Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Clin Exp Dent Res. 2024 Dec;10(6):e70048. doi: 10.1002/cre2.70048.
Bone density is an important factor for long-term implant success. Peri-implant bone density evaluation before implant placement can be useful for treatment planning, such as the selection of proper implant size or drilling protocol in each case. In this study, we aimed to establish an objective intraoperative bone density evaluation method by measuring the drilling torque value using a newly designed density measurement drill.
Drilling torque value measurement was performed intraoperatively using three types of drills; two previously reported drills and a newly designed drill as a density measurement drill. Polyurethane bone blocks of different densities (D1-D4) were used in this experiment. After the measurement, implants were inserted based on the scheduled plan, and insertion torque (IT) and implant stability quotient (ISQ) were measured to assess primary implant stability.
The drilling torque value increased with the bone blocks' density, and there were significant differences among different densities in all groups (p < 0.05). The drilling torque value showed a positive correlation with IT in all groups (p < 0.05). In addition, the drilling torque value increased with the increase in ISQ in all groups.
Within the limitations of this study, a newly designed density measurement drill was able to classify D1-D4 in polyurethane bone blocks despite its narrow diameter, and an objective intraoperative bone evaluation can be achieved. An intraoperative assessment of the drilling torque value can predict primary implant stability and provide valuable information for intraoperative treatment planning, such as undersized drilling protocol and implant size change.
骨密度是长期种植体成功的重要因素。在植入物放置前对种植体周围骨密度进行评估，有助于治疗计划，例如在每种情况下选择适当的植入物大小或钻孔方案。本研究旨在通过使用新设计的密度测量钻头测量钻孔扭矩值来建立一种客观的术中骨密度评估方法。
使用三种钻头（两种之前报道的钻头和一种新设计的密度测量钻头）在术中进行钻孔扭矩值测量。本实验使用不同密度（D1-D4）的聚氨酯骨块。测量后，根据预定计划插入种植体，并测量初始植入扭矩（IT）和种植体稳定性指数（ISQ），以评估初始种植体稳定性。
钻孔扭矩值随骨块密度的增加而增加，所有组中不同密度之间存在显著差异（p<0.05）。在所有组中，钻孔扭矩值与 IT 呈正相关（p<0.05）。此外，在所有组中，钻孔扭矩值随 ISQ 的增加而增加。
在本研究的限制范围内，尽管新设计的密度测量钻头直径较窄，但仍能对聚氨酯骨块中的 D1-D4 进行分类，从而实现客观的术中骨评估。术中评估钻孔扭矩值可以预测初始种植体稳定性，并为术中治疗计划提供有价值的信息，例如采用小尺寸钻孔方案和改变植入物大小。
