High Insertion Torque and Peri-Implant Bone Loss: Is There a Relationship?

Because primary stability has a critical role in implant osseointegration, greater insertion torque is more desirable. However, excessive pressure on the peri-implant bone may lead to bone resorption. This study evaluates the effect of insertion torque on crestal bone level. Periapical radiographs of 136 bone-level implants were assessed in this retrospective cohort study. Sixty-four implants were inserted with high insertion torques (45-70 N/cm) and 72 implants were placed with a torque in the range of 20 to 30 N/cm. The distance between implant shoulder and proximal bone crest was measured on radiographs taken immediately after the insertion and compared to those calculated after uncovering surgeries (inserting the healing abutment). The mean bone resorption around implants placed with high and lower insertion torques was 0.33 and 0.4, respectively; thus, the difference between the two groups was insignificant (p = 0.88). High insertion torques (up to 70 N/cm) did not significantly increase bone resorption around implants.