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Volume 26 , Issue 6
November/December 2011

Pages 13331343

The Influence of Insertion Torque on the Survival of Immediately Placed and Restored Single-Tooth Implants

Michael R. Norton, BDS FDS RCS(Ed)

PMID: 22167441

Purpose: The purpose of this retrospective study was to evaluate the medium- to long-term clinical outcome of single-tooth implants placed into fresh extraction sockets using a low-insertion-torque protocol and immediately restored with acrylic resin provisional crowns. Materials and Methods: Sixty-one patients consecutively referred for the replacement of one or more failing teeth were planned for treatment by means of extraction and immediate implant placement and provisionalization using a low-insertion-torque protocol of ≤ 25 Ncm. Low rotational stability was not a contraindication to treatment unless there was a lack of axial stability. Implant survival and marginal bone levels were documented. A statistical analysis was performed to discover any correlations between insertion torque, age, gender, implant size and tooth position and marginal bone loss. Results: Sixty-eight implants were placed. Three implants failed to osseointegrate; one was replaced and immediately restored and has been successful for more than 5 years. The overall survival rate for all implants was 95.5%, which have been in function for a period of 1.25 to 9.5 years. The mean marginal bone loss of the 54 implants followed for at least 24 months was 0.23 0.60 mm mesially and 0.20 0.72 mm distally. Overall, 78% of implants showed no marginal bone loss, 9% experienced 0.1 to 0.5 mm of bone loss, and 13% demonstrated > 0.5 mm of bone loss. There were no significant correlations between the various parameters analyzed and marginal bone loss. Conclusion: A torque of only 25 Ncm would seem more than sufficient to yield a favorable clinical outcome, and there may be a misconception as to what actually represents adequate primary stability. Immediate provisionalization of single-tooth implants placed with a relatively low insertion torque can yield favorable survival rates and optimal maintenance of marginal bone levels compared to the generally accepted norm. Int J Oral Maxillofac Implants 2011;26:13331343

Key words: dental implants, immediate placement, insertion torque

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