Ex vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densities

Abstract Purpose The objective of this study was to investigate the primary stability of zirconia implants using varying drilling protocols, with a focus on the impact of thread cutting on insertion torque in both mixed (D2/D3) and soft (D4) bone types. The study aimed to evaluate whether reducing t...

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Main Authors: Kawe Sagheb, Senem Yildirimturk, Sebahat Kaya, Shengchi Fan, Marius Morlock, Keyvan Sagheb
Format: Article
Language:English
Published: SpringerOpen 2025-04-01
Series:International Journal of Implant Dentistry
Subjects:
Online Access:https://doi.org/10.1186/s40729-025-00603-z
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author Kawe Sagheb
Senem Yildirimturk
Sebahat Kaya
Shengchi Fan
Marius Morlock
Keyvan Sagheb
author_facet Kawe Sagheb
Senem Yildirimturk
Sebahat Kaya
Shengchi Fan
Marius Morlock
Keyvan Sagheb
author_sort Kawe Sagheb
collection DOAJ
description Abstract Purpose The objective of this study was to investigate the primary stability of zirconia implants using varying drilling protocols, with a focus on the impact of thread cutting on insertion torque in both mixed (D2/D3) and soft (D4) bone types. The study aimed to evaluate whether reducing thread cutting could increase insertion torque and consequently improve primary stability. Methods Four drilling protocols were developed, each varying in the degree of thread cutting: no thread cut, one-third thread cut, two-thirds thread cut, and full thread cut. Implants were placed into fresh porcine hip and tibia bones simulating D2/D3 and D4 bone. The protocols followed each implant system’s manufacturer recommendations. Insertion torque was measured using a torque indicator, and statistical analysis was conducted with the Mann-Whitney U test, with p < 0.05 considered statistically significant. Results Significant differences in primary stability were observed between implant systems and drilling protocols, particularly in D4 bone. Three of the four implant systems showed improved primary stability in D4 bone when the thread cut was reduced (p < 0.05). One system achieved the recommended insertion torque with a full thread cut. In contrast, in D2/D3 bone, all implant systems required a full thread cut to remain within the manufacturer’s torque guidelines. Conclusions Zirconia implant systems exhibit substantial variability in primary stability based on the selected drilling protocol and bone quality. Reducing thread cutting demonstrated improved stability in soft bone. However, excessive torque should be avoided to prevent mechanical failure, especially in systems with lower fracture resistance. Graphical Abstract
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spelling doaj-art-8c32abeb27e447dcb0ee97a69eb304652025-08-20T02:11:42ZengSpringerOpenInternational Journal of Implant Dentistry2198-40342025-04-011111910.1186/s40729-025-00603-zEx vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densitiesKawe Sagheb0Senem Yildirimturk1Sebahat Kaya2Shengchi Fan3Marius Morlock4Keyvan Sagheb5Department of Prosthetic Dentistry, University Medical CentreDepartment of Oral and Maxillofacial Surgery, Istanbul University Faculty of DentistryDepartment of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg - UniversityDepartment of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg - UniversityDepartment of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University MainzDepartment of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg - UniversityAbstract Purpose The objective of this study was to investigate the primary stability of zirconia implants using varying drilling protocols, with a focus on the impact of thread cutting on insertion torque in both mixed (D2/D3) and soft (D4) bone types. The study aimed to evaluate whether reducing thread cutting could increase insertion torque and consequently improve primary stability. Methods Four drilling protocols were developed, each varying in the degree of thread cutting: no thread cut, one-third thread cut, two-thirds thread cut, and full thread cut. Implants were placed into fresh porcine hip and tibia bones simulating D2/D3 and D4 bone. The protocols followed each implant system’s manufacturer recommendations. Insertion torque was measured using a torque indicator, and statistical analysis was conducted with the Mann-Whitney U test, with p < 0.05 considered statistically significant. Results Significant differences in primary stability were observed between implant systems and drilling protocols, particularly in D4 bone. Three of the four implant systems showed improved primary stability in D4 bone when the thread cut was reduced (p < 0.05). One system achieved the recommended insertion torque with a full thread cut. In contrast, in D2/D3 bone, all implant systems required a full thread cut to remain within the manufacturer’s torque guidelines. Conclusions Zirconia implant systems exhibit substantial variability in primary stability based on the selected drilling protocol and bone quality. Reducing thread cutting demonstrated improved stability in soft bone. However, excessive torque should be avoided to prevent mechanical failure, especially in systems with lower fracture resistance. Graphical Abstracthttps://doi.org/10.1186/s40729-025-00603-zZirconiumDental implantInsertion torqueOsseointegrationPrimary stabilityBone density
spellingShingle Kawe Sagheb
Senem Yildirimturk
Sebahat Kaya
Shengchi Fan
Marius Morlock
Keyvan Sagheb
Ex vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densities
International Journal of Implant Dentistry
Zirconium
Dental implant
Insertion torque
Osseointegration
Primary stability
Bone density
title Ex vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densities
title_full Ex vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densities
title_fullStr Ex vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densities
title_full_unstemmed Ex vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densities
title_short Ex vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densities
title_sort ex vivo comparison of drilling techniques for optimizing primary stability of zirconia dental implants in different bone densities
topic Zirconium
Dental implant
Insertion torque
Osseointegration
Primary stability
Bone density
url https://doi.org/10.1186/s40729-025-00603-z
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