Inadequate primary stability planning (bone quality not respected)
What it is
Failing to achieve sufficient primary (mechanical) stability at implant placement, leading to micromotion during the healing period that prevents osseointegration. Measured as insertion torque value (ITV) and implant stability quotient (ISQ).
Why it happens
• Not assessing bone quality/density pre-operatively (D1-D4 classification) • Using a standard drilling protocol in soft bone (D3/D4) — over-preparation of the osteotomy • Implant diameter too small for the prepared site • Failure to adapt the surgical protocol to bone density (same protocol for all bone types) • Over-reliance on implant length rather than engaging cortical bone • Placing implants in freshly grafted bone without adequate native bone anchorage
The full clinical mistake entry includes
- How to avoid it — the prevention protocol
- The clinical tip experienced clinicians use
- The documented reference behind the mistake
More clinical mistakes
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