A comparison of two methods of enhancing implant primary stability

BACKGROUND: Surgical technique and implant design have an effect on the primary stability of oral implants, which in turn increases resistance to implant micromotion during healing. PURPOSE: 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 and changes in the stability of implants during the initial 6-month healing period following implant insertion. A comparison was made between two methods of enhancing primary implant stability: method 1, standard Branemark System implants (Nobel Biocare AB, Gothenburg, Sweden) inserted with a technique designed to enhance primary stability, and method 2: Branemark Mk IV implants (Nobel Biocare AB) inserted according to the manufacturer's instructions. MATERIALS AND METHODS: Thirteen patients were selected for inclusion in the study. A total of 42 implants were placed. Insertion torque data were recorded, and bone quality at the implant site was assessed at implant insertion. Resonance frequency analysis measurements were taken at implant insertion as well as at second-stage surgery 6 months later. RESULTS: A statistically significant difference was recorded between the mean maximum insertion torque for type 4 bone and bone types 2 and 3. No significant difference was recorded between bone types 2 and 3. A significantly lower resonance frequency value was seen for standard implants placed into type 4 bone (p <.05). Across all implant types a significant difference in the energy required when inserting implants into type 4 bone and bone types 2 and 3 was seen. A significantly lower mean energy requirement was seen between the Mk IV implants placed into type 4 bone and the other combinations of implant types and bone. CONCLUSIONS: Within the limitations of this study, the results agree with the manufacturer's claim that when compared with standard implants, the design of the Mk IV implant increases implant primary stability with a reduction in the energy imparted into the bone at the implant site.