Primary implant stability in augmented sinuslift-sites after completed bone regeneration: a randomized controlled clinical study comparing four subantrally inserted biomaterials
Identifieur interne : 001283 ( Pmc/Checkpoint ); précédent : 001282; suivant : 001284Primary implant stability in augmented sinuslift-sites after completed bone regeneration: a randomized controlled clinical study comparing four subantrally inserted biomaterials
Auteurs : Angelo Troedhan [Autriche] ; Izabela Schlichting [Autriche] ; Andreas Kurrek ; Marcel WainwrightSource :
- Scientific Reports [ 2045-2322 ] ; 2014.
Abstract
Implant-Insertion-Torque-Value (ITV) proved to be a significant clinical parameter to predict long term implant success-rates and to decide upon immediate loading. The study evaluated ITVs, when four different and commonly used biomaterials were used in sinuslift-procedures compared to natural subantral bone in two-stage-implant-procedures. The tHUCSL-INTRALIFT-method was chosen for sinuslifting in 155 sinuslift-sites for its minimal invasive transcrestal approach and scalable augmentation volume. Four different biomaterials were inserted randomly (easy-graft CRYSTAL n = 38, easy-graft CLASSIC n = 41, NanoBone n = 42, BioOss n = 34), 2 ccm in each case. After a mean healing period of 8,92 months uniform tapered screw Q2-implants were inserted and Drill-Torque-Values (DTV) and ITV were recorded and compared to a group of 36 subantral sites without need of sinuslifting. DTV/ITV were processed for statistics by ANOVA-tests. Mean DTV/ITV obtained in Ncm were: Control Group 10,2/22,2, Bio-Oss 12,7/26,2, NanoBone 17,5/33,3, easy-graft CLASSIC 20,3/45,9, easy-graft CRYSTAL 23,8/56,6 Ncm, significance-level of differences throughout p < 0,05. Within the limits of this study the results suggest self-hardening solid-block-like bone-graft-materials to achieve significantly better DTV/ITV than loose granulate biomaterials for its suspected improvement of vascularization and mineralization of the subantral scaffold by full immobilization of the augmentation site towards pressure changes in the human sinus at normal breathing.
Url:
DOI: 10.1038/srep05877
PubMed: 25073446
PubMed Central: 5376201
Affiliations:
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PMC:5376201Le document en format XML
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<front><div type="abstract" xml:lang="en"><p>Implant-Insertion-Torque-Value (ITV) proved to be a significant clinical parameter to predict long term implant success-rates and to decide upon immediate loading. The study evaluated ITVs, when four different and commonly used biomaterials were used in sinuslift-procedures compared to natural subantral bone in two-stage-implant-procedures. The tHUCSL-INTRALIFT-method was chosen for sinuslifting in 155 sinuslift-sites for its minimal invasive transcrestal approach and scalable augmentation volume. Four different biomaterials were inserted randomly (easy-graft CRYSTAL n = 38, easy-graft CLASSIC n = 41, NanoBone n = 42, BioOss n = 34), 2 ccm in each case. After a mean healing period of 8,92 months uniform tapered screw Q2-implants were inserted and Drill-Torque-Values (DTV) and ITV were recorded and compared to a group of 36 subantral sites without need of sinuslifting. DTV/ITV were processed for statistics by ANOVA-tests. Mean DTV/ITV obtained in Ncm were: Control Group 10,2/22,2, Bio-Oss 12,7/26,2, NanoBone 17,5/33,3, easy-graft CLASSIC 20,3/45,9, easy-graft CRYSTAL 23,8/56,6 Ncm, significance-level of differences throughout p < 0,05. Within the limits of this study the results suggest self-hardening solid-block-like bone-graft-materials to achieve significantly better DTV/ITV than loose granulate biomaterials for its suspected improvement of vascularization and mineralization of the subantral scaffold by full immobilization of the augmentation site towards pressure changes in the human sinus at normal breathing.</p>
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</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25073446</article-id>
<article-id pub-id-type="pmc">5376201</article-id>
<article-id pub-id-type="pii">srep05877</article-id>
<article-id pub-id-type="doi">10.1038/srep05877</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Primary implant stability in augmented sinuslift-sites after completed bone regeneration: a randomized controlled clinical study comparing four subantrally inserted biomaterials</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Troedhan</surname>
<given-names>Angelo</given-names>
</name>
<xref ref-type="corresp" rid="c1">a</xref>
<xref ref-type="aff" rid="a1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schlichting</surname>
<given-names>Izabela</given-names>
</name>
<xref ref-type="aff" rid="a2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kurrek</surname>
<given-names>Andreas</given-names>
</name>
<xref ref-type="aff" rid="a3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wainwright</surname>
<given-names>Marcel</given-names>
</name>
<xref ref-type="aff" rid="a4">4</xref>
</contrib>
<aff id="a1"><label>1</label>
<institution>Head of Maxillofacial Surgery Dep., Center for Facial Esthetics Vienna</institution>
, Brauhausgasse 12, 1050 Vienna, Austria</aff>
<aff id="a2"><label>2</label>
<institution>Head of Oral Surgery & Implantology Dep., Center for Facial Esthetics Vienna</institution>
, Brauhausgasse 12, 1050 Vienna, Austria</aff>
<aff id="a3"><label>3</label>
