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Unlocking implant success: the impact of surgical techniques on primary stability in the posterior maxilla

Evid Based Dent. 2024 Aug 10. doi: 10.1038/s41432-024-01051-1. Online ahead of print.

ABSTRACT

DESIGN: The study conducted by Olmedo-Gaya et al. aimed to investigate the effects of various surgical techniques on the initial stability of implants placed in the posterior maxilla through a randomized controlled clinical trial. The study compared insertion torque (IT) and implant stability quotients (ISQ) among implants placed using under preparation, expanders, and standard surgical instrumentation.

CASE SELECTION: The study enrolled 108 patients, each receiving one implant in the posterior maxilla region. Patients were distributed into three groups: group 1 (n = 36) with the under preparation technique, group 2 (n = 36) using the expander technique, and group 3 (n = 36) with conventional drilling.

DATA ANALYSIS: IT was measured using a torque indicator, while ISQ was recorded through resonance frequency analysis immediately post-surgery. The ISQ values were analyzed in relation to the patient’s bone quality, categorized into types II, III, and IV.

RESULTS: ISQ values varied significantly with bone quality, being highest in type II (76.65) and type III (73.60), and lowest in type IV (67.34) bone, with a significant difference (p < 0.0001). The conventional drilling technique yielded lower ISQ values (69.31) compared to under preparation (74.29) and expander techniques (73.99), with statistical significance (p = 0.008 and p = 0.005, respectively).

CONCLUSIONS: Surgical technique significantly influences primary stability in low-quality bone. Conventional drilling results in lower ISQ values, suggesting that alternative techniques such as under preparation or expanders should be used in low-quality bone to achieve better primary stability.

CLINICAL RELEVANCE: For implants in low-quality bone, replacing the conventional drilling technique with under preparation or expander techniques can enhance primary stability.

PMID:39127794 | DOI:10.1038/s41432-024-01051-1

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