Implant Diameter, Length, and the Insertion Torque/Depth Integral: A Study Using Polyurethane Foam Blocks.

The amount of energy necessary to place an implant in its seat, described as the integral of the torque-depth curve at insertion (I), has been validated as a reliable measure of primary stability. This study aimed to investigate whether (I) may detect the variations in primary stability caused by changes in the implant length or diameter better than the insertion torque (IT). Cylindric implants featuring a double-etched, sandblasted surface with different diameters or lengths were placed into monolithic polyurethane foam blocks with different densities that mimicked human bone. (I)-, (I)*-, IT-, IT*-diameter and -length plots ((I)* and IT* were the derived values corrected for undersizing) were drawn and the relation between (I), (I)*, IT, and IT* and the fixture diameter or length was investigated with correlation analysis. (I)* and IT* correlated better than (I) and IT with the fixture diameter; (I), (I)*, IT, and IT* correlated equally well with the fixture length. In all cases, the slopes of the lines best fitting the experimental data were greater for (I) or (I)* than IT or IT*, respectively. (I) or (I)* were better detectors than IT or IT* of the changes in primary stability that can be achieved by increasing the fixture diameter or length.

Stress analysis of supporting tissues according to implant fixture diameter and residual alveolar bone width / 대한치과보철학회지

STATEMENT OF PROBLEM: The cumulative success rate of wide implant is still controversial. Some previous reports have shown high success rate, and some other reports shown high failure rate. PURPOSE: The aim of this study was to analyze, and compare the biomechanics in wide implant system embeded in different width of crestal bone under different occlusal forces by finite element approach. MATERIAL AND METHODS: Three-dimensional finite element models were created based on tracing of CT image of second premolar section of mandible with one implant embedded. One standard model(6mm-crestal bone width, 4.0mm implant diameter, central position) was created. Varied crestal dimension(4, 6, 8 mm), different diameter of implants(3.3, 4.0, 5.5, 6.0mm), and buccal position implant models were generated. A 100-N vertical(L1) and 30 degree oblique load from lingual(L2) and buccal(L3) direction were applied to the occlusal surface of the crown. The analysis was performed for each load by means of the ANSYS V.9.0 program. CONCLUSION: 1. In all cases, maximum equivalent stress that applied 30.oblique load around the alveolar bone crest was larger than that of the vertical load. Especially the equivalent stress that loaded obliquely in buccal side was larger. 2. In study of implant fixture diameter, stress around alveolar bone was decreased with the increase of implant diameter. In the vertical load, as the diameter of implant increased the equivalent stress decreased, but equivalent stress increased in case of the wide implant that have a little cortical bone in the buccal side. In the lateral oblique loading condition, the diameter of implant increased the equivalent stress decreased, but in the buccal oblique load, there was not significant difference between the 5.5mm and 6.0mm as the wide diameter implant. 3. In study of alveolar bone width, equivalent stress was decreased with the increase of alveolar bone width. In the vertical and oblique loading condition, the width of alveolar bone increased 6.0mm the equivalent stress decreased. But in the oblique loading condition, there was not a difference equivalent stress at more than 6.0mm of alveolar bone width. 4. In study of insertion position of implant fixture, even though the insertion position of implant fixture move there was not a difference equivalent stress, but in the case of little cortical bone in the buccal side, value of the equivalent stress was most unfavorable. 5. In all cases, it showed high stress around the top of fixture that contact cortical bone, but there was not a portion on the bottom of fixture that concentrate highly stress and play the role of stress dispersion. These results demonstrated that obtaining the more contact from the bucco-lingual cortical bone by installing wide diameter implant plays an important role in biomechanics.

Finite element evaluation of the effect of differences in the abutment and the fixture diameters on the cervical bone stresses / 대한치과보철학회지

STATEMENT OF PROBLEM: Higher stresses at the cervical bone around dental implants have been seen as a primary cause of the bone resorption at the site. PURPOSE: To determine the possibility of stress reduction by assembly of different abutment and implant in diameters. MATERIALS AND METHODS: Abutments of several different diameters assembled on the top of XiVE(R) implants were axisymmetrically modeled for a series of finite element analyses. Abutments of 3.4, 3.8, 4.5, and 5.5 mm diameters were assumed to be sit on implants of the same or bigger diameters. All the abutments with an exception of 3.4mm dia. are technically possible to be assembled on bigger implants. Main consideration was given to the stresses at the cervical cortical bone induced by loads of parallel to the implant axis. RESULTS AND CONCLUSIONS: 1. Higher stresses were observed at the cervical area of all the models of the same diameters of abutment and fixture. The peak stresses, which were shown to be a function of the fixture diameter, were from 1-1.85MPa. 2. Difference in the diameters of the abutments and the implants actually reduced the cervical bone stresses. 3. Downsizing of the abutment by one step resulted in 0.1MPa (5%) reduction of the stresses. In light of the relatively lower bone stress, however, this amount of stress reduction was decided to be biomechanically insignificant.

The effect of osteotome technique on primary implant stability according to implant fixture diameter / 대한치주과학회지

Primary stability is a fundamental criteria of implant success. There has been various trials to increase initial stability and bone to implant contact. The objective of osteotome technique is to preserve all the existing bone by minimizing or even eliminating the drilling sequence of the surgical protocol. The bone layer adjacent to the osteotomy site is progressively compacted with various bone condensers(osteotomes) this will result in a denser bone to implant contact. This improved bone density helps to optimize primary implant stability in low density bone. The use of wide implant is one of methods to increse primary stability. They can be used in special situations in which they can increase the surface area available for implant anchorage and improve their primary stability The aim of this study was to evaluate the influence of the osteotome technique and implant width on primary stability. Osteotome technique was compared with conventional drilling method by resonance frequency measurments according to the implant fixtures diameter. The results were as follows: 1. The average of ISQ value was sightly higher in osteotome technique, but there was not statistically significant in regular and narrow implant(p<0.05). 2. Either osteotome technique or conventional technique, ISQ value was significantly higer as increasing of implant diameter(p<0.05). 3. ISQ value of drilling technique was higer than those of osteotome technique in wide implant. It was assumed to be caused by difference in final preparation diameter.