The Influence of Clinician Experience on the Primary Stability of Tri-Oval Versus Standard Parallel-Walled Implants Placed Using Different Surgical Protocols: An Ex Vivo Study.

Abstract

Purpose: To investigate the effect that clinical experience has on implant primary stability using insertion torque (IT) and resonance frequency analyses (RFA) from two different drilling protocols: (1) implant-specific osteotomy protocol and (2) conventional drilling.

Materials and methods: A total of 60 tri-oval and 60 parallel-walled implants were placed in fresh bovine ribs by three clinicians (B.K., M.Ç., and M.A.D), who were classified according to the total number of implants they had previously placed. Tri-oval implants were placed with an implant-specific osteotomy protocol, and parallel implants were placed with conventional drilling. The ITs of the implants were measured by the same clinician who performed the operation. An independent examiner (O.G.) measured the RFA of all implants after placement via a resonance frequency analyzer.

Results: In the IT evaluation, no statistical significance was observed between the clinicians and both tri-oval implants and parallel implants (P = .293 and P = .98, respectively); in all experience levels, the ITs were significantly lower in parallel implants. Additionally, across all experience levels, tri-oval implants demonstrated greater RFA values than parallel implants (P = .001). Within-group comparisons of RFA by experience level for the tri-oval implants did not show a statistically significant difference (P = .950). However, in parallel implants, there was a significant difference between the moderately experienced and inexperienced groups (P = .019).

Conclusions: The implant-specific osteotomy procedure with tri-oval implants offers greater primary stability compared to conventional osteotomy with parallel-walled implants, regardless of the clinician's experience.