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López‐Jarana P, Marques RP, Jaramillo R, Santos R, Barros J, Matos A, et al. Analysis of Primary Stability in Two Designs of Ultrashort Implants: In Vitro Study. Bioengineering. 2026. doi:10.3390/bioengineering13060606
AutoresPaula López‐Jarana, Rui Pedro Marques, Reyes Jaramillo, Rocio Santos, Juna Barros, André Matos, Daniel Robles, Mariano Herrero-Climent
Este estudio in vitro evalúa cómo el diseño macro y microscópico de implantes ultracortos de 4 mm, junto con el protocolo de fresado y la densidad ósea, afectan su estabilidad primaria. La investigación compara dos sistemas de implantes en modelos de hueso simulando calidades tipo II y III, utilizando torque de inserción y análisis de frecuencia de resonancia (ISQ). Los hallazgos sugieren que la geometría cónica con roscas en V puede ofrecer mayor anclaje mecánico que los diseños de paredes paralelas en implantes de estas dimensiones. Se destaca la influencia significativa de los protocolos de fresado en la estabilidad mecánica, proporcionando datos relevantes para optimizar la colocación de implantes en maxilares posteriores severamente atróficos, buscando asegurar una estabilidad adecuada para su posterior rehabilitación.
Background: This in vitro study evaluated the influence of macro and microscopic implant design, drilling protocol, and bone density on the primary stability of 4 mm ultrashort dental implants, aiming to provide evidence-based guidance for their use in severely atrophic posterior jaws. Methods: Two implant systems were compared: test group (Klockner Essential Cone® conical implants with polished neck, diameters 4.0 mm [B1] and 4.5 mm [B2], shot-blasted and acid-passivated surface) and control group (Straumann Standard Plus® 4.1 mm parallel-walled implants with SLA® surface). A total of 722 implants (n = 30 per condition) were inserted into natural bone blocks simulating Lekholm and Zarb type II (cortical-dominant) and type III (medullary-dominant) bone qualities. Fifteen experimental conditions were tested, combining three main drilling protocols: (1) manufacturer’s standard preparation, (2) horizontal under drilling (final diameter 3.5 mm), (3) vertical overpreparation (1 mm deeper), and (4) combined vertical + horizontal restriction. Primary stability was assessed by insertion torque (measured with a calibrated Tohnichi® torque wrench) and Implant Stability Quotient (ISQ) using Penguin® resonance frequency analysis (RFA) in two perpendicular directions. Subjective insertion ease and complications were also recorded. Conclusions: The conical macrogeometry with progressive, dense V-shaped threads provides significantly better primary mechanical anchorage than parallel-walled designs in ultrashort (4 mm) implants. Within the limitations of this ex vivo animal bone model study, the results indicate that different drilling protocols significantly influence the primary mechanical stability with insertion torque ≥ 25 Ncm and ISQ ≥ 55 of ultra-short implants, as measured by insertion torque and ISQ values. Certain drilling protocols resulted in higher insertion torque and ISQ compared to others, particularly in Type II and Type III bone.
López‐Jarana P, Marques RP, Jaramillo R, Santos R, Barros J, Matos A, et al. Analysis of Primary Stability in Two Designs of Ultrashort Implants: In Vitro Study. Bioengineering. 2026. doi:10.3390/bioengineering13060606
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