Keywords
Dental implants
insertion torque
primary stability
implant design
implant geometry
implant thread
resonance frequency analysis
insertion torque
primary stability
implant design
implant geometry
implant thread
resonance frequency analysis
How to Cite
ZAAROUR, J., CHRABIEH, E., RAMEH, S., KHOURY, A., & YOUNES, R. (2022). Effect of the Implant Macro-Design on Primary Stability: A Randomized Clinical Trial. International Arab Journal of Dentistry (IAJD), 13(1), 7-15. https://doi.org/10.70174/iajd.v13i1.647
Abstract
Aim of the study: Comparing the impact of two different implant macro-designs on the primary stability.
Material and methods: Patients received implants in the lower posterior jaw (bone type II and III). Two different macro-design implants were inserted randomly in accordance with a conventional drilling protocol, the first one is the hybrid self-tapping implant: Straumann® bone level BL and the second one is tapered self-tapping implant: Straumann® bone level tapered BLT.
16 implants (3.3 and 4.1 mm diameter, length between 8 and 10 mm) of each of the two above-mentioned implants were used. The assessment of the primary stability of each implant design was carried out by using two methods, recording the maximum insertion torque IT (DTA device) and recording the implant stability quotient ISQ using the resonance frequency analysis RFA (with the Osstell device).
Results: Within the limitation of the present study, in all bone types, BLT implants showed significantly higher mean insertion torque IT when compared to BL with respectively 46.67±6.85 Ncm for BLT implants and 35.77±6.72 Ncm for BL implants (p=0.01 as per the Anova test), and higher mean ISQ with respectively 77.15±5.16 and 70.74±4.83. (p=0.01 as per the Anova test).
Conclusion: In type II and III bone, the tapered self-tapping implant (Straumann® BLT) statistically showed better primary stability when compared to hybrid self-tapping implant: Straumann® bone level BL. Within the limitations of the present study, it can be concluded that the implant Macro-Design might be considered as a reliable parameter to achieve acceptable primary stability of dental implants in areas with low bone density. In the present study, the two methods used to assess the primary stability of the different macro-designs, torque assessment and the resonance frequency analysis RFA, showed a weak correlation. The macro-geometry is basically made to satisfy the needs in some critical bone situations and in immediate loading protocol.
References
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2. Evaluation of the correlation between insertion torque and primary stability of dental implants using a block bone test. Bayarchimeg, Dorjpalam. 43:30-36 , s.l. : J Periodontal Implant Sci , 2013.
3. Dental Implant Macro-Design Features Can Impact the Dynamics of Osseointegratio. Marcio Vivan Cardoso, Katleen Vandamme. s.l. : Clinical Implant Dentistry and Related Research, 2013, Vol. 19:55:51 .
4. Nanocoating of titanium implant surfaces with organic molecules Polysaccharides including glycosaminoglycans. Gurzawska K., et al. 2012, Journal of Biomedical Nanotechnology 8.6, pp. 1012-1024.
5. Patient selection and preparation. Tissue integrated prostheses: osseointegration in clinical dentistry. Lekholm U, Zarb GA. s.l. : Quintessence Publishing Company, Chicago, USA, 1985, pp. 199–209.
6. Effect of the implant macro-design on the primary stability, review of the litterature ans an ex-vivo model study. Chrabieh, Emile. 2017, JAJD, p. vol 8.
7. Primary Stability of a Hybrid Self‐Tapping Implant Compared to a Cylindrical Non‐Self‐Tapping Implant with Respect to Drilling Protocols in an Ex Vivo Model. akeshi Toyoshima, PhD, et al. 1, Clinical implan dentistry : s.n., 2011, Vol. 13.
8. Implant placement and loading protocols in partially edentulous patients: A systematic review. Clin Oral Impl Res. Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Suppl.16, 2018, Clinical Oral Implants Research, Vol. 29, pp. 106–134. https://doi.org/10.1111/ clr.13276.
9. Dental Implant Thread Pitch and Its Influence on the Osseointegration Process: An In Vivo Comparison Study. Ester Orsini, Gianluca Giavaresi, Alessandra Trirè,Vittoria Ottani, Stefano Salgarello. 2012, The International Journal of Oral & Maxillofacial Implants, pp. 27:383–392.
