{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:25:33Z","timestamp":1768317933622,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100011970","name":"International Team for Implantology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Implant Dent Rel Res"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to assess the final insertion torque values achieved using site\u2010specific drilling protocols for a novel mini implant system for removable complete overdentures. Anatomical and technical factors influencing final insertion torque were recorded and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Participants were randomized to two surgical protocol groups (flapped or flapless) and all received four mini implants (Straumann\u00ae mini implant system; Straumann AG) in the anterior mandible, using a 1.6\u2009mm needle drill and a 2.2\u2009mm pilot drill for the implant bed site preparation. The final insertion torque was recorded as the main outcome variable during surgery. Bone type, radiographical bone density, ridge form, implant length, and the drilling protocol were considered as independent variables. Descriptive statistics, generalized estimating equations (GEE) regression, and heatmap charts were used for data analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 296 mini implants were placed in 74 patients (mean age\u00a0=\u00a064.1\u00a0\u00b1 8.0; 64.9% female) using flapless (<jats:italic>n<\/jats:italic>\u00a0=\u200937) or flapped (<jats:italic>n<\/jats:italic>\u00a0=\u200937) surgeries. Mean final insertion torque was 55.8\u00a0\u00b1\u200918.4\u00a0Ncm (10.5%\u2009&gt;\u200935\u2009Ncm, 48.9% between 35 and 65\u2009Ncm, and 40.6%\u2009&gt;\u200965\u2009Ncm). The needle drill was used in only 43.9% of the implant bed sites. Higher final torque values were observed for higher bone densities (bone type I\u2009&gt;\u2009II\u2009&gt;\u2009III, and D1\u2013D2\u2009&gt;\u2009D3\u2013D4), highly resorbed ridge forms (5\u20136\u2009&gt;\u20093\u20134), flapped surgeries, and male patients. However, regression models showed that the likelihood of achieving optimal insertion torque (\u226535 and \u226465\u2009Ncm) was higher for females (OR\u00a0=\u00a02.14; 95%CI\u00a0=\u00a01.14\u20134.01; <jats:italic>p<\/jats:italic>\u00a0=\u20090.018), ridge forms 3\u20134 (OR\u00a0=\u00a02.87; 95%CI\u00a0=\u00a01.05\u20137.85; <jats:italic>p<\/jats:italic>\u00a0=\u20090.040), and flapless surgeries (OR\u00a0=\u00a01.96; 95%CI\u00a0=\u00a01.09\u20133.51; <jats:italic>p<\/jats:italic>\u00a0=\u20090.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sufficient primary stability for immediate loading was achieved for the majority of the mini implants placed. Surgical implant bed preparation should be site\u2010specific to achieve optimal primary stability for immediate loading while avoiding excessive insertion torque.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cid.13181","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T23:24:12Z","timestamp":1673306652000},"page":"426-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Mandibular bone characteristics, drilling protocols, and final insertion torque for titanium\u2010zirconium mini\u2010implants for overdentures: A cross\u2010sectional analysis"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6812-4849","authenticated-orcid":false,"given":"Cl\u00e1udio Rodrigues","family":"Leles","sequence":"first","affiliation":[{"name":"School of Dentistry Federal University of Goias  Goiania Goias 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