Torque refers to the rotational force applied during the insertion of a dental implant into the bone. Proper torque is crucial for the success of the implant.
Excessive Torque
Excessive torque can lead to several issues:
– *Bone Damage*: Overpressure can damage the bone tissue, impairing its ability to osseointegrate with the implant.
– *Implant Fracture*: High torque may cause mechanical failure of the implant.
– *Decreased Bone-Implant Contact (BIC)*: Excessive torque can reduce BIC, which is essential for the stability and success of the implant.
Insufficient Torque
Insufficient torque can also result in problems:
– *Poor Primary Stability*: Low torque might not provide enough initial stability, leading to micromovements that can prevent proper osseointegration.
– *Loose Fixtures*: Inadequate torque can cause the implant to remain loose, which affects the overall stability and long-term success.
Bone-Implant Contact (BIC)
Bone-Implant Contact (BIC) is a critical factor for the success of dental implants. High BIC values indicate better osseointegration, which leads to improved stability and longevity of the implant. Both excessive and insufficient torque can negatively impact BIC by either damaging the bone or failing to secure the implant properly.
Avascular Necrosis
Avascular necrosis (AVN) is a condition where bone tissue dies due to a lack of blood supply. Excessive torque can cause AVN by disrupting the blood flow to the surrounding bone, leading to implant failure. Recognizing and avoiding excessive torque during implantation is crucial to prevent AVN.
Recommendations of Various Implant Systems:
Different implant systems have specific torque recommendations to ensure optimal outcomes. Here are some guidelines from various popular systems:
– *Biotem*: Recommended torque is less than 40Ncm to maximize primary stability without risking bone damage.(www.biotem.kr)
– *Sewon Medix*: Emphasizes a torque of 40 Ncm to balance stability and bone preservation.https://(sewonmedix.m.ec21.com)
– *Straumann*: Hence, the optimal torque value for implant placement is in the range of 23 to 35 Ncm. This data is supported by the ITI Treatment Guide, which states that the minimum torque value for the Implantation Protocol with immediate loading should not be less than 35 Ncm.(www.straumann.com)
– *BioHorizons*: Place both implants and abutments with 9 distinct torque settings (15, 20, 25, 30, 35, 40, 45, 50 and 60 Ncm).
(www.biohorizons.com)
– *MegaGen*: Advises a torque range of 15-45 Ncm to ensure secure placement without compromising bone integrity.
(www.imegagen.com)