10. Effects of implant thread geometry on percentage of osseointegration and resistance to reverse torque in the tibia of rabbits. Steigenga, J., Al-Shammari, K., Misch, C., Nociti, F.H. Jr & Wang, H.L. 2004, Journal of Periodontology, pp. 75: 1233–1241.
11. Evaluation of design parameters of osseointegrated dental implants using finite element analysis. Chun, H.J., Cheong, S.Y., Han, J.H., Heo, S.J., Chung, J.P., Rhyu, I.C., Choi, Y.C., Baik, H.K., Ku, Y. & Kim, M.H. 2002, Journal of Oral Rehabilitation, pp. 29: 565–574.
12. optimized thread pitch design and stress analysis of the cylinder screwed dental implant. Kong, L., Liu, B.L., Hu, K.J., Li, D.H., Song, Y.L., Ma, P. & Yang, J. 22, 2006, Hua Xi Kou Qiang Yi Xue Za Zhi, Vol. 2, pp. 24: 509–512–515.
13. influence of helix angle and density on primary stability of immediately loaded dental implants: Three-dimensional finite element analysis. Ma, P., Liu, H.C., Li, D.H., Lin, S., Shi, Z. & Peng, Q.J. 2007, Zhonghua Kou Qiang Yi Xue Za Zhi, pp. 42: 618–621.
14. Scientific rationale for dental implant design. Misch, C.E., Strong, T. & Bidez, M.W. 2008, Contemporary Implant Dentistry.3 edition, St Louis: Mosby., pp. 200–229.
15. Measurements comparing the initial stability of five designs of dental implants. O’Sullivan, D., Sennerby, L. & Meredith, N. 2000, Clinical Oral Implants Research, pp. 2: 85–92.
16. The effects of flute shape and thread profile on the insertion torque and primary stability of dental implants. Shu-Wei Wu, Chia-Ching Lee, Ping-Yuen Fu, Shang-Chih Lin. 2011, Med Eng Phys, p. doi:10.1016/j.
17. Resonance frequency analysis measurements of implants at placement surgery. Ostman PO, Hellman M, Wendelhag I, Sennerby L. 19, 2006, Int J Prosthodont, pp. 77–83. 77–83.
18. “Relationship between implant stability measurements obtainedbyinsertiontorqueandresonancefrequencyanalysis:a systematic review. F. S. Lages, D. W. Douglas-de Oliveira, and F. O. Costa,,”. 2018. , Clinical Implant Dentistry and Related Research, pp. vol. 20, no. 1, pp. 26–33, .
19. Factor influencing the resonance frequency of dental implants. Huang H-M, Chiu C-L, Yeh C-Y, Lee S-Y. 2003, J Oral Maxillofac Surg ., pp. 61:1184–1188.
20. comparison between cutting torque and resonance frequency measurements of maxillary implants. A 20-month clinical study. Friberg B, Sennerby L, Meredith N, Lekholm U. 1999, Int J Oral Maxillofac Surg , pp. 28:297–303.
21. Implant design and intraosseous stability of immediately placed implants a human cadaver study. Akkocaoglu, M., Uysal, S., Tekdemir, I., Akca, K. & Cehreli, M.C. 2005, Clinical Oral Implants Research, pp. 16: 202–209.
22. “Implant stability measurements using resonance frequency analysis: biological and biomechanical aspects and clinical implications,. L. Sennerby and N. Meredith, ”. 2008, Periodontology 2000,, pp. vol. 47, no. 1, pp. 51–66, .
23. Roles of bone scintigraphy and resonance frequency analysis in evaluating osseointegration of endosseous implant. Y. Zhou, T. Jiang, M. Qian et al., “. 2008. , Biomaterials, , pp. vol. 29, no. 4, pp. 461–474, .
24. “Correlation between implant stability quotient and boneimplant contact: a retrospective histological and histomorphometrical study of seven titanium implants retrieved from humans,. A. Scarano, M. Degidi, G. Iezzi, G. Petrone, and A. Piattelli,. 2006, Clinical Implant Dentistry and Related Research,, pp. vol. 8, no. 4, pp. 218–222,.
