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Insertion Torque (insertion + torque)
Selected AbstractsA biomechanical and histological analysis of standard versus hydroxyapatite-coated pins for external fixationJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2008Antonio Moroni Abstract This sheep study was designed to make a comparative evaluation of two external fixation pin types each with and without hydroxyapatite (HA) coating. The two pins had different taper, pitch, and self drilling capabilities. Twenty Orthofix standard, self-tapping pins (group A), 20 Orthofix HA-coated, self-tapping pins (group B), 20 X-caliber, self-drilling, self-tapping pins (group C), and 20 X-caliber HA-coated, self-drilling, self-tapping pins (group D) were selected. Four pins were implanted in the right femurs of 20 adult sheep that were euthanized at 6 weeks. Mean pin insertion torque was 2745 ± 822 Nmm in group A, 2726 ± 784 Nmm in group B, 2818 ± 552 Nmm in group C, and 2657 ± 732 Nmm in group D (ns). Mean pin extraction torque was 1567 ± 541 Nmm in group A, 2524 ± 838 Nmm in group B, 1650 ± 650 Nmm in group C, and 2517 ± 726 Nmm in group D. HA-coated pins (group B and D) had a significantly greater mean pin extraction torque compared to similar uncoated pins (group A and C) (p < 0.0005). Histological analysis showed good osteointegration of the two coated pin types. This study shows that HA-coating is more important for optimal pin fixation than the particular combination of design parameters used in each pin type. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008 [source] RFA Values of Implants Placed in Sinus Grafted and Nongrafted Sites after 6 and 12 MonthsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2009Marco Degidi MD ABSTRACT Background: Maxillary sinus floor elevation surgery is widely used as a preimplantology method to permit implant insertion. Nevertheless, very few data are available about long-term stability of dental implants inserted in grafted sites. Purpose: The aims of the present study were to evaluate the evolution of resonance frequency analysis (RFA) values at 6 and 12 months from the implant insertion in sinus grafted sites and nongrafted sites. Materials and Methods: In 14 patients, 80 Xive implants (Dentsply Friadent GmbH, Mannheim, Germany) were inserted. Sixty-three implants were inserted in a site previously treated with a sinus lift; 17 implants were inserted in healed or postextraction sites. For each implant diameter, length, bone density, insertion torque, and percentage of implant fixed to a nongrafted bone were recorded. RFA values at implant insertion after 6 and 12 months were recorded. Results: After 6 and 12 months, grafted sites showed higher RFA values than the control sites; after 12 months, the difference was statistically significant (.007). A statistically significant positive correlation was found between resonance frequency values and bone quality after 12 months (.05). No statistically significant correlation between RFA values and all the other variables considered was found. Conclusions: Sites treated with sinus lift can offer good long-term stability. After 6 and 12 months, the geometric characteristics of the implant are no longer important to obtain high RFA values, and the bone,implant interface seems to be determinant. [source] Immediate Loading of Two Implants Supporting a Ball Attachment-Retained Mandibular Overdenture: A Prospective Clinical StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2007Riccardo Marzola DDS ABSTRACT Background:, A prospective clinical study was conducted to evaluate clinically and radiographically the performance of two implants immediately loaded supporting a ball attachment-retained mandibular overdenture. Materials and Methods:, Seventeen completely edentulous patients were included in the study. Each patient received two implants inserted after a minimal flap reflection and no vestibular extension in order to reduce the postoperative swelling and facilitate immediate prosthesis connection. After implant placement, a mandibular complete denture was connected to the implants using ball attachments of appropriate height according to the depth of the peri-implant tissue. Patients were asked not to remove the denture for 1 week. No limitations to chewing function were given. At implant placement, the maximum value of insertion torque was recorded. Patients were examined at 1, 2, 4, 12, and 52 weeks postsurgery. At