The effect of implant placement torque on crestal bone remodeling after 1 year of loading

Abstract

PurposeThe aim of this study was to evaluate and compare crestal bone levels (CBLs) after 1 year of loading of self-tapping bone condensing implants placed with high insertion torque (IT) compared to those placed with lower IT.Materials and methodsA retrospective chart review of 66 consecutive patients who received at least one self-tapping bone condensing implant and were in function for at least 1 year was conducted. On the basis of intrasurgical notes documenting the implant IT, the patient population was divided into group A (implant IT, >55 Ncm) and group B (IT, <55 Ncm). Radiographs taken immediately after insertion and during annual follow-up appointments were evaluated for detecting crestal bone loss. The relationship between IT and crestal bone loss, bone density, and jaw location were analyzed, and a P-value of 0.05 was considered to be statistically significant.ResultsA total of 113 self-tapping bone condensing NobelActive™ implants were placed. The average follow-up period from the placement of the implant restoration was 12.87 (±4.83) months. Six implants were classified as failures resulting in overall survival rate of 94.6%. Implants in group A had a mean IT of 67.35 ± 4.0 Ncm, whereas implants in the group B had a mean IT of 37.9 ± 12.62 Ncm. Implants in group A had statistically significant crestal bone loss compared to implants in group B (0.95 ± 1.60 and 0.18 ± 0.68 mm, respectively). Group A implants placed in the mandible showed significantly more pronounced crestal bone loss (2.12 ± 1.99 mm) compared to those placed in the maxilla (0.25 ± 0.65 mm; P<0.05); however, this was not the case in group B implants.ConclusionImplants inserted with high IT (>55 Ncm) showed more peri-implant bone remodeling than implants inserted with a less assertive IT (<55 Ncm). Bone density and jaw location affect IT and CBLs.

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

“…A recent meta-analysis concluded that high IT values do not seem to be a predictive factor for implant failure [44]. Nevertheless, in the present study, IT values reached in hard D1 quality bone could potentially introduce risks related to mechanical deformation of implant connection [45] and excessive cortical compression, potential cause of early marginal bone loss [13,46]. Marginal bone remodeling following excessive compressive forces generated by high IT on cortical bone around implant necks was described in both animal [12] and clinical studies [47].…”

Can changes in implant macrogeometry accelerate the osseointegration process?: An in vivo experimental biomechanical and histological evaluations

“…[25,26]. However, the topic of ideal and/or adequate insertion torque, high or low, during implant installation is still a controversial topic in the literature [29]. Furthermore, the possible deleterious effects that could be caused by the high degree of bone compression from the high insertion torque, such as bone resorption, have not been confirmed in the literature [30].…”

“…Furthermore, the possible deleterious effects that could be caused by the high degree of bone compression from the high insertion torque, such as bone resorption, have not been confirmed in the literature [30]. In this sense, Aldahlawi and Collaborates published that implants inserted with high insertion torque (>55 Ncm) showed more peri-implant bone loss than implants inserted with a less assertive insertion torque (<55 Ncm) [29]. Whereas, Bidgoli and collaborates related that the high insertion torques (up to 70 Ncm) did not generate a significant increase in periimplant bone resorption [31].…”

Comparison between Osseo densification burs and osteotome technique for closed sinus lift in partially edentulous maxilla (clinical and radiological study)

“…(12). The main risk factor for implant failure is the primary stability of the implant (13). Bone density and especially cortical thickness are important factors in achieving adequate primary stability (14).…”