Background To date, insertion torque value (ITV) and implant stability quotient (ISQ) obtained by the Osstell instrument are common clinical methods to assess the initial stability of an implant for a predictable loading procedure. The aim of this current study is to evaluate the ITV and ISQ as stability parameters as part of the decision-making protocol in the adoption of immediate loading in fresh extraction sockets. Materials and Methods A total of 41 tapered implants were allocated into two groups: the test group (n = 11; 3 males and 8 females; mean age: 62.8 ± 10.7) which received 18 implants as type 1 fresh extraction sockets after teeth removal and the control group (n = 7; 4 males and 3 females; mean age: 65.4 ± 9.7) which received 23 implants placed in healed sockets for a period of at least 3 months. Both the ITV and ISQ data were recorded at the time of insertion (t0). Since ITV (test group) and ITV/ISQ (control group) values were useful for the immediate loading protocol, a screw-retained temporary crown was immediately loaded. ISQ values were recorded after a healing period of 4 months (t1). Results ITV mean values at t0 in test and control groups were, respectively, 48.61 ± 15.39 and 70.47 ± 14.71, whereas ISQ mean values were 57.55 ± 1.93 and 72.86 ± 5.25, respectively, showing a statistically significant difference (p value < 0.001). ISQ mean values at t1 in either the test or the control group were 68.68 ± 4.20 and 74.54 ± 4.17, not showing a statistical difference. The implant survival rate was 100% in both groups, and no surgical and prosthetic complications were reported during the study. Conclusion In conclusion, this study remarked the presence of a residual gap that influenced the ISQ during implant insertion in fresh extraction sockets making this parameter not sufficient for a conclusive decision in the immediate loading, whereas the ITV alone showed to be the best parameter for a final substantial decision.
The use of graft materials is developed from the strong demand to support the complete bone regeneration of the empty socket and to increase the bone volume in treating the atrophies of sites already consolidated and with adverse alveolar bone conditions. A number of graft materials with different origin and mechanism of bone regeneration are available. Autologous graft materials, coming from the same patient, are defined as the gold-standard. The need of a second surgical site and the risk of morbidity and complications may make their use difficult. Human bone allografts (HBA) have been recently introduced, in order to offer an alternative to the autologous grafts. They have demonstrated to be effective in bone regeneration. Recent studies have proved the ability of HBA in bone regenerating process as they guarantee a three-dimensional structure for the re-growth of the new bone and the maintenance of inductive stimuli. In the present manuscript, Authors reviewed the evidence supporting the use of HBA in the management of the localized ridge atrophies, in the preservation of the extracted socket and in the sinus augmentation surgery, and illustrated some original case reports.
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