25. Implant stability measurement of delayed and immediately loaded implants during healing. Samson, Mark Bischof Rabah Nedir Serge Szmukler‐Moncler Jean‐Pierre Bernard Jacky. Rabah Nedir Serge Szmukler‐Moncler Jean‐Pierre Bernard Jacky Samson : s.n., 2004.
26. Resonance frequency analysis measurements of implants at placement surgery,. Ostman PO, Hellman M, Wendelhag I, Sennerby L. 2006, – Int J Prosthodont, pp. 19(1):77-78.
27. Influence of cortical bone thickness and implant length on implant stability at the time of surgery: Clinical, prospective, biomechanical, and imaging study. . Miyamoto I, Tsuboi Y, Wada E, Suwa H, Iizuka T. 2005, pp. 37:776–780.
28. . Indications for immediate loading of implants and implant success.. Nkenke, E. & Fenner, M.,. 2006, Clinical Oral Implants Research, , pp. p. 17: 19–34.
29. Does bone mineral density influence the primary stability of dental implants? A systematic review. Mariana Marquezan. 7, s.l. : linical Oral research, 2001, Vol. 23.
30. Resonance Frequency Measurement of Implant Stability In Vivo on Implants with a Sandblasted and Acid-Etched Surface. Barewal, Reva M., et al. 5, s.l. : International Journal of Oral & Maxillofacial Implants, 2003, Vol. 18. p641-651. 11p.
31. Correlation Between Insertion Torque and Survival Rates in Immediately Loaded Implants in the Maxilla: A Retrospective Study. Rizkallah, Nadia, Fischer, Scott and Kraut, Richard A. 3, s.l. : Implant Dentistry, 2013, Vol. 22.
32. The Effects of Superficial Roughness and Design on the Primary Stability of Dental Implants. Dos Santos M, Elias C, Lima J,. 2011, Clinical Implant Dentistry and Related Research, pp. 215-223, Volume 13, Number 3.
33. Implant primary stability determined by resonance frequency analysis: Correlation with insertion torque, histologic bone volume, and torsional stability at 6 weeks. Makary, C , Rebaudi, A., Sammartino, G., Naaman, N. 2012, Implant Dent., pp. , 21, 474–480.
34. Implant Primary Stability Determined by Resonance Frequency Analysis: Correlation With Insertion Torque, Histologic Bone Volume, and Torsional Stability at 6 Weeks. Makary C., Rebaudi A., Sammartino G, Naaman N. 2012, Implant Dent, pp. 21(6):474-490.
35. Effect of insertion torque on titanium implant osseointegration: An animal experimental study. Duyck J, Roesems R, Cardoso MV, et al. . 2015;, .Clin Oral Implants Res., pp. 26:191–196.
36. Reliability and failure modes of internal conical dental implant connections. Bonfante, Amilcar C. Freitas-Ju´ nior Erika O. Almeida Estevam A. 2, s.l. : Clinical oral implants research, 2010, Vol. 24.
37. “Implant loading protocols for edentulous patients with fixed prostheses: a systematic review and metaanalysis,”. P. Papaspyridakos, C.-J. Chen, S.-K. Chuang, and H.-P. Weber,. 2014, The International Journal of Oral & Maxillofacial Implants, , pp. vol. 29, pp. 256–270,.
38. “Consensus statementsandclinicalrecommendationsforimplantloading protocols. G. O. Gallucci, G. I. Benic, S. E. Eckert et al.,. 2013, The International Journal of Oral & Maxillofacial Implants, ,, pp. vol. 29, pp. 287–290.
39. “Loading protocols for single-implant crowns: a systematic review and meta-analysis,” . G. I. Benic, J. Mir-Mari, and C. H¨ammerle,. 2014, The International Journal of Oral & Maxillofacial Implants, , pp. vol. 29, pp. 222–238,.
40. Meta-analysis of correlations between marginal bone resorption and high insertion torque of dental implants. . Li H, Liang Y, Zheng Q. 2015, Int J Oral Maxillofac Implants. , pp. ;30:767–772.
