Insertion Torque Value and Implant Stability Quotient of Bone-Level Versus Tissue-Level Dental Implants: A Pilot Randomized Clinical Trial
Abstract Objective This randomized clinical trial aimed to assess the relation of insertion torque value (ITV) and implant stability quotient (ISQ) between bone-level (BL) and tissue-level (TL) dental implants (ISQ recorded immediately and 3 months after implant placement). Materials and Methods A total of 90 dental implants (44 BL, 46 TL; BioHorizons Camlog, Iberica) were placed in 21 patients. ITV was recorded at placement. ISQ (Penguin device, Klockner) was measured horizontally (ISQ-H) and vertically (ISQ-V) at baseline and at the 90-day follow-up. Statistical analysis The Mann–Whitney U test and Spearman's correlation tests (α = 0.05) were used for the analyses. Results No significant difference in ITV was found between the BL (36.0 ± 11.5 Ncm) and TL (38.0 ± 11.5 Ncm) groups ( p = 0.381). Similarly, no significant differences were observed in baseline ISQ-H ( p = 0.928) or ISQ-V ( p = 0.874). At 90 days, ISQ-H values were marginally higher in the TL group (66.5 ± 20.9) compared to the BL group (57.1 ± 18.9; p = 0.029). A significant positive correlation was found between ITV and baseline ISQ ( r = 0.493, p < 0.001), but not with 90-day ISQ values. Conclusions Implant design (BL vs. TL) did not significantly influence ITV or ISQ. The finding of greater horizontal stability for TL implants at 90 days, while marginal, suggests a potential long-term biomechanical difference warranting further study. The dissociation between insertion torque and 90-day stability indicates that secondary stability is governed by factors beyond initial mechanical engagement.