Features of surgical implantation protocol depending on the implant surface roughness and bone density, in vitro

The discovery of osseointegration by Professor Branemark in 1952 [1] revolutionized modern dental implantology. Osseointegration is a dynamic process influenced by numerous factors, with primary stability playing a crucial role. Primary stability refers to the immobility of an implant immediately after placement in the prepared bone bed. Insufficient macro- and microscopic factors can lead to complications and implant loss. This study compares different surgical protocols for implant bed preparation in dense (D2) and less dense (D3) bone using implants with low and aggressive macro-threads. The findings will inform clinical recommendations.

Objective. To evaluate the effectiveness of various implant bed preparation protocols using periotestmetry on experimental models, considering bone type and implant design, identifying key factors determining primary stability for improved clinical placement protocols.

Materials and methods. The study included 10 surgical protocols for dental implant placement. Implants were inserted into polyurethane blocks simulating bone types D2 and D3. Each group consisted of 25 blocks of the same type, with one implant per block. IRIS LIKO-M (low-aggressive thread) and IRIS Evolution (aggressive thread) implants (NPK Likostom LLC, Russia) were used. A Venton M3 physiodispenser (China) recorded insertion torque. Implant stability was measured using a Penguin PFA device (Sweden) in ISQ units. Statistical analysis was performed using StatTech v. 4.7.0 (Stattech LLC, Russia), comparing groups using Student’s t-test (p<0.05).

Conclusions. Statistical analysis demonstrated that primary stability is directly influenced by favorable bone conditions (D2: thick cortical plate surrounding dense cancellous bone; D3: thin cortical plate surrounding less dense cancellous bone) and the use of expanders for D4 bone (thin cortical plate surrounding low-density cancellous bone).

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