Influence of Implant Design and Under-Preparation of the Implant Site on Implant Primary Stability. An In Vitro Study
Abstract
:1. Introduction
2. Materials and methods
2.1. Implants
2.2. Bone
2.3. Sample Size
2.4. Ethical Committee
2.5. Implant Site Preparation
2.6. Study Groups
- P1: standard preparation and the recommended one by the company—control group.
- P2: the same as P1 but does not include the cortical drill (ref nº 18 02 04—3.5 mm ø implants/ref. 18 02 05—4.0 mm ø implants).
- P3: horizontal under-preparation technique that does not include the last full-length drill (ref nº 10 02 05 for 3.5 mm ø and ref. nº 10 02 06 for 4.0 mm diameter implants) but includes the cortical one.
- P4: horizontal under-preparation technique like P3 but without cortical drill (ref nº 18 02 04—3.5 mm ø implants/ref 18 02 05—4.0 mm ø implants).
- A. Cylindrical—VEGA implant
- ○
- 3.5 mm implant diameter
- ○
- 4.0 mm implant diameter
- B. Tapered - VEGA X implant
- ○
- 3.5 mm implant diameter
- ○
- 4.0 mm implant diameter
2.7. Implant Stability Measurements
2.8. Drilling Sequences
- Lanceolate drill/decortication for the first 6 mm (ref. nº 10 02 01)
- 2.35 mm diameter (ø) initiation drill (ref. nº 10 02 02)
- 2.8 mm ø pilot drill (ref. nº 10 02 03)
- 3.5 mm ø cortical drill (ref. nº 18 02 04)
- 3.3 mm ø pilot drill (ref. nº 10 02 05)—last of 3.5 mm diameter implant
- 4.0 mm ø cortical drill (ref. nº 18 02 05)
- 3.6 mm ø pilot drill (ref. nº 10 02 06)—last of 4.0 mm diameter implant
2.9. Statistical Analysis
- For data meeting a normal distribution, two independent data groups were compared using a parametric t-student test, while three or more data groups were compared using ANOVA.
- For data not distributed normally, a Mann–Whitney test was used to compare two data groups and the Kruskall–Wallis test was used to compare three or more data groups. Non-parametric tests were also used to compare data groups meeting a normal distribution with data groups not meeting a normal distribution.
3. Results
4. Discussion
5. Conclusions
- Under-preparation of the implant site can be a viable method to improve the implant primary stability on both ISQ and IT, since there is an increase of implant surface in contact with bone.
- The use of a tapered shaped implant can improve the implant stability when comparing to a cylindrical shaped implant, leading to the fact that it is not necessary to use of an under-preparation of the site combining the use of tapered implants on low density bone (type III/IV).
- The removing of the cortical drill from the standard preparation was the implant site protocol that showed the biggest improvement of the implant stability.
- At the same time the clinician must evaluate the density of the present bone and carefully judge the type of protocol for each case.