postoperative visit, occlusion was checked and the need for any prosthesis maintenance was recorded. The radiographic bone level (RBL) change was measured on periapical radiographs at baseline and 12 months after loading. Results:, After 12 months of loading, no implant failure was reported and the survival rate was 100%. Average RBL change was 0.7 mm ± 0.5 mm. Of the 17 cases, two had major prosthetic complications and five patients required minor extra maintenance appointments. Conclusions:, The immediate loading of two implants by means of ball attachment-retained mandibular complete denture may be a predictable treatment option. This clinical approach offers increased stability and comfort, while keeping a high implant success rate. [source] One-Year Prospective Three-Center Study Comparing the Outcome of a "Soft Bone Implant" (Prototype Mk IV) and the Standard Brånemark ImplantCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2003Bertil Friberg DDS ABSTRACT Background: Oral implant treatment ad modum Brånemark has been used for decades in the rehabilitation of edentate and partially dentate patients. Posterior jaw regions frequently exhibit bone of poor texture, and it is often difficult to obtain primary stability. Thus, it may prove beneficial to deviate from the original protocol and to use implants with a modified design, for example, with a slightly tapered geometry. Purpose: The purpose of the investigation was to compare the early behavior of a modified (prototype Mk IV, Branemark System, Nobel Biocare AB, Gothenburg, Sweden; test) implant with that of the standard Brånemark implant (control) in regions of mainly type 4 bone. Materials and Methods: Three Swedish centers participated, and a total of 44 patients were treated with oral implants for 39 maxillas and 5 mandibles. The study focused on the most distal right and left implant sites (88 implants), which were randomized to receive either a test or a control implant. Various parameters were recorded, such as registered insertion torque (OsseoCare, Nobel Biocare AB), wobbling during insertion, primary and secondary stability (as measured with resonance frequency), and marginal bone loss. The implants were followed up for 1 year. Results.: The test implant more frequently required a higher insertion torque and showed a significantly higher primary stability than the control implant. This difference in stability leveled out over time, and test and control implants exhibited similar secondary stability at abutment operation and at the 1-year visit. Wobbling during insertion was rarely recorded for either of the implant designs. The 1-year cumulative success rate was 93.1% for test implants and 88.4% for control implants. Conclusions: The modified implant design resulted in an increased primary stability, which may be important when placing implants in jaw regions of type 4 bone. However, independent of the achieved primary stability, successful implants tended to approach similar secondary stability in the two designs tested. [source] Immediate Provisional for Single-Tooth Implant Replacement with Brånemark System: Preliminary ReportCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2001Edward Hui MDS, FDSRCS, FRCDC Abstract: Background: The success of osseointegrated implants ad modum Brånemark for single-tooth restorations is documented. Future developments should aim at improving the benefits to patients by decreasing treatment time, minimizing surgical stages, and maximizing esthetic outcomes. Using knowledge from studies of immediate implant placement, one-stage, immediate loading protocols, the authors developed the immediate provisional. Purpose: The purpose of this study was to develop a protocol to provide an immediate solution for restoring a single missing tooth in the esthetic zone. The protocol should be simple, predictable, cost effective, and allow the use of other techniques to improve esthetic outcome. Materials and Method: This prospective clinical study included 24 patients treated from August 1999 to October 2000. Single-tooth implant replacement was done according to immediate provisional protocol. Thirteen of the 24 patients had immediate implant placement after tooth extraction. All implants were placed in the esthetic zone. During surgery, emphasis was placed on obtaining primary stability by achieving bicortical anchorage and maximum insertion torque of at least 40 Ncm. CeraOne (Nobel Biocare) abutments