Relationship between insertion torque, primary stability and success of immediate loading in implant dentistry – systematic review according to prism.
DOI:
https://doi.org/10.69849/0v73jm44Keywords:
dental implants, primary stability, insertion torque, immediate loading, osseointegrationAbstract
Primary stability of dental implants is considered one of the most important factors for successful osseointegration, especially in immediate loading protocols. In this context, insertion torque has been widely used as a clinical parameter to evaluate the initial anchorage of the implant in bone tissue. The aim of this study was to analyze, through a systematic review of the literature, the relationship between insertion torque and primary stability in dental implants, as well as its influence on the predictability of immediate loading protocols. The search for studies was conducted in the PubMed/MEDLINE, SciELO, and LILACS databases using descriptors related to the topic combined with Boolean operators. Clinical studies, clinical trials, and systematic reviews addressing the relationship between insertion torque and primary stability in implant dentistry were included. After applying the eligibility criteria and removing duplicate studies, 38 articles were selected for the final analysis. The results showed that insertion torque values equal to or greater than 30 Ncm are frequently associated with adequate primary stability and higher clinical success rates in immediate loading protocols. However, it was also observed that implant primary stability is influenced by other factors, such as bone quality, implant macrogeometry, and surgical technique. It can be concluded that insertion torque is an important clinical indicator of primary stability and should be used together with other parameters to assist clinical decision- making in implant-supported treatments.
References
ALBREKTSSON, T.; BRÅNEMARK, P. I.; HANSSON, H. A.; LINDSTRÖM, J.
Osseointegrated titanium implants: requirements for ensuring a long-lasting, direct bone-to- implant anchorage in man. Acta Orthopaedica Scandinavica, v. 52, n. 2, p. 155–170, 1981.
ATA-ALI, J.; ATA-ALI, F.; PEÑARROCHA-OLTRA, D.; PEÑARROCHA-DIAGO, M.
Immediate loading of dental implants: systematic review and meta-analysis. Journal of Clinical and Experimental Dentistry, v. 7, n. 2, p. 251–259, 2015.
BENIC, G. I.; HÄMMERLE, C. H. F. Horizontal bone augmentation by means of guided bone regeneration. Periodontology 2000, v. 66, n. 1, p. 13–40, 2014.
BRÅNEMARK, P. I.; ADELL, R.; BREINE, U.; HANSSON, B. O.; LINDSTRÖM, J.;
OHLSSON, Å. Intra-osseous anchorage of dental prostheses. Scandinavian Journal of Plastic and Reconstructive Surgery, v. 3, n. 2, p. 81–100, 1969.
BUSER, D.; SENNERBY, L.; DE BRUYN, H. Modern implant dentistry based on osseointegration: 50 years of progress. Clinical Implant Dentistry and Related Research, v. 19, n. 1, p. 7–17, 2017.
CANNIZZARO, G.; LEONE, M.; FERRI, V.; ESPOSITO, M. Immediate loading of dental implants placed in fresh extraction sockets. European Journal of Oral Implantology, v. 1, n. 2, p. 97–106, 2008.
CHRCANOVIC, B. R.; ALBREKTSSON, T.; WENNERBERG, A. Immediate nonfunctional versus immediate functional loading and dental implant failure rates. Journal of Dentistry, v. 42, n. 9, p. 1052–1059, 2014.
DEGIDI, M.; PIATTELLI, A. Immediate functional and non-functional loading of dental implants: a 2- to 60-month follow-up study. Journal of Periodontology, v. 76, n. 8, p. 1279– 1286, 2005.
ESPOSITO, M.; GRUSOVIN, M.; WORTHINGTON, H. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database of Systematic Reviews,
n. 3, 2013.
GALLUCCI, G. O.; HAMILTON, A.; ZHOU, W.; BUSER, D.; CHEN, S. Implant placement
and loading protocols. Clinical Oral Implants Research, v. 29, p. 106–134, 2018.
GLAUSER, R.; SENNERBY, L.; MEREDITH, N.; RÉE, A.; LUNDGREN, A.; GOTTLOW,
J.; HÄMMERLE, C. Resonance frequency analysis of implants subjected to immediate or early functional occlusal loading. Clinical Oral Implants Research, v. 15, p. 428–434, 2004.
HÄMMERLE, C. H. F.; CHEN, S.; WILSON, T. G. Consensus statements and recommended clinical procedures regarding implant loading protocols. International Journal of Oral & Maxillofacial Implants, v. 29, p. 287–290, 2014.
JAVED, F.; ROMANOS, G. E. The role of primary stability for successful immediate loading of dental implants. Journal of Dentistry, v. 38, n. 8, p. 612–620, 2010.
LANG, N. P.; BERGLUNDH, T. Periimplant diseases: where are we now? Journal of Clinical Periodontology, v. 38, p. 178–181, 2011.
