{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T20:17:18Z","timestamp":1765484238331,"version":"3.37.3"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Prog Orthod."],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A non-invasive method has recently been introduced to remove osseo-integrated palatal implants by using the implantation ratchet which is designed to screw in or unscrew the implants. Although a proof of concept has been published, the torque involved to successfully explant have not been investigated so far. The aim of this study was to assess the removal torque required to explant osseo-integrated and orthodontically utilized palatal implants, and to identify potentially influencing variables.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and method<\/jats:title>\n                <jats:p>Thirty-one consecutive patients (15 females, 16 males; mean age 24.1 \u00b17.4 years) with fully osseo-integrated and previously orthodontically loaded palatal implants (Orthosystem\u00ae: diameter 4.1mm\/length 4.2mm\/sandblasted with large grits (SLA) surface) were randomly assigned to either clockwise or counter-clockwise non-invasive explantation. The respective explantation tool with an electric torque control was placed on the abutment connection of the implant and secured by an occlusal screw.<\/jats:p>\n                <jats:p>The primary outcome studied was maximal removal torque (MRT) needed to detach the implant from its socket which was recorded individually together with other potentially influencing secondary outcomes (gender, age, orthodontic loading time, use of local anaesthetics). Student\u2019s <jats:italic>t<\/jats:italic>-test was used to contrast MRT difference for the gender, type of suprastructure, use of local anaesthetics, and rotational direction.<\/jats:p>\n                <jats:p>Spearman correlations was used to investigate associations between MRT and patient\u2019s age or duration loading time.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Average MRT (148.6 \u00b1 63.2N\/cm) using ratchet as a non-invasive removal method of palatal implant was considered safe. The triangular head fractured of palatal implant at a torque level of 300.1 Ncm. Significantly higher explantation were recorded for male patients compared to female patients (182.0 \u00b1 63.0 Ncm vs 112.8 \u00b1 40.8 Ncm; P=0.001). On the other side, the mean removal torque for palatal removal in clockwise direction was non-significantly different (158.3 \u00b1 58.6 Ncm) compared to counter-clockwise direction (139.4 \u00b1 67.9 Ncm). Neither patient\u2019s age (<jats:italic>p<\/jats:italic>=0.324) nor loading time (<jats:italic>p<\/jats:italic>=0.214) were significantly correlated with removal torque values.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Pertinent literature on this subject is practically non-existent, as orthodontics is presumably the only discipline where implant removal represents a treatment success. Mean MRT for successful palatal implant removal was 148.6\u00b163.2Ncm, but a large spectrum was observed (minimum 31.5Ncm, maximum 272.8Ncm). This obvious heterogeneity underlines the importance to investigate possible influencing factors. The safe and simple non-invasive method for palatal implant removal necessitates moderate, but not high torque MRTs, independently of the torque direction. The necessary MRT seems clearly influenced by gender, but less so by patient\u2019s age or loading time.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40510-021-00359-3","type":"journal-article","created":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T23:04:06Z","timestamp":1623020646000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Factors influencing the removal torque of palatal implant used for orthodontic anchorage"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2019-5223","authenticated-orcid":false,"given":"Marc Andreas","family":"Sch\u00e4tzle","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Hersberger-Zurfluh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Patcas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,7]]},"reference":[{"issue":"1","key":"359_CR1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1563\/aaid-joi-D-14-00193","volume":"42","author":"E Anitua","year":"2016","unstructured":"Anitua E, Murias-Freijo A, Pinas L, Tejero R, Prado R, Orive G. 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