Mandibular bone characteristics, drilling protocols, and final insertion torque for titanium-zirconium mini-implants for overdentures: A cross-sectional analysis.

Autor: Leles CR; School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil., Leles JLR; School of Dentistry, Paulista University, Goiania, Goias, Brazil., Curado TFF; School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil., Silva JR; School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil., Nascimento LN; School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil., de Paula MS; School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil., Maniewicz S; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland., Schimmel M; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland., McKenna G; Consultant in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, UK.
Jazyk: angličtina
Zdroj: Clinical implant dentistry and related research [Clin Implant Dent Relat Res] 2023 Apr; Vol. 25 (2), pp. 426-434. Date of Electronic Publication: 2023 Jan 09.
DOI: 10.1111/cid.13181
Abstrakt: Objective: The aim of this study was to assess the final insertion torque values achieved using site-specific drilling protocols for a novel mini implant system for removable complete overdentures. Anatomical and technical factors influencing final insertion torque were recorded and analyzed.
Material and Methods: Participants were randomized to two surgical protocol groups (flapped or flapless) and all received four mini implants (Straumann® mini implant system; Straumann AG) in the anterior mandible, using a 1.6 mm needle drill and a 2.2 mm pilot drill for the implant bed site preparation. The final insertion torque was recorded as the main outcome variable during surgery. Bone type, radiographical bone density, ridge form, implant length, and the drilling protocol were considered as independent variables. Descriptive statistics, generalized estimating equations (GEE) regression, and heatmap charts were used for data analyses.
Results: A total of 296 mini implants were placed in 74 patients (mean age = 64.1 ± 8.0; 64.9% female) using flapless (n = 37) or flapped (n = 37) surgeries. Mean final insertion torque was 55.8 ± 18.4 Ncm (10.5% > 35 Ncm, 48.9% between 35 and 65 Ncm, and 40.6% > 65 Ncm). The needle drill was used in only 43.9% of the implant bed sites. Higher final torque values were observed for higher bone densities (bone type I > II > III, and D1-D2 > D3-D4), highly resorbed ridge forms (5-6 > 3-4), flapped surgeries, and male patients. However, regression models showed that the likelihood of achieving optimal insertion torque (≥35 and ≤65 Ncm) was higher for females (OR = 2.14; 95%CI = 1.14-4.01; p = 0.018), ridge forms 3-4 (OR = 2.87; 95%CI = 1.05-7.85; p = 0.040), and flapless surgeries (OR = 1.96; 95%CI = 1.09-3.51; p = 0.024).
Conclusions: Sufficient primary stability for immediate loading was achieved for the majority of the mini implants placed. Surgical implant bed preparation should be site-specific to achieve optimal primary stability for immediate loading while avoiding excessive insertion torque.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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