<institution>Head of Oral Surgery & Implantology Dep.</institution>
, Implantology Clinic Oberkassel, Dominikanerstrasse 10, 40545 Dusseldorf</aff>
<aff id="a4"><label>4</label>
<institution>Head of Oral Surgery & Implantology Dep.</institution>
, Implantology Clinic Kaiserswerth, Kaiserswerther Markt 25, 40489 Dusseldorf</aff>
</contrib-group>
<author-notes><corresp id="c1"><label>a</label>
<email>troed@aon.at</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>30</day>
<month>07</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="collection"><year>2014</year>
</pub-date>
<volume>4</volume>
<elocation-id>5877</elocation-id>
<history><date date-type="received"><day>20</day>
<month>05</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>01</day>
<month>07</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2014, Macmillan Publishers Limited. All rights reserved</copyright-statement>
<copyright-year>2014</copyright-year>
<copyright-holder>Macmillan Publishers Limited. All rights reserved</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd/4.0/"><pmc-comment>author-paid</pmc-comment>
<license-p>This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder in order to reproduce the material. To view a copy of this license, visit <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-nd/4.0/">http://creativecommons.org/licenses/by-nc-nd/4.0/</ext-link>
</license-p>
</license>
</permissions>
<abstract><p>Implant-Insertion-Torque-Value (ITV) proved to be a significant clinical parameter to predict long term implant success-rates and to decide upon immediate loading. The study evaluated ITVs, when four different and commonly used biomaterials were used in sinuslift-procedures compared to natural subantral bone in two-stage-implant-procedures. The tHUCSL-INTRALIFT-method was chosen for sinuslifting in 155 sinuslift-sites for its minimal invasive transcrestal approach and scalable augmentation volume. Four different biomaterials were inserted randomly (easy-graft CRYSTAL n = 38, easy-graft CLASSIC n = 41, NanoBone n = 42, BioOss n = 34), 2 ccm in each case. After a mean healing period of 8,92 months uniform tapered screw Q2-implants were inserted and Drill-Torque-Values (DTV) and ITV were recorded and compared to a group of 36 subantral sites without need of sinuslifting. DTV/ITV were processed for statistics by ANOVA-tests. Mean DTV/ITV obtained in Ncm were: Control Group 10,2/22,2, Bio-Oss 12,7/26,2, NanoBone 17,5/33,3, easy-graft CLASSIC 20,3/45,9, easy-graft CRYSTAL 23,8/56,6 Ncm, significance-level of differences throughout p < 0,05. Within the limits of this study the results suggest self-hardening solid-block-like bone-graft-materials to achieve significantly better DTV/ITV than loose granulate biomaterials for its suspected improvement of vascularization and mineralization of the subantral scaffold by full immobilization of the augmentation site towards pressure changes in the human sinus at normal breathing.</p>
</abstract>
</article-meta>
</front>
<floats-group><fig id="f1"><label>Figure 1</label>
<caption><p>tHUCSL-INTRALIFT surgical protocol for Piezotome II/SOLO/Implant Center II: minimal invasive crestal flap (A), opening of the bony antral floor with the diamond coated ultrasonic tip “TKW 2” (B), preparation of the receptacle with the diamond coated ultrasonic tip “TKW 4” (C), tight-fit insertion of the ultrasonic detachment tip “TKW 5” and hydrodynamic ultrasonic detachment of the sinus-membrane utilizing the ultrasonic cavitation effect (D), subantral application of 2 ccm biomaterial and marking the osteotomy-site with medical ink (E), Drill-Torque-measurement after mean healing period of 8,92 months at original osteotomy-site marked with medical ink (F), Implant-Insertion-Torque-measurement (G).</p>
</caption>
<graphic xlink:href="srep05877-f1"></graphic>
</fig>
<fig id="f2"><label>Figure 2</label>
<caption><title>Clinical depiction of a typical transcrestal osteotomy.</title>
<p>Site is marked with a medical marker after subantral augmentation with biomaterial for precise location of later ITV/DTV-measurements (A) and after wound-closure (B).</p>
</caption>
<graphic xlink:href="srep05877-f2"></graphic>
</fig>
<fig id="f3"><label>Figure 3</label>
<caption><title>Typical clinical case.</title>
<p>a) presurgical x-ray, b) post-surgical x-ray after tHUCSL-INTRALIFT, the transcrestal osteotomy site is marked with a white arrow, c) intrasurgical x-ray with implant in site after ITV/DTV determination, d) post-surgical x-ray after implant insertion.</p>
</caption>
<graphic xlink:href="srep05877-f3"></graphic>
</fig>
<fig id="f4"><label>Figure 4</label>
<caption><title>Various cases of the control group with implants inserted in natural subantral bone.</title>
<p>Implants used for determination of DTV/ITV are marked with bluish rectangles.</p>
</caption>
<graphic xlink:href="srep05877-f4"></graphic>
</fig>
<fig id="f5"><label>Figure 5</label>
<caption><title>Drill-Torque notched box plot: depicts the interquartile range (IQR) between the 25th and 75th percentile of the specific biomaterial tested where 50% of the data points were located.</title>
<p>Additionally, the upper whiskers represent data within the 75th percentile +1.5 times the IQR. The lower whisker delimits data of the 25th percentile – 1.5 times the IQR. Circles [<inline-formula id="m1"><inline-graphic id="d32e476" xlink:href="srep05877-m1.jpg"></inline-graphic>
</inline-formula>
