Does Subcrestal Position Affect Insertion Torque Of Different Implant Designs At Different Bone Densities? An In Vitro Model Study

Purpose: To evaluate the insertion torque at the equicrestal and subcrestal positions of three implant designs in synthetic polyurethane blocks simulating different bone conditions. Materials and Methods: Overall, 72 implants with three different designs (two conical and one cylindrical) were inserted at equicrestal and subcrestal positions (-2 mm) into polyurethane blocks simulating the anterior (0.32 g/cm(3)) and posterior (0.48 g/cm(3)) regions of the maxilla. The final insertion torque of all implants was measured using a digital torque meter, and the results were evaluated and statistically analyzed. Results: For all implant systems, insertion torque decreased significantly when placed at the subcrestal position (P < .05), except for cylindrical implants placed in the bone blocks with high cancellous density. The implants with higher body conicity and square threads had higher insertion torque values than the cylindrical and conical implants with a lower body conical angle and trapezoidal threads. The implants inserted into higher-density blocks showed greater stability. Conclusion: The different implant systems lost insertion torque in a nonuniform manner at the subcrestal position and varied according to bone density. Implant design significantly influenced the initial stability at the equicrestal and subcrestal positions, especially in lower-density bone.