title: Two alternative surgical techniques for enhancing primary implant stability in the posterior maxilla: a clinical study including bone density, insertion torque, and resonance frequency analysis data.
abstract: BACKGROUND
  The primary stability of dental implants associated with resistance to micromotion during healing is affected by surgical technique and implant design, which are important especially in the soft bone, where implant failures are more likely.
  
  
  OBJECTIVE
  This study was designed to compare the parameters associated with implant insertion using two different methods of enhancing implant primary stability and to identify any relationship between these parameters at implant insertion.
  
  
  METHODS
  A total of 60 implants were placed in the maxillary posterior regions of 22 patients. The bone densities at the implant sites were recorded using a computerized tomography machine in Hounsfield unit (HU). The maximum insertion torque data were recorded with the Osseocare (Nobel Biocare AB, Göteborg, Sweden) equipment, while resonance frequency analysis (RFA) measurements were taken using an Osstell (Integration Diagnostics AB, Göteborg, Sweden) machine at implant surgery. Comparisons including HU, Ncm, and implant stability quotient were made between two control groups (C1 and C2), and corresponding four test groups (T1-T4) using thinner drills to enhance primary implant stability.
  
  
  RESULTS
  Two implants were lost, meaning an overall implant survival rate of 96.6% after 3 +/- 1 years. When compared to control groups, significantly higher mean maximum insertion torque and RFA values were found for corresponding test groups. In addition, strong correlations were observed between the bone density and insertion torque, and implant stability values at implant placement.
  
  
  CONCLUSIONS
  The results of this study suggest that using thinner drills for implant placement in the maxillary posterior region where bone quality is poor may improve the primary implant stability, which helps clinicians to obtain higher implant survival rates.
authors.affiliation: Department of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43218-2357, USA. turkyilmaz.1@osu.edu
authors.forename: Ilser
authors.initials: I
authors.lastname: Turkyilmaz
authors.forename: Utku
authors.initials: U
authors.lastname: Aksoy
authors.forename: Edwin A
authors.initials: EA
authors.lastname: McGlumphy
mesh_terms: D015519:Bone Density; D003758:Dental Implantation, Endosseous / Q000295:instrumentation* / Q000379:methods*; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D003830:Denture, Partial, Fixed; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000534:rehabilitation; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D019415:Torque; D014732:Vibration
chemical_list: D015921:Dental Implants