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Abstract
Purpose
The aim of present investigation was to find out the influence of several times iatrogenic mobilization in the initial stage of implant installation on bone-implant osteointegration.
Materials and methods
The experimental implants (3.75 mm in diameter, 8.0 mm in length) were made of commercially pure (Grade IV) titanium, and were treated with RBM (MegaGen®: Ca-P) on lower 4.0 mm part. Only lower part of implant was inserted to bone and the implants were nonsubmerged. The 130 implants (two in each tibia) were inserted into the monocortical tibias of 33 rabbits which each weighed more than 3.5 kg (Female, New Zealand White). According to the removal torque interval, the groups were divided into 13 groups, group I (1 day), group II (1 day + 2 days), group III (1 day + 2 days + 3 days), group IV (1 day + 2 days + 3 days + 4 days), group V (2 days), group VI (2 days + 4 days), group VII (2 days + 4 days + 6 days), group VIII (2 days + 4 days + 6 days + 8 days), group IX (4 days), group X (4 days + 7 days), group XI (4 days + 7 days + 10 days), group XII (4 days + 7 days + 10 days + 14 days) and control group. In the control group, the removal torque was measured at 8 weeks with a digital torque gauge (Mark-10, USA). In the experimental groups, the removal torque was given once, twice, three times or four times by experiment design before the final removal torque and the value was measured each time. The implants were then screwed back to their original positions. All the experimental groups were given a final healing time of 8 weeks after placement, in which values were compared with the control groups and the 1st, 2nd, 3rd or 4th removal torque values in each experimental group.
Results
In comparison of the final removal torque tests among experimental groups, the removal torque value of experimental groups except group XII were not statistically different that of control group. And the values of group I and II were significantly higher than the values of group VI, VIII, X, XI, and XII. In addition, the values of group III, IV, and V were significantly higher than group XI and XII. In comparison of the removal torque in the each experimental group, the final removal torque were significantly higher in all groups except group VIII, X, XI, and XII.
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Fig. 3.
A photograph of the removal torque test holding the sample. The driver is connected to the implant and the jaws of the digital torque gauge (MGT12, Mark-10 Co., NY, USA).
Fig . 4.
Comparison of final removal torque force among experimental groups and control group. ∗ P-value is determined by Kruskal-Wallis test. a, b,c, d The same letter means there was no statistically significant difference between groups by Bonferroni corrected Wilcoxon's rank sum test.
Table 1.
Removal torque test frequency and time interval in each group
Table 2.
Removal torque force of in experimental groups (N/cm)
| G | RTT (Mean ± SD) | P-value∗ | ||||
|---|---|---|---|---|---|---|
| 1st | 2nd | 3rd | 4th | Final | ||
| I | 4.91 ± 3.09 | 21.75 ± 4.45 | .005 | |||
| II | 5.15 ± 2.96a | 4.36 ± 2.45a | 21.27 ± 5.58b | <.001 | ||
| III | 4.52 ± 3.83a | 3.91 ± 3.45a | 3.71 ± 2.72a | 19.79 ± 6.41b | <.001 | |
| IV | 4.22 ± 1.92a | 3.45 ± 1.66a | 3.51 ± 1.21a | 2.90 ± 0.89a | 19.19 ± 12.05b | <.001 |
| V | 3.22 ± 1.15 | 18.88 ± 5.89 | .005 | |||
| VI | 2.57 ± 1.11a | 2.65 ± 0.77a | 8.24 ± 6.47b | .006 | ||
| VII | 3.24 ± 1.14a | 2.93 ± 0.96a | 3.53 ± 0.81a | 12.34 ± 6.06b | <.001 | |
| VIII | 3.77 ± 2.46 | 3.14 ± 2.09 | 3.57 ± 1.55 | 4.57 ± 1.93 | 8.35 ± 8.17 | .102 |
| IX | 3.55 ± 1.54 | 16.14 ± 10.16 | .007 | |||
| X | 3.61 ± 1.85 | 4.59 ± 3.04 | 8.08 ± 6.84 | .459 | ||
| XI | 4.61 ± 2.89 | 4.92 ± 3.41 | 6.08 ± 4.52 | 6.54 ± 6.55 | .416 | |
| XII | 4.38 ± 2.07 | 4.29 ± 2.01 | 5.42 ± 3.24 | 5.38 ± 5.17 | 5.18 ± 7.07 | .536 |
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