Implant insertion torque load analysis for mandible using CBCT images

Abstract

Introduction: Osteoporotic patients require particular attention to their implant site bone quality as an indication of prognosis and may require modified surgical technique Insertion Torque (IT). Aim: It is the purpose of this study to test whether IT is significantly correlated with bone density or not, as assessed by the cone-beam computed tomography (CBCT) in a group of osteopenic and osteoporotic patients. Materials and methods: A total of 30 patients were included in the study. The mandibular second premolar region was chosen as the site of investigation to prevent variability in surgical implant placement technique in different locations affecting bone mineral density (BMD). Partially, edentulous female patients between 51 and 60 years of age who were scheduled to receive implant placement were recruited for the study. CBCT (Master Series 3D Dental Imaging) was used for preoperative evaluation of the jaws for each patient. Materialise’s Interactive Medical Image Control System (MIMICS) was used to process stacks of 2D images from CBCT. Finite element analysis were carried out on bone using Ansys software. Maximum displacement and maximum stress–strain patterns were compared in normal, osteoporotic, and osteopenic groups. Results: The difference in mean bone density in all three groups were statistically significant (p < 0.05) (Table 1). FEA at 32, 36, 40 N in all 3 groups was statistically significant. (Table 2). Conclusion: Within the limitations of the study, the amount of stress–strain that exhibits at 40 N load in normal bone will be almost the same stress–strain given at 32 N load in osteoporotic bone. Normal IT load analysis exhibits more stress/strain in osteoporotic patients when compared with other groups, showing that IT must be achieved to an optimum level to avoid further complication and failures.