Impact of High Insertion Torque on Pain: A Randomized Split-Mouth Clinical Trial

During and after implant surgery, pain is one of the most frequent complaints, and its intensity is thought to be influenced by a variety of factors. This study aimed to examine the association between insertion torque values and patients' pain levels measured with the visual analog scale and investigate the relationship between insertion torque, implant stability quotient, and periotest values. This study was designed as a randomized, controlled, split-mouth clinical trial. Fifteen patients with bilateral single tooth loss in the posterior mandible were included. A total of 30 implants were randomly placed with high insertion torque (≥ 50 Ncm) on one side and regular insertion torque (<50 Ncm) on the other side in the same operation. The insertion torque, implant stability quotient, periotest values, and preoperative anxiety and postoperative pain levels were recorded. Mean insertion torque values for high and regular insertion torque groups were 77.27±5.77 Ncm and 30.47±8.33 Ncm, respectively. Pain levels were higher in the high insertion torque group than the regular insertion torque group on the operation day (p=0.016) and the following day (p=0.007). Furthermore, correlations were observed between insertion torque, implant stability quotient, and periotest values (p < 0.05). The study found that implants placed with high insertion torque had higher reported pain levels on the day of the operation and the following day.