• Jordi Ortega-Martínez associate professor



“bone density”, “immediate loading”, “implants”, “insertion torque”, “torque”


Title: Correlation between local bone density and insertion torque as predictor of immediate implant loading. A bibliographic review.

 Background: Implants have become an alternative to rehabilitate lost teeth. One of the prerequisites for immediate loading is to determine primary stability by analyzing bone density and insertion torque.

Aims: A bibliographic review is conducted to correlate local bone density and insertion torque as predictors of the immediate loading of an implant.

Materials and methods: Review using PubMed databases of systematic reviews, meta-analyses, randomized clinical studies, non-randomized clinical studies, in vitro studies, cohort studies, cross-sectional studies, and clinical trials, either in English or in Spanish. The focus was on the correlation between local bone density and insertion torque.

Results: Local bone density is a useful guide for determining insertion torque and predicting initial implant stability.

Discussion: The insertion torque and bone density values determine whether immediate loading of the implant is possible or not, and therefore predict this possibility.

Conclusions: A correlation between local bone density and insertion torque was established, and this correlation predicts immediate loading of an implant. Therefore, to reach a consensus, further studies should consider all the factors influencing this concept.


1. Greenstein G, Cavallaro J. Implant Insertion Torque: Its Role in Achieving Primary Stability of Restorable Dental Implants. Compend Contin Educ Dent. 2017;38(2):88–95;
2. Becker W, Sennerby L, Bedrossian E, Becker BE, Lucchini JP. Implant Stability Measurements for Implants Placed at the Time of Extraction: A Cohort, Prospective Clinical Trial. J Periodontol. 2005 Mar;76(3):391–7.
3. Gapski R, Wang HL, Mascarenhas P, Lang NP. Critical review of immediate implant loading. Vol. 14, Clinical Oral Implants Research. Clin Oral Implants Res; 2003. p. 515–27.
4. Morton D, Jaffin R, Weber HP. Immediate restoration and loading of dental implants: clinical considerations and protocols. Int J Oral Maxillofac Implants. 2004;19 Suppl:103-8.
5. Makary C, Rebaudi A, Mokbel N, Naaman N. Peak Insertion Torque Correlated to Histologically and Clinically Evaluated Bone Density. Implant Dent. 2011;20(3):182–91.
6. Bayarchimeg D, Namgoong H, Kim BK, Kim MD, Kim S, Kim T Il, et al. Evaluation of the correlation between insertion torque and primary stability of dental implants using a block bone test. J Periodontal Implant Sci. 2013;43(1):30–6.
7. Wada M, Suganami T, Sogo M, Maeda Y. Can we predict the insertion torque using the bone density around the implant? Int J Oral Maxillofac Surg. 2016;45(2):221–5.
8. Bavetta G, Bavetta G, Randazzo V, Cavataio A, Paderni C, Grassia V, Dipalma G, Gargiulo Isacco C, Scarano A, De Vito D, Cantore S, Ballini A, Inchingolo F. A Retrospective Study on Insertion Torque and Implant Stability Quotient (ISQ) as Stability Parameters for Immediate Loading of Implants in Fresh Extraction Sockets. Biomed Res Int. 2019;2019:9720419.
9. Glauser R, Ree A, Lundgren AK, Gottlow J, Hammerle CHR, Scharer P. Immediate occlusal loading of Brånemark implants applied in various jawbone regions: A prospective, 1-year clinical study. Clin Implant Dent Relat Res. 2001;3(4):204–13.
10. Lachmann S, Jäger B, Axmann D, Gomez-Roman G, Groten M, Weber H. Resonance frequency analysis and damping capacity assessment - Part 1: An in vitro study on measurement reliability and a method of comparison in the determination of primary dental implant stability. Clin Oral Implants Res. 2006;17(1):75–9.
