Within the limitations of this in vitro study and the specific implant system evaluated, increasing insertion torque produced progressive, torque-dependent degradation of implant surface microtexture and nanohydroxyapatite coating integrity, with corresponding evidence of material transfer to the surrounding substrate. Surface changes were limited at 30 Ncm but became substantial at 60 Ncm and extensive at 80 Ncm, despite no gross macroscopic deformation. These findings suggest that higher insertion torques may compromise engineered surface features intended to support early osseointegration and reinforce the clinical value of controlled insertion torque that prioritizes both mechanical stability and surface preservation.
Elkahly et al. (Mon,) studied this question.