MEREDITH, N. Assessment of implant stability as a prognostic determinant. International Journal of Prosthodontics, v. 11, p. 491–501, 1998.
MEREDITH, N.; BOOK, K.; FRIBERG, B.; JEMT, T.; SENNERBY, L. Resonance
frequency measurements of implant stability. Clinical Oral Implants Research, v. 8, n. 3, p. 226–233, 1997.
MORASCHINI, V.; PORTO BARBOZA, E. Immediate versus conventional loading of dental implants. International Journal of Oral and Maxillofacial Surgery, v. 44, n. 4, p. 517–526, 2015.
OTTONI, J. M. P.; OLIVEIRA, Z. F. L.; MANSINI, R.; CABRAL, A. M. Correlation
between placement torque and survival of single-tooth implants. International Journal of Oral and Maxillofacial Implants, v. 20, p. 769–776, 2005.
O’SULLIVAN, D.; SENNERBY, L.; JEMT, T. Influence of implant taper on the primary and secondary stability. Clinical Oral Implants Research, v. 15, n. 4, p. 474–480, 2004.
PAPASPYRIDAKOS, P.; CHEN, C. J.; CHU, S.; WEBER, H. P.; GALLUCCI, G. O.
Success criteria in implant dentistry. Journal of Dental Research, v. 91, p. 242–248, 2012.
RABEL, A.; KÖHLER, S. G.; SCHMIDT-WESTHAUSEN, A. M. Clinical study on
resonance frequency analysis of implants. Clinical Oral Implants Research, v. 18, n. 3, p. 257–261, 2007.
SANZ-SÁNCHEZ, I.; SANZ-MARTÍN, I.; FLICHMAN, I.; SÁNCHEZ, M.; SANZ, M.
Immediate implant placement. Clinical Oral Implants Research, v. 29, p. 67–79, 2018.
SENNERBY, L.; MEREDITH, N. Implant stability measurements using resonance frequency analysis. Clinical Oral Implants Research, v. 19, n. 6, p. 575–580, 2008.
SZMUKLER-MONCLER, S.; SALAMA, H.; REINGEWIRTZ, Y.; DUBRUILLE, J. H.
Timing of loading and effect on implant survival. International Journal of Oral & Maxillofacial Implants, v. 13, p. 857–868, 1998.
TRISI, P.; BERARDINI, M.; FALCO, A.; PODALIRI VULPIO, M. Effect of insertion torque on bone-to-implant contact. Clinical Oral Implants Research, v. 20, p. 467–471, 2009.
TURKYILMAZ, I.; TOZUM, T. F.; TUMER, C. Bone density assessments and primary implant stability. Journal of Oral Rehabilitation, v. 34, p. 267–272, 2007.
WITTNEBEN, J. G.; BUSER, D.; SALVI, G.; BÜCHI, D.; HÄMMERLE, C. F. F.
Complications and failures with implant-supported fixed dental prostheses. Clinical Oral Implants Research, v. 25, p. 116–125, 2014.
CHEN, S.; BUSER, D. Clinical and esthetic outcomes of implants placed in postextraction sites. International Journal of Oral & Maxillofacial Implants, v. 29, p. 186–215, 2014.
LOPES, A. et al. Influence of insertion torque on implant stability: clinical evaluation.
Implant Dentistry, v. 31, p. 125–131, 2022.
ROCHA, S. S. et al. Primary stability of dental implants: clinical considerations. Brazilian Dental Journal, v. 32, p. 1–8, 2021.
PEREIRA, J. R. et al. Immediate loading of dental implants: clinical outcomes. Journal of Prosthodontics, v. 28, p. 123–129, 2019.
ALMEIDA, E. O. et al. Factors affecting primary stability of dental implants. Journal of Oral Implantology, v. 45, p. 290–295, 2019.
CARVALHO, P. S. et al. Dental implant stability and insertion torque: a clinical analysis.
Clinical Implant Dentistry and Related Research, v. 25, p. 45–52, 2023.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Juliane Camile Almeida Nogueira, Rodrigo Marocchio Pavane (Autor)
This work is licensed under a Creative Commons Attribution 4.0 International License.
"Os Autores que publicam nesta revista concordam com os seguintes termos:
-
Os Autores mantêm os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a licença Creative Commons Attribution 4.0 International (CC BY 4.0). Esta licença permite que o trabalho seja compartilhado, copiado e adaptado em qualquer suporte ou formato, para qualquer fim, inclusive comercial, desde que seja atribuído o devido crédito de autoria e de publicação inicial nesta revista.
-
Os Autores têm autorização para assumir compromissos contratuais adicionais separadamente, para a distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
-
A revista permite e incentiva os autores a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) após o processo de edição e publicação, pois isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado."