] represent the outliers. Within the boxes the notches mark the confidence interval based on the median +/− 1.58 (IQR/sqrt of n) [n = number of measurements]. Additionally, the mean value is indicated by a black square [<inline-formula id="m2"><inline-graphic id="d32e479" xlink:href="srep05877-m2.jpg"></inline-graphic>
</inline-formula>
] and the cross symbol [+] displays the standard deviation. Bio-Oss (n = 34), NanoBone (n = 42), easy-graft CLASSIC (n = 41), easy-graft CRYSTAL (n = 38), Control Group (n = 36).</p>
</caption>
<graphic xlink:href="srep05877-f5"></graphic>
</fig>
<fig id="f6"><label>Figure 6</label>
<caption><title>Implant-Insertion-Torque notched box plot: depicts the interquartile range (IQR) between the 25th and 75th percentile of the specific biomaterial tested where 50% of the data points were located.</title>
<p>Additionally, the upper whiskers represent data within the 75th percentile +1.5 times the IQR. The lower whisker delimits data of the 25th percentile – 1.5 times the IQR. Circles [<inline-formula id="m3"><inline-graphic id="d32e488" xlink:href="srep05877-m3.jpg"></inline-graphic>
</inline-formula>
] represent the outliers. Within the boxes the notches mark the confidence interval based on the median +/− 1.58 (IQR/sqrt of n) [n = number of measurements]. Additionally, the mean value is indicated by a black square [<inline-formula id="m4"><inline-graphic id="d32e491" xlink:href="srep05877-m4.jpg"></inline-graphic>
</inline-formula>
] and the cross symbol [+] displays the standard deviation. Bio-Oss (n = 34), NanoBone (n = 42), easy-graft CLASSIC (n = 41), easy-graft CRYSTAL (n = 38), Control Group (n = 36).</p>
</caption>
<graphic xlink:href="srep05877-f6"></graphic>
</fig>
<table-wrap position="float" id="t1"><label>Table 1</label>
<caption><title>Drill-Torque-Value (DTV) Comparison ANOVA-Test: Statistical analysis of Drill-Torque-Values (DTV) by one-way ANOVA at 95% level of significance for the parameters evaluated</title>
</caption>
<table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
</colgroup>
<thead valign="bottom"><tr><th align="justify" valign="top" charoff="50">DRILL Torque Values (DTV)</th>
<th align="center" valign="top" charoff="50">Sum of Squares</th>
<th align="center" valign="top" charoff="50">df</th>
<th align="center" valign="top" charoff="50">Mean Square</th>
<th align="center" valign="top" charoff="50">F</th>
<th align="center" valign="top" charoff="50">Sig.</th>
</tr>
</thead>
<tbody valign="top"><tr><td align="center" valign="top" charoff="50">Between Groups</td>
<td align="char" valign="top" char="." charoff="50">4423,895</td>
<td align="char" valign="top" char="." charoff="50">4</td>
<td align="char" valign="top" char="." charoff="50">1105,974</td>
<td align="char" valign="top" char="." charoff="50">124,913</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">Within Groups</td>
<td align="char" valign="top" char="." charoff="50">1637,979</td>
<td align="char" valign="top" char="." charoff="50">185</td>
<td align="char" valign="top" char="." charoff="50">8,854</td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr><td align="center" valign="top" charoff="50">Total</td>
<td align="char" valign="top" char="." charoff="50">6061,874</td>
<td align="char" valign="top" char="." charoff="50">189</td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap position="float" id="t2"><label>Table 2</label>
<caption><title>DTV-Post Hoc Test (Multiple comparisons with dependent variable: DRILL Torque Values (DTV) calculating Least Signficance Difference (LSD)): Post-hoc multiple comparisons by Fisher’s Least Significant Difference test to discern whether the differences between the means of the different biomaterials were statistically significant. Values with p <0.05 were considered statistically significant</title>
</caption>
<table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
</colgroup>
<thead valign="bottom"><tr><th align="justify" valign="top" charoff="50">Biomaterial compared to</th>
<th align="center" valign="top" charoff="50">Biomaterial</th>
<th align="center" valign="top" charoff="50">Mean Difference</th>
<th align="center" valign="top" charoff="50">Std. Error</th>
<th align="center" valign="top" charoff="50">Sig.</th>
</tr>
</thead>
<tbody valign="top"><tr><td align="center" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="left" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="char" valign="top" char="." charoff="50">3,470<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,670</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">NanoBone</td>
<td align="char" valign="top" char="." charoff="50">6,311<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,666</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">Bio-Oss</td>
<td align="char" valign="top" char="." charoff="50">11,028<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,702</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="char" valign="top" char="." charoff="50">13,563<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,697</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="left" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="char" valign="top" char="." charoff="50">−3,470<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,670</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">NanoBone</td>
<td align="char" valign="top" char="." charoff="50">2,840<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,653</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">Bio-Oss</td>
