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Less than ideal Primary Stability
Faulty osteotomy (a bigger osteotomy than required for the selected diameter of implant) can result when excessive force is used to disengage a locked drill during the implant site osteotomy preparation, due to faulty hand positioning of the surgeon during drilling or threading or poor bone quality where there is less resistance to the drill.. Bone cell injury with subsequent necrosis and elliptical preparation of the site with subsequent soft tissue encapsulation around the implant are the resultant effects.
Literature has shown that gaps in the range of 0.25 mm around the implant healed albeit with lesser bone implant contact, and the increase of the gap from 0.7 to 1.7 mm led to a thin soft tissue layer around the implant. The presence of micromotion of greater amplitude in implants with poor primary stability leads to failure of osseointegration. It is imperative that the osteotomy preparation be precise.
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