Journal List > J Korean Acad Prosthodont > v.52(2) > 1034776

Kwak, Cho, Lee, and Lee: The influence of iatrogenic mobilization in the initial stage of implant installation on final osteointegration

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.

Conclusion

If sufficient healing time was allowed, a few mobilization of fixture at the very early stage after the implant placement in the rabbits didn't interrupt the final bone to implant osseointegration. (J Korean Acad Prosthodont 2014;52:105-12)

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Fig. 1.
Schematic diagram of experimental implant.
jkap-52-105f1.tif
Fig. 2.
Digital torque gauge (Ncm).
jkap-52-105f2.tif
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).
jkap-52-105f3.tif
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.
jkap-52-105f4.tif
Table 1.
Removal torque test frequency and time interval in each group
G N 1st RTT time interval after placement 2nd RTT time interval after placement 3rd RTT time interval after placement 4th RTT time interval after placement Final RTT time interval after placement
I 10 1 day       8 weeks
II 10 1 day 2 days     8 weeks
III 10 1 day 2 days 3 days   8 weeks
IV 10 1 day 2 days 3 days 4 days 8 weeks
V 10 2 days       8 weeks
VI 10 2 days 4 days     8 weeks
VII 10 2 days 4 days 6 days   8 weeks
VIII 10 2 days 4 days 6 days 8 days 8 weeks
IX 10 4 days       8 weeks
X 10 4 days 7 days     8 weeks
XI 10 4 days 7 days 10 days   8 weeks
XII 10 4 days 7 days 10 days 14 days 8 weeks
C 10         8 weeks

C; control group

RTT# = Removal Torque Test

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

P-value is determined by Friedman test.

a,b The same letter means there was no statistically significant difference between groups by Bonferroni corrected Wilcoxon's signed rank test.

Table 3.
Comparison of average removal torque force among experimental group I - IV, V - VIII, and IX - XII
G N Mean ± SD P-value
I - IV 40 4.70 ± 2.93a .043
V - VIII 40 3.20 ± 1.57b  
IX - XII 40 4.05 ± 2.12ab  

P-value is determined by Kruskal-Wallis test.

a,b The same letter means there was no statistically significant difference between groups by Bonferroni corrected Wilcoxon's rank sum test.

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