were used, and provisional crowns were fabricated immediately before wound closure. The occlusion was protected by adjacent teeth. Results: Within the follow-up period of between 1 month and 15 months, all fixtures in the 24 patients were stable. Crestal bone loss greater than one thread-width was not detected. The esthetic result was considered satisfactory by all patients. Conclusions: The implant placement and restoration protocol used in this study showed promising initial results for both the immediate implant and healed extraction site groups. The desirable goals of patient satisfaction, excellent esthetic outcomes, and no increase in treatment cost were achieved in this protocol. Further studies to elucidate the potential of the immediate provisional protocol are justified. [source] Influence of surgical technique and surface roughness on the primary stability of an implant in artificial bone with different cortical thickness: a laboratory studyCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2010Afsheen Tabassum Abstract Objective: The aim of this biomechanical study was to assess the interrelated effect of both surface roughness and surgical technique on the primary stability of dental implants. Material and methods: For the experiment, 160 screw-designed implants (Biocomp®), with either a machined or an etched surface topography, were inserted into polyurethane foam blocks (Sawbones®). As an equivalent of trabecular bone, a density of 0.48 g/cm3 was chosen. To mimic the cortical layer, on top of these blocks short-fibre-filled epoxy sheets were attached with a thickness varying from 0 to 2.5 mm. The implant sites were prepared using either a press-fit or an undersized technique. To measure the primary stability of the implant, both the insertion and the removal torques were scored. Results: Independent of the surgical technique used, both implant types showed an increased insertion and removal torque values with increasing cortical thickness, although >2 mm cortical layer no further increase in insertion torque was observed. In the models with only trabecular bone (without cortical layer) and with a 1 mm cortical layer, both implant types showed a statistically higher insertion and removal torque values for undersized compared with the press-fit technique. In addition, etched implants showed a statistically higher insertion and removal torque mean values compared with machined implants. In the models with 2 and 2.5 mm cortical layers, with respect to the insertion torque values, no effect of either implantation technique or implant surface topography could be observed. Conclusion: The placement of etched implants in synthetic bone models using an undersized preparation technique resulted in enhanced primary implant stability. A correlation was found between the primary stability and the cortical thickness. However, at or above a cortical thickness of 2 mm, the effect of both an undersized surgical approach, as also the presence of a roughened (etched) implant surface, had no extra effect. Besides the mechanical aspects, the biological effect of undersized drilling, i.e. the bone response on the extra insertion torque forces should also be elucidated. Therefore, additional in vivo studies are needed. To cite this article: Tabassum A, Meijer GJ, Wolke JGC, Jansen JA. Influence of surgical technique and surface roughness on the primary stability of an implant in artificial bone with different cortical thickness: a laboratory study. Clin. Oral Impl. Res. 21, 2010; 213,220. doi: 10.1111/j.1600-0501.2009.01823.x [source] Relevance of resonance frequency analysis to evaluate dental implant stability: simulation and histomorphometrical animal experimentsCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2008Yoshihiro Ito Abstract Background: Resonance frequency analysis (RFA) is applied to evaluate implant stability, and the clinical relevance of this application is accepted. However, a discrepancy between resonance frequency (RF) and other parameters of implant stability such as implant insertion torque and bone mineral density at the insertion site has been reported. In addition, the relation between RF and histological implant,bone contact has not been well documented. Purpose: To explain this discrepancy and to clarify the relation between RF and histological implant,bone contact, we conducted the present study. Materials and methods: A hydroxyapatite-coated implant, 4 mm diameter and 10 mm