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Objective: The aim of this study was to quantify the effect of adapted preparation on the insertion torque of self-tapping implants in cancellous bone. In adapted preparation, bone condensation – and thus, insertion torque – is controlled by changing the diameter of the drilling. Material and methods: After preparation of cancellous porcine vertebral bone with drills of 2.85, 3, 3.15 or 3.35 mm final diameters, Branemark sytem® Mk III implants (3.75 × 11.5 mm) were inserted in 141 sites. During implantation, the insertion torque was recorded. Prior to implant insertion, bone mineralization (bone mineral density (BMD)) was measured with dental quantative computed tomography. The BMD values measured at the implant position were correlated with insertion torque for varying bone condensation. Results: Based on the average torque recorded during implant insertion into the pre-drilled canals with a diameter of 3 mm, torque increased by approximately 17% on reducing the diameter of the drill by 5% (to 2.85 mm). On increasing the diameter of the osteotomy to 3.15 mm (5%) or 3.35 mm (12%), torque values decreased by approximately 21% and 50%, respectively. Conclusion: The results demonstrate a correlation between primary stability (average insertion torque) and the diameter of the implant bed on using a screw-shaped implant. Thus, using an individualized bone mineralization-dependent drilling technique, optimized torque values could be achieved in all tested bone qualities with BMDs ranging from 330 to 500 mg/cm3. The results indicate that using a bone-dependent drilling technique, higher torque values can also be achieved in poor bone using an individualized drilling resulting in higher bone condensation. As immediate function is dependent on primary stability (high insertion torque), this indicates that primary stability can be increased using a modified drilling technique in lesser mineralized bone.

Objective: The aim of this study was to establish a correlation between bone mineral density measured preoperatively with dental computed tomography (CT), and insertion torque of screw-shaped dental implants. Material and methods: In eight human mandibles obtained postmortem, bone mineral density (BMD) was measured with dental quantitative CT (DQCT) and correlated with insertion torque values at 45 implant sites during insertion of screw-shaped dental implants (Branemark System MKIII, Nobel Biocare, AB, Goteborg, Sweden). Results: A significant correlation (r=0.86, P

The aim of this study was to establish a correlation between bone mineral density measured preoperatively with dental computed tomography (CT), and insertion torque of screw-shaped dental implants.In eight human mandibles obtained postmortem, bone mineral density (BMD) was measured with dental quantitative CT (DQCT) and correlated with insertion torque values at 45 implant sites during insertion of screw-shaped dental implants (Brånemark System MKIII, Nobel Biocare, AB, Göteborg, Sweden).A significant correlation (r=0.86, P0.001) between BMD and torque values was observed, indicating that local BMD at a specific implant position is related to the supportive capacity of the jawbone. BMD exhibited no correlation with bone height or position.The noninvasive assessment of BMD using a DQCT scan employing a low-dose protocol may be used to estimate expected primary stability depending on BMD, implant type and preparation procedure. These data may therefore help the surgeon to select the optimum implant position, implant type and operation technique.