Standard Drilling Versus Ultrasonic Implant Site Preparation

Makary, Christian; Rebaudi, Alberto; Demircioğlu, Arzu; Lahoud, Pierre; Naaman, Nada

doi:10.1097/id.0000000000000615

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…In the present work, overall mean IT value was 82.3 Ncm, with a relatively high mean value of 55.2 Ncm in soft D4 bone, when compared to others studies with ISQ values ranging between 22 Ncm and 40 Ncm when using implants with tapered geometry [9,11]. Low implant IT was reported to favor micromotion [35], potentially jeopardizing implant osseointegration [36].…”

Section: Discussionmentioning

confidence: 44%

“…When recorded in soft and hard bone, mean ISQ values showed significantly different results (73.2 and 81.9, respectively). The correlation between ISQ values and bone density was already reported in the literature with higher values in denser bone qualities [10,11]. Nevertheless, the relationship between IT and ISQ was not linear: They correlated significantly only in soft bone (D4, p = 0.0008), while the strength of their association was not significant in the other groups (D1, p = 0.28; D2, p = 0.31; D3, p = 0.16).…”

Section: Discussionmentioning

confidence: 77%

“…When looking into IT values in hard bone, the present results showed a mean value of 107.2 Ncm. Even though this value may be high when compared to commonly described IT values [42], it is lower than that described in some clinical studies using tapered implant geometry reporting values ranging from 120 Ncm up to 176 Ncm [9,11,43]. A recent meta-analysis concluded that high IT values do not seem to be a predictive factor for implant failure [44].…”

Section: Discussionmentioning

confidence: 85%

“…Nevertheless, it is always difficult to attain optimal implant stability in all bone types. High IT and ISQ values are easily achieved in hard bone, while low values are often observed in soft bone conditions [11]. Both of these occurrences may negatively impact on the healing outcomes, since very high IT values may excessively compress the cortical bone, leading to early marginal bone loss [12,13], whereas low IT values could impede early healing and bone-to-implant interface quality [10].…”

Section: Introductionmentioning

confidence: 99%

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Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants

Makary

Menhall

Zammarie³

et al. 2019

Materials

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Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according to the bone density of the implant site. Materials and Methods: Patients needing implant therapy for fixed prosthetic rehabilitation were treated by inserting fixtures with four different thread diameters, selected based on clinical assessment of bone quality at placement (D1, D2, D3, and D4, according to Misch classification). Final insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and ISQ measurements repeated after one, two, three, and four weeks. At the three-week measurement (four weeks after implant replacement), implants with ISQ > 70 Ncm were functionally loaded with provisional restorations. Marginal bone level was radiographically measured 12 months after implant insertion. Results: Fourteen patients were treated with the insertion of forty implants: Among them, 39 implants showing ISQ > 70 after 3 weeks of healing were loaded with provisional restoration. Mean IT value was 82.3 ± 33.2 Ncm and varied between the four different types of bone (107.2 ± 35.6 Ncm, 74.7 ± 14.0 Ncm, 76.5 ± 31.1 Ncm, and 55.2 ± 22.6 Ncm in D1, D2, D3, and D4 bone, respectively). Results showed significant differences except between D2 and D3 bone types. Mean ISQ at baseline was 79.3 ± 4.3 and values in D1, D2, D3, and D4 bone were 81.9 ± 2.0, 81.1 ± 1.0, 78.3 ± 3.7, and 73.2 ± 4.9, respectively. Results showed significant differences except between D1 and D2 bone types. IT and ISQ showed a significant positive correlation when analyzing the entire sample (p = 0.0002) and D4 bone type (p = 0.0008). The correlation between IT and ISQ was not significant when considering D1, D2, and D3 types (p = 0.28; p = 0.31; p = 0.16, respectively). ISQ values showed a slight drop at three weeks for D1, D2, and D3 bone while remaining almost unchanged in D4 bone. At 12-month follow-up, all implants (39 early loading, 1 conventional loading) had satisfactory function, showing an average marginal bone loss of 0.12 ± 0.12 mm, when compared to baseline levels. Conclusion: Matching implant macro-geometry to bone density can lead to adequate implant stability both in hard and soft bone. High primary stability and limited implant stability loss during the first month of healing could allow the application of early loading protocols with predictable clinical outcomes.

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants

Makary

Menhall

Zammarie³

et al. 2019

Materials

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“…UISP was previously clinically tested on a large number of patients showing that this novel approach could represent a reliable alternative to traditional drilling protocols [ 37 , 38 ]. Recent studies showed that UISP leads to a limited decrease of primary stability during the early phases of bone healing [ 32 – 34 ], likely due to a slightly different biochemical response in the osteotomy area.…”

Section: Discussionmentioning

confidence: 99%

Immediate Loading of Implant-Supported Single Crowns after Conventional and Ultrasonic Implant Site Preparation: A Multicenter Randomized Controlled Clinical Trial

Stacchi

Lombardi²,

Baldi

et al. 2018

BioMed Research International

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Aim To compare implant survival rate and marginal bone loss (MBL) of immediately loaded single implants inserted by using ultrasonic implant site preparation (UISP) (test) and conventional rotary instrumentation (control). Methods Two single implants were inserted for each patient: after randomization, test site was prepared by using an ultrasonic device (Piezosurgery Touch, Mectron, Italy) and control site was prepared by using the drills of the selected implant system (Premium AZT, Sweden & Martina, Italy), until reaching a final diameter of 3 mm in both groups. Identical implants (3.8x11.5 mm) were inserted in all sites at crestal level. Impressions were taken and screwed resin single crowns with platform-switched provisional abutments were delivered with 48 hours. Periapical radiographs were taken at provisional crown insertion (T0), 6 months (T1) and one year (T2) after prosthetic loading to measure MBL. All data were tested for normality and subsequently analyzed by paired samples t-test and forward multiple linear regression. Results Forty-eight patients were treated in six centers with the insertion of ninety-six implants (48 test; 48 control). Four implants in four patients failed within the first six months of healing (two in test group; two in control group; no difference between groups). Forty patients (age 60.1±10.7 years; 22 female, 18 male) were included in the final analysis. Mean MBL after six months of loading was 1.39±1.03 mm in the test group and 1.42±1.16 mm in the control group (p>0.05) and after one year was 1.92±1.14 mm and 2.14±1.55 mm in test and control, respectively (p>0.05). Conclusions No differences in survival rate and MBL were demonstrated between UISP and conventional site preparation with rotary instruments in immediately loaded dental implants: UISP, with its characteristics of enhanced surgical control and safety in proximity of delicate structures, may be used as a reliable alternative to the traditional drilling systems.

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Does the instrument used for the implant site preparation influence the bone–implant interface? A systematic review of clinical and animal studies

Tretto

Fabris

Cericato

et al. 2019

International Journal of Oral and Maxillofacial Surgery

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Standard Drilling Versus Ultrasonic Implant Site Preparation

Abstract: Implant placement after ultrasonic preparation can be considered a predictable technique leading to clinical and biological responses similar to SD 4 weeks after insertion.

Cited by 12 publications

References 16 publications

Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants

Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants

Immediate Loading of Implant-Supported Single Crowns after Conventional and Ultrasonic Implant Site Preparation: A Multicenter Randomized Controlled Clinical Trial

Does the instrument used for the implant site preparation influence the bone–implant interface? A systematic review of clinical and animal studies

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