11. Meyer U, Vollmer D, Runte C, Bourauel C, Joos U. Bone loading pattern around implants in average and atrophic edentulous maxillae: a finite-element analysis. J Maxillofac Surg. 2001;29(2):100–5.
12. Zaied, Amira Ali Ahmed. "Validity of computer guided bone density measurement as a predictor for immediate loading of maxillary dental implant." CU Theses (2012).
13. Friberg B, Sennerby L, Meredith N, Lekholm U. A comparison between cutting torque and resonance frequency measurements of maxillary implants. A 20-month clinical study. Int J Oral Maxillofac Surg. 1999;28(4):297–303.
14. Martinez H, Davarpanah M, Missika P, Celletti R, Lazzara R. Optimal implant stabilization in low density bone. Clin Oral Implants Res. 2001;12(5):423–32.
15. Baqain ZH, Moqbel WY, Sawair FA. Early dental implant failure: Risk factors. Br J Oral Maxillofac Surg. 2012;50(3):239–43.
16. Manzano G, Montero J, Martín-Vallejo J, Fabbro M Del, Bravo M, Testori T. Risk factors in early implant failure: A meta-analysis. Implant Dent. 2016;25(2):272–80.
17. He J, Zhao B, Deng C, Shang D, Zhang C. Assessment of Implant Cumulative Survival Rates in Sites with Different Bone Density and Related Prognostic Factors: An 8-Year Retrospective Study of 2,684 Implants. Int J Oral Maxillofac Implants. 2015;30(2):360–71.
18. Turkyilmaz I, Tumer C, Ozbek EN, Tözüm TF. Relations between the bone density values from computerized tomography, and implant stability parameters: a clinical study of 230 regular platform implants. J Clin Periodontol. 2007;34(8):716–22.
19. Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil. 2014;41(6):443-76.
20. Rebaudi A, Trisi P, Cella R, Cecchini G. Preoperative evaluation of bone quality and bone density using a novel CT/microCT-based hard-normal-soft classification system. Int J Oral Maxillofac Implants. 2010;25(1):75-85.
21. Trisi P, Rao W. Bone classification: clinical-histomorphometric comparison. Clin Oral Implants Res. 1999;10(1):1-7.
22. Bice WS Jr, Walker ES, Gearty S, Walker AV, Marbach JR, Prestidge BR. A comparative evaluation of loading times and exposures for permanent prostate brachytherapy. J Appl Clin Med Phys. 2002;3(4):263-72.
23. Beer A, Gahleitner A, Holm A, Tschabitscher M, Homolka P. Correlation of insertion torques with bone mineral density from dental quantitative CT in the mandible. Clin Oral Implants Res. 2003;14(5):616–20.
24. Neugebauer J, Traini T, Thams U, Piattelli A, Zöller JE. Peri-Implant Bone Organization Under Immediate Loading State. Circularly Polarized Light Analyses: A Minipig Study. J Periodontol. 2006;77(2):152–60.
25. Duyck J, Corpas L, Vermeiren S, Ogawa T, Quirynen M, Vandamme K, et al. Histological, histomorphometrical, and radiological evaluation of an experimental implant design with a high insertion torque. Clin Oral Implants Res. 2010;21(8):877–84.
26. Ottoni JM, Oliveira ZF, Mansini R, Cabral AM. Correlation between placement torque and survival of single-tooth implants. Int J Oral Maxillofac Implants. 2005;20(5):769-76.
27. Marconcini S, Giammarinaro E, Toti P, Alfonsi F, Covani U, Barone A. Longitudinal analysis on the effect of insertion torque on delayed single implants: A 3-year randomized clinical study. Clin Implant Dent Relat Res. 2018;20(3):322-332
28. Traini T, Neugebauer J, Thams U, Zöller JE, Caputi S, Piattelli A. Peri-Implant Bone Organization under Immediate Loading Conditions: Collagen Fiber Orientation and Mineral Density Analyses in the Minipig Model. Clin Implant Dent Relat Res. 2009;11(1):41–51.
29. Kacer CM, Dyer JD, Kraut RA. Immediate loading of dental implants in the anterior and posterior mandible: a retrospective study of 120 cases. J Oral Maxillofac Surg. 2010;68(11):2861-7.




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