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Machine-Driven Versus Manual Insertion Mode: Influence on Primary Stability of Orthodontic Mini-Implants

Novsak Domen DDS; Zrinski, Magda Trinajstic DDS; Spalj, Stjepan DDS, PhD
doi: 10.1097/ID.0000000000000174
Basic and Clinical Research: PDF Only


The study aimed to explore the effect of the insertion method on maximal insertion torque as a measure of primary stability while controlling for the effect of cortical bone thickness, mini-implant length and diameter, and vertical insertion force on insertion torque.


Six types of mini-implants (Dual Top; Jeil Medical, Corp.) with diameters of 1.4, 1.6, and 2.0 mm and lengths of 6 and 8 mm were inserted manually and in a machine-driven mode into pig rib bone samples, and experiments were repeated 10 times, which totaled 120 tested implants in 120 pig rib samples. Cortical bone thickness was measured with a sliding caliper, whereas insertion torque and vertical insertion forces were recorded with a specially designed device.


Significant predictors of better primary stability are thicker cortical bone (explaining 24.2% of variability), wider diameter (20.6%), manual insertion (9.9%), greater length (3.7%), higher maximal vertical insertion force (2.2%), and lower vertical force at maximal insertion torque (1.4%).


Manual insertion is associated with higher primary stability of orthodontic mini-implants than mechanical insertion, but thicker cortical bone and larger implant diameter seem to be stronger predictors of primary stability.

Reprint requests and correspondence to: Magda Trinajstic Zrinski, DDS, Department of Orthodontics, School of Medicine, University of Rijeka, Kresimirova 40, Rijeka 51000, Croatia, Phone: +38551345638, Fax: +38551345630, E-mail:

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