Science

The relationship between the extent of cortical undersizing, the primary stability it allows to achieve, the early and late marginal bone resorption it may induce has still not been clarified: studies on this matter are contradictory and inconclusive.
However, IDI Evolution systems are the only ones capable of site-specific discrimination and operator-independent assessment of different combinations of cortical thickness and cancellous density, providing a measure of implant primary stability, the Torque-Depth Integral, which also evaluates the mechanical stress exerted on the cortical thickness.

The research carried out by IDI Evolution shows that TMM3 measures even bone quality, that is the combination of a given cortical layer thickness and a given trabecular density.

The Integral of the torque-depth curve, measured by TMM3 during implant insertions, varies predictably in relation to how underprepared the implant tunnel is.
The variation of the Integral is also predictable when altering the implant geometry, both in terms of shape (conical, cylindrical, etc.) and dimensions (diameter/length).
The mathematical algorithms describing these variations are also influenced by bone density.

The IDI Evolution bone density measurement system has allowed for the first time in the history of clinical research to draw the topological map of trabecular bone density of the maxillae. The results of IDI Evolution's research on the distribution of bone density in the maxillae support personalized implantology for each patient: site-specific density measurement, performed with TMM3, is fundamental for customizing the implant insertion protocol and therefore the entire prosthetic rehabilitation.

The IDI Evolution bone density measurement system underwent many independent validations: the bone density measurement obtained using TMM3 is both a measure of physical density (mass/volume), trabecular density (number of trabeculae/ area), and radiographic density (CBCT gray values).

First meaningful evidence of the significant impact that TMM3 and the IDI Evolution bone density and primary stability measurement systems can have on everyday clinical practice came with the publication, in 2018, of the results of a retrospective study, where the system was used in a rather challenging condition: implant placement performed concurrently with maxillary sinus lift, even in quite thin ridges (≤ 2mm).

Tests carried out by IDI Evolution have allowed to endow the TMM3 micromotor with a special interfaced alerting surgeons when they run the risk of overheating bone when preparing the implant site; this increases the patient’s safety, as well as the predictability of success concerning the whole rehabilitation.

The Integral of the torque-depth curve recorded during implant insertion is a validated primary stability measure. The Integral, in fact, not only correlates with IT and ISQ, the two other well-known primary stability measures, but also correlates with the BIC, the bone-to-implant contact are. Current research indicates that the Integral is also a measure of the micromovements the implant is subjected to at the end of its placement.

The bone density measurement system devised by IDI Evolution applies a fundamental insight, already noted in 1995 by two renowned implantologists – Lars Sennerby and Bertil Friberg: bone resistance to cutting measures its density.
Starting from this insight, IDI Evolution has endowed a specific a special instant torque measuring micromotor with a bone density measurement probe, to be used after passing the initial drill for implant tunnel preparation, while the motor measures the instant torque required to allow its descent into the tunnel at a constant speed. The average of all the instant torque values has been shown to be a reliable bone density estimator.