length, was used. We placed the implant in a small plastic box vertically and fixed the implant in the box with small screws at different height positions. An ,Osstell' transducer was mounted on the implant and RF was measured with or without loosening the screws. Twenty-four implants were placed in the tibiae of four mini-pigs. The animals were sacrificed 1, 2 and 4 weeks after the placement, and the RF of each implant was measured. Ground sections were prepared and implant,bone contact was histomophometrically measured. Results: Loosening the screw at the neck region of the implant remarkably decreased RF compared with the screws of the other regions. Correlation between RF and implant,bone contact, which was measured all around the implant, was not significant (r=0.221, P=0.299). However, the correlation coefficient increased to ,0.361' when implant,bone contact was measured at the neck of the implant (P=0.0835), although these two parameters were not statistically correlated. Conclusions: Although RF did not correlate with histological implant,bone contact, the present results demonstrated that a connection between the implant and bone at the neck region of the implant affects RF the most effectively, further suggesting the superiority of RFA in the process of implant treatment and the follow-up. The present results could explain the discrepancy between RFA and other parameters of implant stability. [source] Influence of implant taper on the primary and secondary stability of osseointegrated titanium implantsCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2004Dominic O'Sullivan Abstract Objectives: The study presented was designed to analyse the mechanical performance and the primary and secondary stability characteristics of endosseous titanium implants with 1° (EXP1) and 2° (EXP2) of taper when compared with the standard Brånemark design (Nobel Biocare AB, Gothenburg, Sweden). Materials and methods: One pair of 10 mm EXP1 and control implants were placed in the femoral condyles of six rabbits. Paired 6 mm EXP1 and control implants and 6 mm EXP2 and control implants were placed in the tibial metaphysis. The control implants used were 4 mm diameter standard Brånemark implants, the same length as the test implants. At placement, insertion torque (IT) and resonance frequency analysis (RFA) measurements were performed. Six weeks postoperatively when the animals were killed, RFA and removal torque (RT) measurements were made. Results: At placement, significantly higher IT was needed to insert the EXP implants compared with the controls. RFA values were significantly higher for EXP1 implants placed in the tibia but not in the femur. In pooling data from the femur and tibia there was a significant difference. The EXP2 implants failed to insert fully and demonstrated a lower RFA value than may have been expected due to the exposed threads, although this difference was not statistically significant. Conclusions: The results from the present study showed that 1° of taper results in a better primary stability compared with the standard Brånemark design. There was no evidence that the tapered design caused negative bone tissue reactions. All the implants gained in stability during the healing period. Résumé L'étude présente a été effectuée pour analyser la performance mécanique et les caractéristiques de stabilité primaire et secondaire d'implants endoosseux en titane avec un taper (fuselé) 1° (EXP1) et 2 (EXP 2) comparés au modèle ad modum Branemark® standard. Une paire d'implants contrôles et un EXP1 de 10 mm ont été placés dans les condyles fémoraux de six lapins. Des paires d'implants contrôles et EXP1 de 6 mm et des implants contrôles et EXP2 de 6 mm ont été placés dans les métaphyses tibiales. Les implants contrôles utilisés avaient un diamètre standard de 4 mm, la même longueur que les implants tests. Lors du placement, des mesures de force d'insertion (IT) et d'analyse de fréquence de résonnance (RFA) ont été effectuées. Six semaines après l'opération lorsque les animaux ont été euthanasiés, les mesures RFA et les forces d'enlèvement (RT) ont été relevées. Lors du placement un IT significativement plus important a été nécessaire pour insérer les implants EXP1 comparé au contrôle. Les valeurs RFA étaient significativement plus importantes pour les implants EXP1 placés dans le tibia mais pas dans le fémur. En rassemblant les données du fémur et du tibia il y avait une différence significative. Les