Clinical Implications
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Prep. | Implant | IT—N/cm | ISQ | ||
---|---|---|---|---|---|
Mean | SD | Mean | SD | ||
3.5 mm | |||||
P1 | Cylindrical | 34.6 | 15.4 | 74.9 | 5.3 |
Tapered | 54.2 | 22.6 | 78.2 | 7.5 | |
P2 | Cylindrical | 44.1 | 12.4 | 78.2 | 6.5 |
Tapered | 57.3 | 15.2 | 78.6 | 3.9 | |
P3 | Cylindrical | 63.7 | 18.7 | 76.4 | 6.8 |
Tapered | 75.9 | 16.2 | 79.0 | 7.3 | |
P4 | Cylindrical | 66.4 | 24.4 | 76.2 | 11.2 |
Tapered | 68.8 | 21.7 | 79.6 | 5.2 | |
4.0 mm | |||||
P1 | Cylindrical | 43.6 | 25.5 | 76.0 | 5.0 |
Tapered | 64.7 | 22.8 | 78.5 | 3.2 | |
P2 | Cylindrical | 45.2 | 15.2 | 79.1 | 4.8 |
Tapered | 65.7 | 19.2 | 79.9 | 2.5 | |
P3 | Cylindrical | 52.5 | 20.4 | 76.2 | 5.9 |
Tapered | 60.3 | 24.0 | 76.1 | 6.6 | |
P4 | Cylindrical | 54.5 | 22.9 | 76.8 | 6.7 |
Tapered | 65.0 | 27.4 | 76.3 | 8.0 |
Implant Diameter | Prep. Technique | IT | Distribution | ISQ A | Distribution | ISQ B | Distribution | ISQ X | |||
---|---|---|---|---|---|---|---|---|---|---|---|
3.5 mm | P1 | V < VX p = 0.000 | V(N) | VX(NO) | V < VX p = 0.000 | V(NO) | VX(NO) | V < VX p = 0.000 | V(NO) | VX(NO) | V < VX |
P2 | V < VX p = 0.000 | V(N) | VX(NO) | V = VX p = 0.422 | V(NO) | VX(NO) | V = VX p = 0.610 | V(NO) | VX(NO) | V = VX | |
P3 | V < VX p = 0.002 | V(N) | VX(NO) | V < VX p = 0.000 | V(NO) | VX(NO) | V < VX p = 0.000 | V(NO) | VX(NO) | V < VX | |
P4 | V = VX p = 0.711 | V(NO) | VX(NO) | V = VX p = 0.082 | V(NO) | VX(NO) | V = VX p = 0.351 | V(NO) | VX(NO) | V = VX | |
4.0 mm | P1 | V < VX p = 0.000 | V(NO) | VX(NO) | V < VX p = 0.016 | V(N) | VX(NO) | V < VX p = 0.039 | V(N) | VX(NO) | V < VX |
P2 | V < VX p = 0.000 | V(NO) | VX(N) | V = VX p = 0.965 | V(NO) | VX(NO) | V = VX p = 0.684 | V(NO) | VX(NO) | V = VX | |
P3 | V = VX p = 0.127 | V(N) | VX(N) | V = VX p = 1.000 | V(NO) | VX(NO) | V = VX p = 0.348 | V(NO) | VX(NO) | V = VX | |
P4 | V < VX p = 0.038 | V(N) | VX(NO) | V = VX p = 0.358 | V(NO) | VX(NO) | V = VX p = 0.942 | V(NO) | VX(NO) | V = VX |
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Herrero-Climent, M.; Lemos, B.F.; Herrero-Climent, F.; Falcao, C.; Oliveira, H.; Herrera, M.; Gil, F.J.; Ríos-Carrasco, B.; Ríos-Santos, J.-V. Influence of Implant Design and Under-Preparation of the Implant Site on Implant Primary Stability. An In Vitro Study. Int. J. Environ. Res. Public Health 2020, 17, 4436. https://doi.org/10.3390/ijerph17124436
Herrero-Climent M, Lemos BF, Herrero-Climent F, Falcao C, Oliveira H, Herrera M, Gil FJ, Ríos-Carrasco B, Ríos-Santos J-V. Influence of Implant Design and Under-Preparation of the Implant Site on Implant Primary Stability. An In Vitro Study. International Journal of Environmental Research and Public Health. 2020; 17(12):4436. https://doi.org/10.3390/ijerph17124436
Chicago/Turabian StyleHerrero-Climent, Mariano, Bernardo Ferreira Lemos, Federico Herrero-Climent, Carlos Falcao, Helder Oliveira, Manuela Herrera, Francisco Javier Gil, Blanca Ríos-Carrasco, and José-Vicente Ríos-Santos. 2020. "Influence of Implant Design and Under-Preparation of the Implant Site on Implant Primary Stability. An In Vitro Study" International Journal of Environmental Research and Public Health 17, no. 12: 4436. https://doi.org/10.3390/ijerph17124436