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Journal of Oral Science & Rehabilitation Volume 2 | Issue 4/2016 65 E f f e c t s o f i n s e r t i o n t o r q u e o n h a r d a n d s o f t t i s s u e a f t e r t w o y e a r s Table 1 1:100,000 epinephrine) and rinsing with a 0.2% chlorhexidine mouthwash, a crestal incision and full-thickness flap elevation were performed in all of the patients. The implant osteotomypreparationfollowed themanufacturer’srecommendations.Asurgical guide was used to prosthetically determine the implant position after the initial perforation of the cortical bone. A 2 mm twist drill was used with the surgical guide in order to achieve the position and angulation planned, and the osteo- tomywas widened according to the manufactu- rer’s recommendations.Afterthefinaldrilling, all of the surgical sites were prepared in the coron- al part to as deep as 2 mm with a countersink drill. Implants were inserted with a surgical unit (ElcoMed,W&HDentalwerkBürmoos,Bürmoos, Austria; Fig. 1) at a calibrated maximum torque of40 N cm at a predetermined 30 rpm.Allofthe implants were positioned at the bone crest level andwere seated atthefinalposition, utilizingfor thelast2mmadigitaltorquegauge(BTGE10CN, Tohnichi Torque, Northbrook, Ill., U.S.). After po- sitioning of the cover screw, the flaps were su- tured using 4-0 silk stitches. The patients were instructed to take anti-in- flammatory therapy (ibuprofen 600 mg tablets t.i.d. for as long as required) and to rinse with a Table 1 Demographic data. Fig. 1 Insertion of an implant of the regular-IT group. Regular-IT group High-IT group Sample size 58(1) 58(2) Age (years) 51.5 ± 8.2 51.3 ± 8.2 Age range (years) 31.0–68.4 38.8–65.8 Male–female ratio 19/39(1) 20(1)/39(1) Incisor 1 1 Canine 7 8(1) Premolar 29(1) 36(1) Molar 21 13 Smoker–nonsmoker ratio 17/41(1) 18(1)/40(1) Buccal bone thickness (mm) 0.97 ± 0.33 0.84 ± 0.36 Mean insertion torque (N cm) 30.3 ± 7.5 68.8 ± 9.0 Fig. 1 Volume 2 | Issue 4/201665 Age (years) 51.5 ± 8.251.3 ± 8.2 Age range (years) 31.0–68.438.8–65.8 Incisor 11 Canine 78(1) Molar 2113 Buccal bone thickness (mm) 0.97 ± 0.330.84 ± 0.36 Mean insertion torque (N cm) 30.3 ± 7.568.8 ± 9.0