Measurement of implant insertion torque in intentionally undersized osteotomy site preparation in the posterior maxilla, a prospective clinical study.

Abstract

Abstract Background Achieving adequate primary stability for dental implants in the posterior maxilla is challenging due to the low bone density and the presence of fine trabecular bone in the area. Low primary implant stability can compromise the long-term success of the implant. Purpose the study aims to evaluate the effect of intentionally undersized osteotomy sites on the insertion torque of implants placed in type 4 bone density in the posterior maxilla, regardless of the surgeon's tactile sense of the bone density. Materials and methods Conventional implant placement technique was performed in the posterior maxilla by intentionally omitting the last drill of the recommended drilling sequence protocol. The insertion torque was measured using an integrated surgical motor software. Results The study included 72 implants in both genders and different age groups. The retrieved samples were divided into four groups with insertion torque ranging from 11 Ncm to 48 Ncm. The mean insertion torque was 26.51±0.18 Ncm for all cases (P=0.001). No significant difference was found in the mean insertion torque between different age groups (26.51±2.845, P=0.84). However, a significant difference was observed between male and female cases (P=0.84). Conclusions Most implant insertion torque measurements vary significantly between cases in the intentionally under-prepared posterior maxillary osteotomy site. Omitting the last drill should be applied for all the preparations of the posterior maxillary implant sites. Minimizing the osteotomy site intentionally is recommended for all posterior maxillary implant cases.