J Periodontal Implant Sci.  2016 Aug;46(4):254-265. 10.5051/jpis.2016.46.4.254.

Primary implant stability in a bone model simulating clinical situations for the posterior maxilla: an in vitro study

• Han HC
• Lim HC
• Hong JY
• Ahn SJ
• Han JY
• Shin SI
• Chung JH
• Herr Y
• Shin SY

• KMID: 2350026
• DOI: http://doi.org/10.5051/jpis.2016.46.4.254

Abstract

PURPOSE
The aim of this study was to determine the influence of anatomical conditions on primary stability in the models simulating posterior maxilla.
METHODS
Polyurethane blocks were designed to simulate monocortical (M) and bicortical (B) conditions. Each condition had four subgroups measuring 3 mm (M3, B3), 5 mm (M5, B5), 8 mm (M8, B8), and 12 mm (M12, B12) in residual bone height (RBH). After implant placement, the implant stability quotient (ISQ), Periotest value (PTV), insertion torque (IT), and reverse torque (RT) were measured. Two-factor ANOVA (two cortical conditions×four RBHs) and additional analyses for simple main effects were performed.
RESULTS
A significant interaction between cortical condition and RBH was demonstrated for all methods measuring stability with two-factor ANOVA. In the analyses for simple main effects, ISQ and PTV were statistically higher in the bicortical groups than the corresponding monocortical groups, respectively. In the monocortical group, ISQ and PTV showed a statistically significant rise with increasing RBH. Measurements of IT and RT showed a similar tendency, measuring highest in the M3 group, followed by the M8, the M5, and the M12 groups. In the bicortical group, all variables showed a similar tendency, with different degrees of rise and decline. The B8 group showed the highest values, followed by the B12, the B5, and the B3 groups. The highest coefficient was demonstrated between ISQ and PTV.
CONCLUSIONS
Primary stability was enhanced by the presence of bicortex and increased RBH, which may be better demonstrated by ISQ and PTV than by IT and RT.

Keyword

Anatomic models; Dental implants; Maxilla; Maxillary sinus

MeSH Terms

Dental Implants
In Vitro Techniques*
Maxilla*
Maxillary Sinus
Models, Anatomic
Polyurethanes
Torque
Dental Implants
Polyurethanes

Figure

• 

  Figure 1 Schematic drawings of the designed models. The thin dark layers represent cortical bone layers of 1 mm in thickness. B and M indicate bicortical and monocortical conditions, respectively. The numbers following the B or the M indicate bone height. (A) The B3 group: bicortical bone, 3 mm in height, (B) the B5 group: bicortical bone, 5 mm in height, (C) the B8 group: bicortical bone, 8 mm in height, (D) the B12 group: bicortical bone, 12 mm in height, (E) the M3 group: monocortical bone, 3 mm in height, (F) the M5 group: monocortical bone, 5 mm in height, (G) the M8 group: monocortical bone, 8 mm in height, (H) the M12 group: monocortical bone, 12 mm in height.

• 

  Figure 2 Bar graphs of each parameter for different residual bone heights (RBH) with mono- and bicortical conditions. Blue and green bars indicate mono- and bicortical conditions, respectively. X-axes represent RBH. (A) ISQ (Implant stability quotient) values, (B) PTV (Periotest value), (C) IT (Insertion torque) values, and (D) RT (Removal torque) values for different bone heights with mono- and bicortical conditions. ISQ and PTV were statistically higher in all bicortical subgroups than the corresponding monocortical subgroups, but bicortical fixation did not yield greater IT and RT values than monocortical fixation. In the monocortical groups, ISQ and PTV showed a constantly rising tendency with increasing RBH, which was statistically significant. However, the changes of IT and RT showed a different tendency of increase and decrease. In the bicortical group, all variables showed a similar tendency with different degrees of rise and decline. It should be noted that the B12 group did not attain bicortical fixation due to the length of the implant installed (10 mm). a)Significant difference compared to 3-mm subgroup in each cortical condition (adjusted P<0.0042). b)Significant difference compared to 5-mm subgroup in each cortical condition (adjusted P<0.0042). c)Significant difference compared to 8-mm subgroup in each cortical condition (adjusted P<0.0042). d)Significant difference between mono- and bicortical conditions regarding each of the 4 different bone heights (adjusted P<0.0125).

• 

  Figure 3 Scatter plots showing the correlation between measuring methods. The Pearson correlation coefficient was used for analyzing the relationship. (A) ISQ (implant stability quotient) vs. PTV (Periotest value), (B) ISQ vs. IT (insertion torque), (C) PTV vs. IT, (D) IT vs. RT (reverse torque), (E) ISQ vs. RT, (F) PTV vs. RT. High reverse correlation was demonstrated between ISQ and PTV. Moderate correlation was demonstrated between ISQ and IT, PTV and IT, and IT and RT. No correlation was demonstrated between ISQ and RT, and PTV and RT. a)Statistically significant correlation between parameters on the X- and Y-axes.

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