Int J Oral Maxillofac Implants. 2020 Sep/Oct;35(5):955-964. doi: 10.11607/jomi.8176.
To assess the effects of drilling protocol and bone density on the primary stability of implants with different macrogeometries currently used in clinical practice.
This in vitro study compared the designs of two implants: Biomimetic Coral, a parallel-walled design with a slightly expanded platform and a symmetric progressive thread; and tapered Biomimetic Ocean, a reverse coronal design with an asymmetric progressive thread. The drilling alternatives were grouped according to the standard sequence for each type, plus an extra drill for hard bone, using laminated blocks with different densities. The insertion torques and implant stability quotient (ISQ) values were obtained with a surgical motor and resonance frequency analysis (RFA), respectively.
A total of 120 implants (n = 60 Ocean, n = 60 Coral) were inserted and analyzed without registering any deviation from the protocol. The Coral implants presented significantly higher insertion torque values (P < .001), consistent with optimal osseointegration, for the standard drill, the dense bone drill, and the screw tap. Insertion torque was not affected by the drilling sequence (P = .124), and the effect of interaction between the implant design and drilling sequence was not significant (P = .940). Statistically significant differences were observed in insertion torque values due to the type of implant but not due to the bone density. The ISQ values were significantly higher (P < .001) for the Coral design. In both the Ocean and Coral implants, ISQ was affected by the drilling sequence (P < .001), as the ISQ values were higher in the standard sequence with screw tap drilling than in the standard sequence with a dense bone drill. A positive correlation was found between the insertion torque and ISQ values.
The macrogeometry of the implant and the drilling sequence have a significant effect on both primary stability values (ISQ and insertion torque). The values for the Coral implant were statistically higher but still within the range required to achieve proper osseointegration. These results support the drilling sequence recommended by the manufacturer for this type of implant, using larger-diameter drills and screw taps in sites with harder or cortical bone.
评估不同宏观设计的种植体在目前临床应用中的初始稳定性，研究钻针方案和骨密度的影响。
本体外研究比较了两种种植体的设计：仿生珊瑚，一种具有轻微扩展平台和对称渐进螺纹的平行壁设计；以及锥形仿生海洋，一种具有不对称渐进螺纹的反向冠部设计。根据每种类型的标准顺序对钻针方案进行分组，对于硬骨，使用不同密度的层压块，外加一根额外的钻头。使用外科动力系统和共振频率分析（RFA）分别获得植入扭矩和种植体稳定性指数（ISQ）值。
共植入和分析了 120 颗种植体（n = 60 颗海洋，n = 60 颗珊瑚），没有记录到任何偏离方案的情况。珊瑚种植体的初始扭矩值明显更高（P <.001），这与标准钻头、致密骨钻头和丝锥的最佳骨整合一致。初始扭矩不受钻针方案的影响（P =.124），且种植体设计和钻针方案之间的相互作用影响不显著（P =.940）。由于种植体类型，而不是骨密度，导致了初始扭矩值的差异具有统计学意义。珊瑚设计的 ISQ 值明显更高（P <.001）。在海洋和珊瑚种植体中，ISQ 受到钻针方案的影响（P <.001），标准丝锥钻针方案的 ISQ 值高于标准致密骨钻针方案。插入扭矩和 ISQ 值之间存在正相关关系。
种植体的宏观设计和钻针方案对初始稳定性值（ISQ 和初始扭矩）有显著影响。珊瑚种植体的数值具有统计学意义，但仍在获得适当骨整合所需的范围内。这些结果支持该类型种植体制造商推荐的钻针方案，在较硬或皮质骨部位使用较大直径的钻头和丝锥。
