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Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical
Christian Makary1, Abdallah Menhall2, Carole Zammarie3
1Department of Oral Surgery, St Joseph University, Beirut 17-5208, Lebanon. christian.makary@usj.edu.lb.
Materials (Basel, Switzerland)
|July 31, 2019
Summary
Matching dental implant geometry to bone density ensures stability for early loading protocols. This approach leads to predictable clinical outcomes and successful prosthetic rehabilitation, even in challenging bone types.
Area of Science:
- Dental Implantology
- Biomaterials Science
- Prosthodontics
Background:
- Implant stability is influenced by macro- and micro-geometry, impacting loading protocols.
- Controlling implant stability through fixture selection based on bone density is key for early loading.
- This study investigates a novel early loading protocol using tailored implant fixtures.
Purpose of the Study:
- To test an early loading protocol for dental implants.
- To control implant stability by selecting fixtures with appropriate thread depth for specific bone densities (D1-D4).
- To evaluate the clinical outcomes of early functional loading based on implant stability measurements.
Main Methods:
- Dental implants with varying thread diameters were inserted based on bone quality assessment (Misch classification D1-D4).
- Insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and weekly for four weeks.
- Implants with ISQ > 70 Ncm at three weeks were subjected to early functional loading with provisional restorations.
- Marginal bone level was assessed radiographically at 12 months post-insertion.
Main Results:
- Thirty-nine out of forty implants met the ISQ > 70 criteria for early loading.
- Significant differences in mean Insertion Torque (IT) were observed across bone types (D1-D4), with a positive correlation between IT and ISQ.
- Mean ISQ at baseline varied by bone type, with a slight drop at three weeks for D1-D3 bone types.
- All implants demonstrated satisfactory function at 12 months, with an average marginal bone loss of 0.12 mm.
Conclusions:
- Matching implant macro-geometry to bone density effectively achieves adequate implant stability in diverse bone types.
- High primary stability and minimal loss of stability during early healing facilitate predictable early loading protocols.
- This tailored approach supports successful prosthetic rehabilitation with dental implants.
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