41. Histological, histomorphometrical, and radiological evaluation of an experimental implant design with a high insertion torque. . Duyck J, Corpas L, Vermeiren S, et al. 2010, Clin Oral Implants Res. , pp. ;21: 877–884. .
43. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Meredith N, Book K, Friberg B, Jemt T, Sennerby L. 1997, Clin Oral Implants Res, pp. 8:226–233.
44. Three-dimensional morphometric analysis of human cadaver bone:microstructural data from maxilla and mandible. Fanuscu, M.I. & Chang, T.L. 2004, Clinical Oral Implants Research, pp. 15: 213–218.
45. The Effects of Superficial Roughness and Design on the Primary Stability of Dental Implants. Dos Santos M, Elias C, Lima J,. 2011, Clinical Implant Dentistry and Related Research, pp. 215-223, Volume 13, Number 3.
46. Dental Implant Thread Pitch and Its Influence on the Osseointegration Process: An In Vivo Comparison Study. Ester Orsini, Gianluca Giavaresi, Alessandra Trirè,Vittoria Ottani, Stefano Salgarello. 2012, The International Journal of Oral & Maxillofacial Implants, pp. 27:383–392.
2. Evaluation of the correlation between insertion torque and primary stability of dental implants using a block bone test. Bayarchimeg, Dorjpalam. 43:30-36 , s.l. : J Periodontal Implant Sci , 2013.
3. Dental Implant Macro-Design Features Can Impact the Dynamics of Osseointegratio. Marcio Vivan Cardoso, Katleen Vandamme. s.l. : Clinical Implant Dentistry and Related Research, 2013, Vol. 19:55:51 .
4. Nanocoating of titanium implant surfaces with organic molecules Polysaccharides including glycosaminoglycans. Gurzawska K., et al. 2012, Journal of Biomedical Nanotechnology 8.6, pp. 1012-1024.
5. Patient selection and preparation. Tissue integrated prostheses: osseointegration in clinical dentistry. Lekholm U, Zarb GA. s.l. : Quintessence Publishing Company, Chicago, USA, 1985, pp. 199–209.
6. Effect of the implant macro-design on the primary stability, review of the litterature ans an ex-vivo model study. Chrabieh, Emile. 2017, JAJD, p. vol 8.
7. Primary Stability of a Hybrid Self‐Tapping Implant Compared to a Cylindrical Non‐Self‐Tapping Implant with Respect to Drilling Protocols in an Ex Vivo Model. akeshi Toyoshima, PhD, et al. 1, Clinical implan dentistry : s.n., 2011, Vol. 13.
8. Implant placement and loading protocols in partially edentulous patients: A systematic review. Clin Oral Impl Res. Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Suppl.16, 2018, Clinical Oral Implants Research, Vol. 29, pp. 106–134. https://doi.org/10.1111/ clr.13276.
9. Dental Implant Thread Pitch and Its Influence on the Osseointegration Process: An In Vivo Comparison Study. Ester Orsini, Gianluca Giavaresi, Alessandra Trirè,Vittoria Ottani, Stefano Salgarello. 2012, The International Journal of Oral & Maxillofacial Implants, pp. 27:383–392.
10. Effects of implant thread geometry on percentage of osseointegration and resistance to reverse torque in the tibia of rabbits. Steigenga, J., Al-Shammari, K., Misch, C., Nociti, F.H. Jr & Wang, H.L. 2004, Journal of Periodontology, pp. 75: 1233–1241.
11. Evaluation of design parameters of osseointegrated dental implants using finite element analysis. Chun, H.J., Cheong, S.Y., Han, J.H., Heo, S.J., Chung, J.P., Rhyu, I.C., Choi, Y.C., Baik, H.K., Ku, Y. & Kim, M.H. 2002, Journal of Oral Rehabilitation, pp. 29: 565–574.
12. optimized thread pitch design and stress analysis of the cylinder screwed dental implant. Kong, L., Liu, B.L., Hu, K.J., Li, D.H., Song, Y.L., Ma, P. & Yang, J. 22, 2006, Hua Xi Kou Qiang Yi Xue Za Zhi, Vol. 2, pp. 24: 509–512–515.