<td align="char" valign="top" char="." charoff="50">7,557<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,690</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="char" valign="top" char="." charoff="50">10,093<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,685</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">NanoBone</td>
<td align="left" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="char" valign="top" char="." charoff="50">−6,311<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,666</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="char" valign="top" char="." charoff="50">−2,840<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,653</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">Bio-Oss</td>
<td align="char" valign="top" char="." charoff="50">4,717<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,686</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="char" valign="top" char="." charoff="50">7,252<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,681</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">Bio-Oss</td>
<td align="left" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="char" valign="top" char="." charoff="50">−11,028<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,702</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="char" valign="top" char="." charoff="50">−7,557<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,690</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">NanoBone</td>
<td align="char" valign="top" char="." charoff="50">−4,717<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,686</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="char" valign="top" char="." charoff="50">2,535<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,717</td>
<td align="char" valign="top" char="." charoff="50">,001</td>
</tr>
<tr><td align="center" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="left" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="char" valign="top" char="." charoff="50">−13,563<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,697</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="char" valign="top" char="." charoff="50">−10,093<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,685</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">NanoBone</td>
<td align="char" valign="top" char="." charoff="50">−7,252<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,681</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">Bio-Oss</td>
<td align="char" valign="top" char="." charoff="50">−2,535<xref ref-type="fn" rid="t2-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">,717</td>
<td align="char" valign="top" char="." charoff="50">,001</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="t2-fn1"><p>*. The mean difference is significant at the 0.05 level</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap position="float" id="t3"><label>Table 3</label>
<caption><title>Insertion-Torque-Value (ITV) Comparison ANOVA-Test: Statistical analysis of Insertion-Torque-Values (ITV) by one-way ANOVA at 95% level of significance for the parameters evaluated</title>
</caption>
<table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
</colgroup>
<thead valign="bottom"><tr><th align="justify" valign="top" charoff="50">INSERTION Torque Values (ITV)</th>
<th align="center" valign="top" charoff="50">Sum of Squares</th>
<th align="center" valign="top" charoff="50">df</th>
<th align="center" valign="top" charoff="50">Mean Square</th>
<th align="center" valign="top" charoff="50">F</th>
<th align="center" valign="top" charoff="50">Sig.</th>
</tr>
</thead>
<tbody valign="top"><tr><td align="center" valign="top" charoff="50">Between Groups</td>
<td align="char" valign="top" char="." charoff="50">30047,979</td>
<td align="char" valign="top" char="." charoff="50">4</td>
<td align="char" valign="top" char="." charoff="50">7511,995</td>
<td align="char" valign="top" char="." charoff="50">345,661</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">Within Groups</td>
<td align="char" valign="top" char="." charoff="50">4020,463</td>
<td align="char" valign="top" char="." charoff="50">185</td>
<td align="char" valign="top" char="." charoff="50">21,732</td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
<tr><td align="center" valign="top" charoff="50">Total</td>
<td align="char" valign="top" char="." charoff="50">34068,442</td>
<td align="char" valign="top" char="." charoff="50">189</td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50"> </td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap position="float" id="t4"><label>Table 4</label>
<caption><title>ITV-Post Hoc Test (Multiple comparisons with dependent variable: INSERTION Torque Values (ITV) calculating Least Signficance Difference (LSD)): Post-hoc multiple comparisons by Fisher’s Least Significant Difference test to discern whether the differences between the means of the different biomaterials were statistically significant. Values with p <0.05 were considered statistically significant</title>
</caption>
<table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
<col align="center"></col>
</colgroup>
<thead valign="bottom"><tr><th align="justify" valign="top" charoff="50">Biomaterial compared to</th>
<th align="center" valign="top" charoff="50">Biomaterial</th>
<th align="center" valign="top" charoff="50">Mean Difference</th>
<th align="center" valign="top" charoff="50">Std. Error</th>
