J Periodontal Implant Sci.  2013 Feb;43(1):30-36. 10.5051/jpis.2013.43.1.30.

Evaluation of the correlation between insertion torque and primary stability of dental implants using a block bone test

• Bayarchimeg D
• Namgoong H
• Kim BK
• Kim MD
• Kim S
• Kim TI
• Seol YJ
• Lee YM
• Ku Y
• Rhyu IC
• Lee EH
• Koo KT

• KMID: 1783675
• DOI: http://doi.org/10.5051/jpis.2013.43.1.30

Abstract

PURPOSE
Implant stability at the time of surgery is crucial for the long-term success of dental implants. Primary stability is considered of paramount importance to achieve osseointegration. The purpose of the present study was to investigate the correlation between the insertion torque and primary stability of dental implants using artificial bone blocks with different bone densities and compositions to mimic different circumstances that are encountered in routine daily clinical settings.
METHODS
In order to validate the objectives, various sized holes were made in bone blocks with different bone densities (#10, #20, #30, #40, and #50) using a surgical drill and insertion torque together with implant stability quotient (ISQ) values that were measured using the Osstell Mentor. The experimental groups under evaluation were subdivided into 5 subgroups according to the circumstances.
RESULTS
In group 1, the mean insertion torque and ISQ values increased as the density of the bone blocks increased. For group 2, the mean insertion torque values decreased as the final drill size expanded, but this was not the case for the ISQ values. The mean insertion torque values in group 3 increased with the thickness of the cortical bone, and the same was true for the ISQ values. For group 4, the mean insertion torque values increased as the cancellous bone density increased, but the correlation with the ISQ values was weak. Finally, in group 5, the mean insertion torque decreased as the final drill size increased, but the correlation with the ISQ value was weak.
CONCLUSIONS
Within the limitations of the study, it was concluded that primary stability does not simply depend on the insertion torque, but also on the bone quality.

Keyword

Bone density; Dental implants; Torque

MeSH Terms

Bone Density
Dental Implants
Humans
Mandrillus
Mentors
Osseointegration
Torque

Figure

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  Figure 1 Photographic presentation of the bone block with various bone densities that were used in the present study.

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  Figure 2 Photographic presentation of the fixture type used in the present study (SS II fixture, Osstem Implant Co.).

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  Figure 3 Torque measurement at fixture placement.

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  Figure 4 Measurement of the implant stability quotient values using the Ostell Mentor (Osstell).

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  Figure 5 A diagram presenting the correlation between the insertion torque (IT) and implant stability quotient (ISQ) values according to the various bone densities tested in the present study. The insertion torque increased according to the bone density, and the same was observed for the ISQ. The two variables appeared to have a strong positive correlation, which was statistically significant (correlation coefficient=0.82).

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  Figure 6 Diagram illustrating the relationship between the insertion torque and implant stability quotient (ISQ) according to the various drill sizes under evaluation. The insertion torque (IT) decreased when the correlation with the ISQ value was weak and nonsignificant (correlation coefficient=0.07).

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  Figure 7 The insertion torque (IT) increased according to the thickness of the cortical bone, as did the implant stability quotient (ISQ) value. The two variables had a stronger positive correlation (correlation coefficient=0.84) with statistically significant values.

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  Figure 8 Insertion torque (IT) increased according to the bone density, while the correlation with the implant stability quotient (ISQ) value was weak and non-significant (correlation coefficient=0.45).

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  Figure 9 Insertion torque (IT) decreased according to the size of the final drill, but the correlation (correlation coefficient=0.57) with the implant stability quotient (ISQ) value was weak and nonsignificant.

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