Implant success depends on many factors, some technical, others anatomical and others still related to the expertise of the dentist; also inserting an implant with immediate or deferred loading is a clinical choice dictated by some parameters, including primary stability.
Dental implants and primary stability
Primary stability is a fundamental parameter for implant success. Once the dental implant has been inserted, there is a good seal of primary stability when there are no movements greater than 150 microns.
A jaw bone with adequate thickness and density can be an excellent starting point for ensuring good primary stability.
The effectiveness of the osseointegration process is given both by the type of bone in which the implant is inserted, and by the technique used for implantology.
In particular, bone density is a determining factor for the primary stability of the implant, measuring bone density is in fact the first step for planning the best implantology protocol and for identifying the most suitable implant, with immediate or deferred loading. .
To obtain the best solution for a single clinical case, a competent dentist measures primary stability even during the implant insertion phase to choose the most appropriate protocol: immediate or deferred loading.
Immediate or deferred loading: measure primary stability during implant surgery
There are different ways to measure primary stability during the insertion phase of dental implants, one is the calculation of the integral of the torque-time curve, which summarizes the dynamic interactions between bone and implant during insertion and therefore represents the quantification of the energy required for implant placement in the bone.
Measuring the integral therefore means measuring the energy required to overcome the resistance of the bone in inserting the implant.
This technique for measuring primary stability during insertion of dental implants has been subjected to a validation study by the scientific community.
The study was carried out by inserting dental implants in polyurethane blocks with various densities, to simulate bone density, the measurement of primary stability took place through an implant micromotor which determines the torque-depth curve and calculates the integral.
The study showed that the integral is a reliable parameter to measure primary stability, and the measurement was the same regardless of the operator who performed it.
The measurement of the mechanical stress suffered by the bone allows the dentist to plan the protocol: immediate or deferred loading and the type of implant to be inserted, without evaluation errors.
