Comparative analysis of insertion torque and radiological texture analysis following sinus lift surgery between
Mayha Gharouni1, Masoumeh Faramarzi2, Narges Bayat1
1Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
Purpose:
This study aimed to investigate the relationship between insertion torque during dental implant placement and radiological changes in hard tissue texture following sinus lift surgery using allograft and xenograft materials. Directional texture analysis via Gray-Level Co-Occurrence Matrix (GLCM) offsets was employed to assess anisotropic bone remodeling patterns.
Methods:
This randomized clinical trial included 32 adults (≥ 18 years) with ≤ 5 mm residual bone height, randomized to sinus lift with allograft or xenograft. All procedures were performed by one surgeon, with CBCT-based texture analysis (Mazda software) at 6 months and subsequent implant placement. Gray-level co-occurrence matrix parameters were calculated from standardized ROIs. Insertion torque was recorded using a manual torque meter. statistical analysis compared outcomes between groups.
Results:
Mean insertion torque was higher in the allograft group (45.2 ± 6.8 N·cm) than the xenograft group (32.1 ± 5.3 N·cm; P < 0.001). Allografts showed greater structural uniformity (higher Angular Second Moment and pixel correlation), while xenografts exhibited higher entropy, sum entropy, and contrast (P < 0.001). Directional GLCM offsets revealed anisotropic remodeling patterns: allografts displayed organized vertical alignment, xenografts horizontal variation and multidirectional irregularity.
Conclusion:
Allografts provide higher insertion torque and improved initial stability by creating a dense and uniform structure, while xenografts show longer-term adaptation to the host bone due to their structural complexity. Directional differences in tissue parameters introduce anisotropy as an indicator of bone maturity, highlighting the need to personalize surgical protocols based on graft material characteristics and radiological patterns.
