Primary and Secondary Stability of Subcrestal Morse-Taper Implants Placed Immediately into Extraction Sockets or into Grafted or Healed Ridges: A Retrospective Cohort Study
- 1Bublik Dental Implant & Surgical Center, Wausau, WI 54401, USA
- 2Department of Oral and Maxillofacial Surgery, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc, 779 00 Olomouc, Czech Republic
Abstract
Background/Objectives: Immediate implant placement into fresh extraction sockets is often assumed to provide lower primary stability than placement into healed ridges, but comparative data for subcrestal Morse-taper (conical-connection) implants are lacking. This study compared insertion torque value (ITV) and implant stability quotient (ISQ) between two management protocols: immediate placement and delayed placement. Methods: This retrospective single-surgeon cohort included consecutive Argon K3 Pro implants placed in 2019–2022, grouped as immediate (IM), delayed into sites grafted within the preceding 12 months (DG) or delayed into healed ridges (HR). The protocols differed in more than timing (placement depth, grafting, flap design and healing management). ITV, ISQ at placement and ISQ at 3 months were compared with mixed-effects models accounting for multiple implants per patient. ISQ differences were tested against a post hoc ±5-unit equivalence margin; no equivalence test was applied to ITV. Results: Of 178 implants screened, 130 implants in 85 patients (52 women, 33 men) were analyzed: 56 IM, 30 DG and 44 HR. No difference was detected in ITV (delayed minus IM −1.4 Ncm, 95% CI −5.0 to 2.1), placement ISQ (IM 72.3 ± 7.8 vs. delayed 72.5 ± 9.0) or 3-month ISQ (78.8 ± 4.8 vs. 79.4 ± 5.6); in the primary analysis, the 90% confidence intervals of both ISQ differences lay within ±5 units, but the placement ISQ interval did not lie within ±3 units, and equivalence at placement was borderline in a size-adjusted sensitivity analysis. ISQ change was strongly related to starting ISQ (Spearman’s ρ = −0.77), largely through arithmetic coupling and regression to the mean, and baseline-adjusted 3-month ISQ did not differ between protocols (p = 0.46). All 19 immediate implants starting below ISQ 70 reached ISQ ≥ 70 by 3 months under the protocol used. In an exploratory analysis, ITV correlated with placement ISQ in healed ridges (ρ = 0.55) and more weakly in extraction sockets (ρ = 0.25); the difference between these correlations was inconsistent across methods. Conclusions: In this cohort, immediate and delayed protocols showed no detectable difference in insertion torque or ISQ, and ISQ differences were statistically within a post hoc ±5-unit margin. Whether torque is a weaker indicator of stability in extraction sockets is a hypothesis for prospective study.
Related
- Five-Year Marginal Bone-Level Changes Around Immediately Loaded or Immediately Restored Implants After Maxillary Sinus Floor Elevation: A Retrospective Cohort Analysis of Three Implant-Site Preparation Techniques
- Histologic Patterns of Connective Tissue Organization in the Subcrestal Peri-Implant Compartment: A Three-Case Report
- Association of Mandibular Morphological and Trabecular Bone Characteristics with Long-Term Outcomes Following First Permanent Molar Extraction: A Retrospective Study
- Secondary mental healthcare utilisation and costs before and after diagnosis of mild cognitive impairment or dementia: a retrospective observational cohort study from a South London mental health service.
- Association Between Pre-pregnancy Obesity and Adverse Obstetric Outcomes: A Retrospective Cohort Study at a Secondary Care Center in Tbilisi, Georgia
BibTeX
@article{bublik2026primary,
title = {{Primary and Secondary Stability of Subcrestal Morse-Taper Implants Placed Immediately into Extraction Sockets or into Grafted or Healed Ridges: A Retrospective Cohort Study}},
author = {Jan Bublik and Alica Klieštiková and Kristína Frimelová and Petr Michl},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208184},
url = {https://www.mdpi.com/2077-0383/15/20/8184},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Primary and Secondary Stability of Subcrestal Morse-Taper Implants Placed Immediately into Extraction Sockets or into Grafted or Healed Ridges: A Retrospective Cohort Study
AU - Jan Bublik
AU - Alica Klieštiková
AU - Kristína Frimelová
AU - Petr Michl
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208184
UR - https://www.mdpi.com/2077-0383/15/20/8184
AB - Background/Objectives: Immediate implant placement into fresh extraction sockets is often assumed to provide lower primary stability than placement into healed ridges, but comparative data for subcrestal Morse-taper (conical-connection) implants are lacking. This study compared insertion torque value (ITV) and implant stability quotient (ISQ) between two management protocols: immediate placement and delayed placement. Methods: This retrospective single-surgeon cohort included consecutive Argon K3 Pro implants placed in 2019–2022, grouped as immediate (IM), delayed into sites grafted within the preceding 12 months (DG) or delayed into healed ridges (HR). The protocols differed in more than timing (placement depth, grafting, flap design and healing management). ITV, ISQ at placement and ISQ at 3 months were compared with mixed-effects models accounting for multiple implants per patient. ISQ differences were tested against a post hoc ±5-unit equivalence margin; no equivalence test was applied to ITV. Results: Of 178 implants screened, 130 implants in 85 patients (52 women, 33 men) were analyzed: 56 IM, 30 DG and 44 HR. No difference was detected in ITV (delayed minus IM −1.4 Ncm, 95% CI −5.0 to 2.1), placement ISQ (IM 72.3 ± 7.8 vs. delayed 72.5 ± 9.0) or 3-month ISQ (78.8 ± 4.8 vs. 79.4 ± 5.6); in the primary analysis, the 90% confidence intervals of both ISQ differences lay within ±5 units, but the placement ISQ interval did not lie within ±3 units, and equivalence at placement was borderline in a size-adjusted sensitivity analysis. ISQ change was strongly related to starting ISQ (Spearman’s ρ = −0.77), largely through arithmetic coupling and regression to the mean, and baseline-adjusted 3-month ISQ did not differ between protocols (p = 0.46). All 19 immediate implants starting below ISQ 70 reached ISQ ≥ 70 by 3 months under the protocol used. In an exploratory analysis, ITV correlated with placement ISQ in healed ridges (ρ = 0.55) and more weakly in extraction sockets (ρ = 0.25); the difference between these correlations was inconsistent across methods. Conclusions: In this cohort, immediate and delayed protocols showed no detectable difference in insertion torque or ISQ, and ISQ differences were statistically within a post hoc ±5-unit margin. Whether torque is a weaker indicator of stability in extraction sockets is a hypothesis for prospective study.
SN - 2077-0383
ER -