13. influence of helix angle and density on primary stability of immediately loaded dental implants: Three-dimensional finite element analysis. Ma, P., Liu, H.C., Li, D.H., Lin, S., Shi, Z. & Peng, Q.J. 2007, Zhonghua Kou Qiang Yi Xue Za Zhi, pp. 42: 618–621.
14. Scientific rationale for dental implant design. Misch, C.E., Strong, T. & Bidez, M.W. 2008, Contemporary Implant Dentistry.3 edition, St Louis: Mosby., pp. 200–229.
15. Measurements comparing the initial stability of five designs of dental implants. O’Sullivan, D., Sennerby, L. & Meredith, N. 2000, Clinical Oral Implants Research, pp. 2: 85–92.
16. The effects of flute shape and thread profile on the insertion torque and primary stability of dental implants. Shu-Wei Wu, Chia-Ching Lee, Ping-Yuen Fu, Shang-Chih Lin. 2011, Med Eng Phys, p. doi:10.1016/j.
17. Resonance frequency analysis measurements of implants at placement surgery. Ostman PO, Hellman M, Wendelhag I, Sennerby L. 19, 2006, Int J Prosthodont, pp. 77–83. 77–83.
18. “Relationship between implant stability measurements obtainedbyinsertiontorqueandresonancefrequencyanalysis:a systematic review. F. S. Lages, D. W. Douglas-de Oliveira, and F. O. Costa,,”. 2018. , Clinical Implant Dentistry and Related Research, pp. vol. 20, no. 1, pp. 26–33, .
19. Factor influencing the resonance frequency of dental implants. Huang H-M, Chiu C-L, Yeh C-Y, Lee S-Y. 2003, J Oral Maxillofac Surg ., pp. 61:1184–1188.
20. comparison between cutting torque and resonance frequency measurements of maxillary implants. A 20-month clinical study. Friberg B, Sennerby L, Meredith N, Lekholm U. 1999, Int J Oral Maxillofac Surg , pp. 28:297–303.
21. Implant design and intraosseous stability of immediately placed implants a human cadaver study. Akkocaoglu, M., Uysal, S., Tekdemir, I., Akca, K. & Cehreli, M.C. 2005, Clinical Oral Implants Research, pp. 16: 202–209.
22. “Implant stability measurements using resonance frequency analysis: biological and biomechanical aspects and clinical implications,. L. Sennerby and N. Meredith, ”. 2008, Periodontology 2000,, pp. vol. 47, no. 1, pp. 51–66, .
23. Roles of bone scintigraphy and resonance frequency analysis in evaluating osseointegration of endosseous implant. Y. Zhou, T. Jiang, M. Qian et al., “. 2008. , Biomaterials, , pp. vol. 29, no. 4, pp. 461–474, .
24. “Correlation between implant stability quotient and boneimplant contact: a retrospective histological and histomorphometrical study of seven titanium implants retrieved from humans,. A. Scarano, M. Degidi, G. Iezzi, G. Petrone, and A. Piattelli,. 2006, Clinical Implant Dentistry and Related Research,, pp. vol. 8, no. 4, pp. 218–222,.
25. Implant stability measurement of delayed and immediately loaded implants during healing. Samson, Mark Bischof Rabah Nedir Serge Szmukler‐Moncler Jean‐Pierre Bernard Jacky. Rabah Nedir Serge Szmukler‐Moncler Jean‐Pierre Bernard Jacky Samson : s.n., 2004.
26. Resonance frequency analysis measurements of implants at placement surgery,. Ostman PO, Hellman M, Wendelhag I, Sennerby L. 2006, – Int J Prosthodont, pp. 19(1):77-78.
27. Influence of cortical bone thickness and implant length on implant stability at the time of surgery: Clinical, prospective, biomechanical, and imaging study. . Miyamoto I, Tsuboi Y, Wada E, Suwa H, Iizuka T. 2005, pp. 37:776–780.
28. . Indications for immediate loading of implants and implant success.. Nkenke, E. & Fenner, M.,. 2006, Clinical Oral Implants Research, , pp. p. 17: 19–34.
29. Does bone mineral density influence the primary stability of dental implants? A systematic review. Mariana Marquezan. 7, s.l. : linical Oral research, 2001, Vol. 23.
