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Primary stability is a huge factor in implant success, but what exactly is it and how do you get it?

Primary stability is the implant’s mechanical stability as soon as it is placed in the patient’s alveolar ridge. It is the first phase of the implant integrating into the bone, where the implant mechanically adapts to the host’s tissue. ARIA Implant Courses stress its role in improving implant success, and provide you with tips and tricks to achieve it.

Why is it Important?

Primary stability is important because it improves the chances of achieving secondary stability (the implant’s actual osseointegration into bone). This is through preventing a connective tissue layer forming between the implant and the bone, thus allowing bone deposition. Furthermore, it was traditionally believed that implants should not be loaded until they had fully healed. Primary stability, however, allows for a high survival rate of immediate loading on the dental implants.

How to Achieve Primary Stability

So how can we improve our chances of achieving primary stability? The aim is to have a well-seated dental implant that is adapted mechanically. Its stiffness and location in the bone determines this. Stiffness refers to stiffness of the implant components themselves, the implant-bone interface and the bone itself. Below are some considerations to achieving this.

Bone Quality and Quantity

Resorption is reduced and healing is improved in the presence of good bone quality. The posterior mandible is one of the best sites for implant placement due to its thin cortical and thick trabecular bone. CT radiographs are a recommended radiographic method to decipher the bone’s contours and density. Our Master Implant Courses in Melbourne and Adelaide show you how to interpret CT radiographs, and its relevance in implant dentistry.

Implant Geometry

The implant’s shape can also improve its integration into bone. Tapered implants can enhance aesthetics and placement between teeth. It may allow for some compression of cortical bone at the implant site, which can further improve bone density and quality. On the other hand, wide cylindrical implants increase the risk of labial bone perforation, especially in areas where the alveolar ridges are thin, such as buccal concavities. Implant surface roughness can also increase its integration into the bone by stimulating osteoblastic activity. Specialist prosthodontists and periodontists at ARIA can provide you with insight on implant specifications that are ideal for individual cases.

Surgical Technique

Different methods of implant installation can aid its mechanical locking. This can include using a final drill diameter that is a size smaller than the implant, or condensing the surrounding bone after the pilot hole drill to improve bone quality. The amount of torque placed on the implant and its components is also important for mechanical locking. These are discussed in further detail at our implant courses.

Host and implant features can play a role in primary stability. As much as possible, these should be utilised to gain the ideal initial mechanical locking.

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