Patient-Clustered Analysis of Recorded Insertion Torque in 101 MultiNeO Titanium Dental Implant Placements: An Exploratory Retrospective Cohort Study
Primary implant stability arises from mechanical engagement at placement, and insertion torque is not a direct measure of osseointegration. This retrospective single-centre study included 101 MultiNeO titanium implant placements in 55 adults treated between April 2023 and January 2026. Four experienced operators placed implants subcrestally using a W&H Implantmed SI-1023, a bone-resistance-adapted drilling protocol, and a programmed target of 35 N·cm. Associations with recorded torque were assessed using a patient-clustered Gaussian generalized estimating equation adjusted for sex, age, anatomical sector, implant length and diameter, hard-tissue augmentation, and placement timing. The mean torque was 31.63 ± 5.57 N·cm; the median was 35 N·cm (Q1–Q3, 30–35). Recorded torque was 3.25 N·cm higher for implants placed in women than for those placed in men (95% CI 1.20–5.31; p = 0.002). Relative to maxillary anterior/premolar sites, mandibular molar sites showed higher torque (β = 4.02; p = 0.001), whereas mandibular anterior/premolar sites showed lower torque (β = −5.41; p = 0.013). Implant length had a modest adjusted association (β = 0.93 N·cm/mm; p = 0.022); age, diameter, augmentation, and placement timing did not. The concentration of recorded values at 35 N·cm reflects a clinical target rather than the device limit. These exploratory associations do not establish an intrinsic sex effect or predict osseointegration, and residual confounding due to unmeasured bone characteristics remains possible.