How much torque is TOO MUCH?? (Or too little)
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- Опубліковано 8 вер 2024
- How much insertion torque is too much insertion torque when placing a dental implant? Or is there such a thing? Isn't the bigger risk under-torquing the implant? We hear a lot about insertion torque in dentistry, so it may come as a big surprise that our orthopedic colleagues don't pay attention to this metric-even when working with bones as large as the femur!
If insertion torque isn't a good measurement, how do you know if you're placing an implant properly for primary stability and longevity of the implant solution? Well, that's where the Stanley Five Thread Rule comes in! With this rule, you can predict primary stability with greater than 99% accuracy for implant placements without worrying about insertion torque.
Check out the video to hear the full explanation of why insertion torque isn't the major factor some make it out to be, and how to properly assess your chances of stability instead.
The Five Thread Rule video: • You can PREDICT primar...
For more information, check us out at stanleyinstitu...
Hey doc. But what's the answer? Is there no max torque? Are we not still worried about pressure necrosis? Fracture of the implant or instruments? Does it depend on if the torque is created at the cortical bone level or lower? Does it depend on the implant design? Does it matter if you use a cortical bone relief drill? I'm now placing neodent and they recommend only up to 65Ncm. I used to place biohorizons and their kit doesn't even have a torque wrench with which to measure.
Doctor, why are everybody so obsessed with primary stability? I had spinners, no primary stability at all, so I did submucosal healing and they healed perfectly. Im not talking about immediate implants now
I do the same thing! If I have a spinner but it is surrounded with bone I leave it! The only axis that doesn’t have stability is the rotation around the implant. All the other five dimensions of motion have stability! And, after all you have a beautiful autogenous graft around the threads!
This all just gets at the elephant in the room, which is that so much of what we “know” in dentistry is anecdotal and “feels right”. We have to do better…
I could not agree more with that sentiment and I have some more elephants coming. 😮Stay tuned!
Well we're trying to do better. You think we're trying to do worse?
@@marionharris5952
Don’t take it as a personal attack. Notice I said “we”…
I’m always learning and improving in my practice and especially in my implant surgery journey. I don’t believe anyone is intentionally trying to do worse, but I do maintain there are some who are rather deluded about things they “know” to be true that simply aren’t so.
Sir i have a implant in anterior mandible ,had high torque in end 2-3 threads like 50-55. Is it fine
It should be just fine. That happens often due the dense nature of the lower anterior mandible.
Sir i have question…
I didnt find an answer to what happen with me
I insert the implant by motor in 35ncm so 3/4 of implant go with motor then i continue with wrench down i find torque less than 20ncm
It is possible to start with higher torques and end with lower torques, if during the insertion process, the implant threads engage compact bone, which resist the apical movement of the implant, which in effect turns your implant into an auger and strips the bone in between the threads. The worst case scenario is the implant turns into a spinner.