa ◽  
Filipe Freitas ◽  
Helena Francisco ◽  
...  

Objectives: To evaluate the influence of implant geometry and anatomical region on implant stability. Methods: A randomized controlled clinical trial was conducted on 45 patients, in whom a total of 79 implants were placed: 40 MIS C1 Implants and 39 MIS Seven Implants. The implant stability quotient was measured using resonance frequency analysis immediately after implant placement and 8 weeks later with an Osstell Mentor device. Results: 76 implants were analyzed. The implant stability quotient was statistically significantly higher for secondary stability than primary stability (68.7±8,6 vs. 65.2±10.3, respectively, p=0.023). Considering primary stability, no statistical differences were found between the implant lengths 8.0 mm, 10.0 mm, 11.0 mm, and 11.5 mm (67.9±7.6, 63.9±10, 57.2±11.1, and 66.4±11.3, respectively, p=0.312). The same was observed for secondary stability (68.4±9.4, 67.9±9.3, 74.7±1.5, and 69.2±7.9, respectively, p=0.504). Also, there were no statistically significant differences between the implant diameters 3.75 mm and 4.20 mm concerning primary stability (64.3±8.7 and 66.1±11.7 respectively, p=0.445) or secondary stability (68.8±8.2 and 68.7±9.1 respectively, p=0.930). Regarding implant design, a statistically significant difference was found only for secondary stability, favoring MIS Seven implants (p=0.048). The intraoral location was statistically significant for both primary and secondary stability, as these were higher on the anterior maxilla than the posterior maxilla and mandible (p<0.05). Conclusions: The diameter and length of the implants studied did not influence their stability. Implant design may influence secondary stability, whereas intraoral location has a relevant effect on primary and secondary stability.


Author(s):  
André Moreira ◽  
◽  
José Rosa ◽  
Filipe Freitas ◽  
Helena Francisco ◽  
...  

Objectives: To evaluate the influence of implant geometry and anatomical region on implant stability. Methods: A randomized controlled clinical trial was conducted on 45 patients, in whom a total of 79 implants were placed: 40 MIS C1 Implants and 39 MIS Seven Implants. The implant stability quotient was measured using resonance frequency analysis immediately after implant placement and 8 weeks later with an Osstell Mentor device. Results: 76 implants were analyzed. The implant stability quotient was statistically significantly higher for secondary stability than primary stability (68.7±8,6 vs. 65.2±10.3, respectively, p=0.023). Considering primary stability, no statistical differences were found between the implant lengths 8.0 mm, 10.0 mm, 11.0 mm, and 11.5 mm (67.9±7.6, 63.9±10, 57.2±11.1, and 66.4±11.3, respectively, p=0.312). The same was observed for secondary stability (68.4±9.4, 67.9±9.3, 74.7±1.5, and 69.2±7.9, respectively, p=0.504). Also, there were no statistically significant differences between the implant diameters 3.75 mm and 4.20 mm concerning primary stability (64.3±8.7 and 66.1±11.7 respectively, p=0.445) or secondary stability (68.8±8.2 and 68.7±9.1 respectively, p=0.930). Regarding implant design, a statistically significant difference was found only for secondary stability, favoring MIS Seven implants (p=0.048). The intraoral location was statistically significant for both primary and secondary stability, as these were higher on the anterior maxilla than the posterior maxilla and mandible (p<0.05). Conclusions: The diameter and length of the implants studied did not influence their stability. Implant design may influence secondary stability, whereas intraoral location has a relevant effect on primary and secondary stability.


Author(s):  
João Paulo do Vale Souza ◽  
Clóvis Lamartine de Moraes Melo Neto ◽  
Lucas Tavares Piacenza ◽  
Emily Vivianne Freitas da Silva ◽  
André Luiz de Melo Moreno ◽  
...  

Abstract Objectives This study aimed to assess the relation between the insertion torque and implant stability quotient (ISQ recorded immediately and 6 months after implant placement). Materials and Methods Twenty-five patients over the age of 18 years were selected for this study. One implant was placed per patient after tooth extraction. The implant site needed 15 mm in height and 8 mm in width. All implants had the same size (11.5 × 3.75 mm) and brand (Hexagonal Morse cone, DSP Biomedical). The insertion torque (Ncm) and resonance frequency analysis (ISQ value) (Osstell Mentor) were used to assess the primary stability (on the day of surgery). After 6 months, ISQ value was used to assess the secondary stability of each implant. Statistical Analysis The insertion torque data were correlated with ISQ measurements by using Pearson’s correlation. The significance level was 5%. Results There was a positive correlation between insertion torque and initial ISQ (correlation: 0.457; p = 0.022); however, no correlation was found between insertion torque and final ISQ (p = 0.308). Conclusion The present study demonstrated that there is a positive correlation between the insertion torque and the initial ISQ. Therefore, the higher the insertion torque, the higher the initial ISQ (or vice versa).


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