30. Resonance Frequency Measurement of Implant Stability In Vivo on Implants with a Sandblasted and Acid-Etched Surface. Barewal, Reva M., et al. 5, s.l. : International Journal of Oral & Maxillofacial Implants, 2003, Vol. 18. p641-651. 11p.
31. Correlation Between Insertion Torque and Survival Rates in Immediately Loaded Implants in the Maxilla: A Retrospective Study. Rizkallah, Nadia, Fischer, Scott and Kraut, Richard A. 3, s.l. : Implant Dentistry, 2013, Vol. 22.
32. The Effects of Superficial Roughness and Design on the Primary Stability of Dental Implants. Dos Santos M, Elias C, Lima J,. 2011, Clinical Implant Dentistry and Related Research, pp. 215-223, Volume 13, Number 3.
33. Implant primary stability determined by resonance frequency analysis: Correlation with insertion torque, histologic bone volume, and torsional stability at 6 weeks. Makary, C , Rebaudi, A., Sammartino, G., Naaman, N. 2012, Implant Dent., pp. , 21, 474–480.
34. Implant Primary Stability Determined by Resonance Frequency Analysis: Correlation With Insertion Torque, Histologic Bone Volume, and Torsional Stability at 6 Weeks. Makary C., Rebaudi A., Sammartino G, Naaman N. 2012, Implant Dent, pp. 21(6):474-490.
35. Effect of insertion torque on titanium implant osseointegration: An animal experimental study. Duyck J, Roesems R, Cardoso MV, et al. . 2015;, .Clin Oral Implants Res., pp. 26:191–196.
36. Reliability and failure modes of internal conical dental implant connections. Bonfante, Amilcar C. Freitas-Ju´ nior Erika O. Almeida Estevam A. 2, s.l. : Clinical oral implants research, 2010, Vol. 24.
37. “Implant loading protocols for edentulous patients with fixed prostheses: a systematic review and metaanalysis,”. P. Papaspyridakos, C.-J. Chen, S.-K. Chuang, and H.-P. Weber,. 2014, The International Journal of Oral & Maxillofacial Implants, , pp. vol. 29, pp. 256–270,.
38. “Consensus statementsandclinicalrecommendationsforimplantloading protocols. G. O. Gallucci, G. I. Benic, S. E. Eckert et al.,. 2013, The International Journal of Oral & Maxillofacial Implants, ,, pp. vol. 29, pp. 287–290.
39. “Loading protocols for single-implant crowns: a systematic review and meta-analysis,” . G. I. Benic, J. Mir-Mari, and C. H¨ammerle,. 2014, The International Journal of Oral & Maxillofacial Implants, , pp. vol. 29, pp. 222–238,.
40. Meta-analysis of correlations between marginal bone resorption and high insertion torque of dental implants. . Li H, Liang Y, Zheng Q. 2015, Int J Oral Maxillofac Implants. , pp. ;30:767–772.
41. Histological, histomorphometrical, and radiological evaluation of an experimental implant design with a high insertion torque. . Duyck J, Corpas L, Vermeiren S, et al. 2010, Clin Oral Implants Res. , pp. ;21: 877–884. .
43. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Meredith N, Book K, Friberg B, Jemt T, Sennerby L. 1997, Clin Oral Implants Res, pp. 8:226–233.
44. Three-dimensional morphometric analysis of human cadaver bone:microstructural data from maxilla and mandible. Fanuscu, M.I. & Chang, T.L. 2004, Clinical Oral Implants Research, pp. 15: 213–218.
45. The Effects of Superficial Roughness and Design on the Primary Stability of Dental Implants. Dos Santos M, Elias C, Lima J,. 2011, Clinical Implant Dentistry and Related Research, pp. 215-223, Volume 13, Number 3.
46. Dental Implant Thread Pitch and Its Influence on the Osseointegration Process: An In Vivo Comparison Study. Ester Orsini, Gianluca Giavaresi, Alessandra Trirè,Vittoria Ottani, Stefano Salgarello. 2012, The International Journal of Oral & Maxillofacial Implants, pp. 27:383–392.