Primary Implant Stability Analysis of Different Dental Implant Connections and Designs-An In Vitro Comparative Study

Are Torque-Induced Bone Texture Alterations Related to Early Marginal Jawbone Loss?

The reason why marginal bone loss (MBL) occurs after dental implant insertion without loading has not yet been clearly investigated. There are publications that confirm or reject the notion that there are factors that induce marginal bone loss, but no research investigates what exactly occurs in the bone surrounding the implant neck. In this study, 2196 samples of dental implant neck bone radiographs were analyzed. The follow-up period was 3 months without functional loading of the implant. Marginal bone loss was evaluated in relation to the torque used during the final phase of implant insertion. Radiographic texture features were also analyzed and evaluated. The analyses were performed individually for the anterior and posterior part of the alveolar crest in both the mandible and maxilla. After 3 months, an MBL relation with higher torque (higher than 40 Ncm; p < 0.05) was observed, but only in the lower jaw. The texture features Sum Average (SumAverg), Entropy, Difference Entropy (DifEntr), Long-Run Emphasis (LngREmph), Short-Run Emphasis (ShrtREmph), and discrete wavelet decomposition transform features were changed over time. This study presents that MBL is related to the torque value during dental implant insertion and the location of the procedure. The increasing values of SumAverg and LngREmph correlated with MBL, which were 64.21 to 64.35 and 1.71 to 2.01, respectively. The decreasing values of Entr, DifEntr, and ShrtREmph also correlated with MBL, which were 2.58 to 2.47, 1.11 to 1.01, and 0.88 to 0.84, respectively. The analyzed texture features may become good indicators of MBL in digital dental surgery.