2021
DOI: 10.1371/journal.pone.0251904
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Abstract: Objective During the insertion of dental implants in the bone tissue, different torque values can be applied. However, the high applied torque can cause damage to the implant connection. Our study sought to evaluate, by measuring the angle of rotation of the insertion drive and, later microscopic observation, possible changes in the structure of implants of different diameters with 3 different types of connections after the application of 4 different torque intensities. Materials and methods Three hundred ta… Show more

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Cited by 7 publications
(5 citation statements)
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“…On the contrary, other studies have suggested that a high insertion torque produces compressive forces in the peri-implant bone, which may alter the bone microcirculation and produce bone necrosis and therefore compromise osseointegration [ 18 ]. Additionally, the compressive forces can lead to mechanical complications [ 23 ], such as deformation of the prosthetic connection, abrasion of the threads, or biological complications, such as peri-implantitis, due to the release of titanium particles in the surrounding bone [ 24 ]. In fact, a similar ex vivo study showed that implant placement could release up to 0.5 mg of titanium particles at the bone/implant interface [ 25 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…On the contrary, other studies have suggested that a high insertion torque produces compressive forces in the peri-implant bone, which may alter the bone microcirculation and produce bone necrosis and therefore compromise osseointegration [ 18 ]. Additionally, the compressive forces can lead to mechanical complications [ 23 ], such as deformation of the prosthetic connection, abrasion of the threads, or biological complications, such as peri-implantitis, due to the release of titanium particles in the surrounding bone [ 24 ]. In fact, a similar ex vivo study showed that implant placement could release up to 0.5 mg of titanium particles at the bone/implant interface [ 25 ].…”
Section: Discussionmentioning
confidence: 99%
“…Furthermore, regarding the deformation at the level of the implant connection, the study of Gehrke et al reported that independently of the type of implant/abutment connection, torque values exceeding 80 Ncm resulted in a significant irreversible deformation, which could lead to clinical complications, such as abutment and crown loosening, screw fractures, abutment adaptation issues and bacterial microfiltration [ 26 , 27 ]. However, in the latter study, the torque application was performed on the implant completely static, which is not similar to any clinical scenario [ 23 ]. In contrast, in our study, implants were in motion during insertion into bony tissue, which in its turn could absorb some of the applied stress.…”
Section: Discussionmentioning
confidence: 99%
“…14 Moreover, excessive insertion torque has been shown to create damage to the implant itself during placement. 15,16 Consequently, the selection of a suitable drilling protocol for each specific bone site is essential for the control of insertion torque levels, and should be adapted to the implant design. 17 With excessive insertion torque values, the reduced dimensions of mini implants could increase the risk of implant fracture, deterioration of the prosthetic interface (especially in one-piece mini implants), as well as damage to the surgical instruments.…”
Section: Introductionmentioning
confidence: 99%
“…However, extreme forces and strain at the bone‐implant interface can jeopardize osseointegration, as bone microfractures can occur, leading to ischemic necrosis and bone resorption 14 . Moreover, excessive insertion torque has been shown to create damage to the implant itself during placement 15,16 …”
Section: Introductionmentioning
confidence: 99%
“…Animal studies [8,9] have observed an increased predictability of implant treatment when the insertion resulted in an insertion torque ≥ 32 Ncm; however, there are conflicting opinions in literature on the limits of this value [10]. A high insertion torque (greater than 50 or 70 Ncm) has been shown to lead to the formation of microfractures, damage to microcirculation leading to bone necrosis especially in cortical or bicortical bones, alterations to the prosthetic connection, and changes in the surface roughness and microtopography of implants [5,11,12]. Another animal study noticed that implants inserted in underprepared sites with high ITQ (> 100 Ncm) induced considerable bone remodeling, circumferential to the implant [13].…”
mentioning
confidence: 99%