<th align="center" valign="top" charoff="50">Sig.</th>
</tr>
</thead>
<tbody valign="top"><tr><td align="center" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="left" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="char" valign="top" char="." charoff="50">10,725<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,050</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">NanoBone</td>
<td align="char" valign="top" char="." charoff="50">23,269<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,044</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">Bio-Oss</td>
<td align="char" valign="top" char="." charoff="50">30,373<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,100</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="char" valign="top" char="." charoff="50">34,465<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,092</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="left" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="char" valign="top" char="." charoff="50">−10,725<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,050</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">NanoBone</td>
<td align="char" valign="top" char="." charoff="50">12,544<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,023</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">Bio-Oss</td>
<td align="char" valign="top" char="." charoff="50">19,648<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,081</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="char" valign="top" char="." charoff="50">23,739<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,073</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">NanoBone</td>
<td align="left" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="char" valign="top" char="." charoff="50">−23,269<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,044</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="char" valign="top" char="." charoff="50">−12,544<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,023</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">Bio-Oss</td>
<td align="char" valign="top" char="." charoff="50">7,104<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,075</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="char" valign="top" char="." charoff="50">11,195<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,067</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">Bio-Oss</td>
<td align="left" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="char" valign="top" char="." charoff="50">−30,373<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,100</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="char" valign="top" char="." charoff="50">−19,648<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,081</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">NanoBone</td>
<td align="char" valign="top" char="." charoff="50">−7,104<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,075</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="char" valign="top" char="." charoff="50">4,092<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,123</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="center" valign="top" charoff="50">ContrGroupNormBone</td>
<td align="left" valign="top" charoff="50">easy-graft CRYSTAL</td>
<td align="char" valign="top" char="." charoff="50">−34,465<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,092</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">easy-graft CLASSIC</td>
<td align="char" valign="top" char="." charoff="50">−23,739<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,073</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">NanoBone</td>
<td align="char" valign="top" char="." charoff="50">−11,195<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,067</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
<tr><td align="left" valign="top" charoff="50"> </td>
<td align="left" valign="top" charoff="50">Bio-Oss</td>
<td align="char" valign="top" char="." charoff="50">−4,092<xref ref-type="fn" rid="t4-fn1">*</xref>
</td>
<td align="char" valign="top" char="." charoff="50">1,123</td>
<td align="char" valign="top" char="." charoff="50">,000</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="t4-fn1"><p>*. The mean difference is significant at the 0.05 level.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list><country><li>Autriche</li>
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<region><li>Vienne (Autriche)</li>
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<settlement><li>Vienne (Autriche)</li>
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<tree><noCountry><name sortKey="Kurrek, Andreas" sort="Kurrek, Andreas" uniqKey="Kurrek A" first="Andreas" last="Kurrek">Andreas Kurrek</name>
<name sortKey="Wainwright, Marcel" sort="Wainwright, Marcel" uniqKey="Wainwright M" first="Marcel" last="Wainwright">Marcel Wainwright</name>
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<country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Troedhan, Angelo" sort="Troedhan, Angelo" uniqKey="Troedhan A" first="Angelo" last="Troedhan">Angelo Troedhan</name>
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<name sortKey="Schlichting, Izabela" sort="Schlichting, Izabela" uniqKey="Schlichting I" first="Izabela" last="Schlichting">Izabela Schlichting</name>
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</record>
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