implants EXP2 ne parvenaient pas àêtre insérés à fond et ont montré une valeur RFA inférieure qui n'était pas inattendue vu les filetages exposés bien que ces différences n'étaient pas statistiquement significatives. Les résultats de l'étude présente ont montré que le taper 1 résultait en une stabilité primaire supérieure comparé au modèle ad modum Branemark® standard. Il n'y avait aucun signe que ce nouveau modèle causait des réactions tissulaires osseuses négatives. Tous les implants ont gagné en stabilité durant leur période de guérison. Zusammenfassung Ziele: Die hier vorgestellte Studie hatte zum Ziel, das mechanische Verhalten und die Charakteristika von Primär- und Sekundärstabilität bei enossalen Implantaten mit einer Gewindeneigung von 1° (EXP1) und von 2° (EXP2) zu untersuchen. Man verglich die Daten mit dem Standarddesign von Brånemark (Nobel Biocare AB, Gothenburg, Schweden). Material und Methode: Man implantierte ein Päärchen von 10mm-Implantaten (EXP1 und Kontrollimplantat) in die Femurkondylen von 6 Kaninchen. Zwei weitere Päärchen von 6mm-Implantaten (EXP1 und Kontrollimplantat, sowie EXP2 und Kontrollimplantat) implantierte man in die Metaphyse der Tibia. Bei den Kontrollimplantaten handelte es sich um Standardtypen von Brånemark mit einem Durchmesser von 4 Millimetern und derselben Länge wie die Testimplantate. Bei der Implantation mass man die Kraft, die es zu Eindrehen der Implantate brauchte (IT) und führte Messungen mit der Resonanzfrequenzanalyse (RFA) durch. Sechs Wochen nach der Operation wurden die Tiere geopfert, die RFA erneut durchgeführt und anschliessend der Ausdrehwiderstand (RT) bestimmt. Resultate: Bei der Implantation brauchte es signifikant grössere IT um die EXP-Implantate einzusetzen, als bei den Kontrollimplantaten. Die RFA-Werte waren bei den EXP1-Implantaten, die in die Tibia geschraubt worden waren, signifikant höher. Dies gilt aber nicht für die in den Femur geschraubten Implantate. Wurden die Daten vom Femur mit denen der Tibia verglichen, so erkannte man signifikante Unterschiede. Die EXP2-Implantate konnten nicht vollständig inseriert werden und zeigten auch tiefere RFA-Werte, als man den freiliegenden Schraubenwindungen entsprechend erwarten könnte. Diese Unterschiede waren aber nicht statistisch signifikant. Zusammenfassung: Die Resultate dieser Studie zeigten, das Schraubenwindungen mit 1° Steigung verglichen mit dem Standarddesign von Brånemark eine bessere Primärstabilität erzielten. Man fand andererseits keine Beweise, dass sich dieses neue Design der Schraubenwindungen negativ auf die Reaktion des Knochengewebes auswirkt. Alle Implantate gewannen während in der Heilphase an Stabilität dazu. Resumen Objetivos: El estudio presentado se diseñó para analizar el rendimiento mecánico y las características de estabilidad primaria y secundaria de implantes endoóseos de titanio con 1o (EXP1) y 2o (EXP 2) de autoroscado al compararlos con el diseño estándar de Brånemark (Nobel Biocare AB, Gothenburg, Suecia). Material y Métodos: Se colocó una pareja de implantes de 10 mm EXP1 y de control en los cóndilos femorales de 6 conejos. Se colocaron pareja de implantes de 6 mm EXP1 y de control y de 6 mm EXP2 y de control en la metáfisis tibial. Los implantes de control utilizados fueron Brånemark estándar de 4 mm de diámetro. A la colocación, se llevaron a cabo mediciones del torque de inserción (IT) y del análisis de la frecuencia de resonancia (RFA). Los animales se sacrificaron a las seis semanas de la operación, y se tomaron medidas del torque de remoción (RT). Resultados: Al colocarse, se necesitó un IT significativamente mas alto para insertar los implantes EXP en comparación con los de control. Los valores RFA fueron significativamente mas altos para implantes EXP1 colocados en la tibia pero no en el fémur. Confrontando los datos del fémur y de la tibia apareció una diferencia significativa. Los implantes EXP2 fracasaron en insertarse completamente y demostraron un menor valor de RFA del que se podía esperar debido a la exposición de las roscas, aunque esta diferencia no fue estadísticamente significativa. Conclusiones: Los resultados del presente estudio mostraron que 1o de autoroscado resultan en una mejor estabilidad primaria comparada con el diseño estándar de Brånemark. No hubo evidencia de que el diseño de autoroscado causara reacciones negativas en el tejido óseo. Todos los implantes ganaron estabilidad durante el periodo de cicatrización. [source] | ||||||||||