Assessment of implant stability as a prognostic determinant.
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This paper aims to establish the parameters necessary to monitor successful implant placement and osseointegration.Implant stability is considered to play a major role in the success of osseointegration. Primary implant stability at placement is a mechanical phenomenon that is related to the local bone quality and quantity, the type of implant and placement technique used. Secondary implant stability is the increase in stability attributable to bone formation and remodeling at the implant/tissue interface and in the surrounding bone. Techniques for measuring implant stability and osseointegration, including the clinical measurement of cutting resistance during implant placement and removal torque following osseointegration, are discussed. Nondestructive test methods, including impact-based techniques such as the Periotest and the Dental Fine Tester, are also discussed. An alternative method, resonance frequency analysis, is described in detail.It is clear that stability both at placement and during function is an important criterion for the success of dental implants. Quantitative methods, including resonance frequency analysis, can yield valuable information.Keywords:
Resonance frequency analysis
Implant stability quotient
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The aim of the present study was to monitor implant stability after sinus floor elevation with two biomaterials during the first six months of healing by resonance frequency analysis (RFA), and how physico-chemical properties affect the implant stability quotient (ISQ) at the placement and healing sites. Bilateral maxillary sinus augmentation was performed in 10 patients in a split-mouth design using a bobine HA (BBM) as a control and porcine HA (PBM). Six months after sinus lifting, 60 implants were placed in the posterior maxilla. The ISQ was recorded on the day of surgery from RFA at T1 (baseline), T2 (three months), and T3 (six months). Statistically significant differences were found in the ISQ values during the evaluation period. The ISQ (baseline) was 63.8 ± 2.97 for BBM and 62.6 ± 2.11 for PBM. The ISQ (T2) was ~73.5 ± 4.21 and 67 ± 4.99, respectively. The ISQ (T3) was ~74.65 ± 2.93 and 72.9 ± 2.63, respectively. All of the used HAs provide osseointegration and statistical increases in the ISQ at baseline, T2 and T3 (follow-up), respectively. The BBM, sintered at high temperature with high crystallinity and low porosity, presented higher stability, which demonstrates that variations in the physico-chemical properties of a bone substitute material clearly influence implant stability.
Implant stability quotient
Resonance frequency analysis
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Citations (16)
The most important prerequisite for the success of an osseointegrated dental implant is achievement and maintenance of implant stability. The aim of the study was to measure the 208 Straumann dental implant stability quotient (ISQ) values during the osseointegration period and determine the factors that affect implant stability. A total of 164 of the implants inserted were standard surface, and 44 of them were SLActive surface. To determine implant stability as ISQ values, measurements were performed at the stage of implant placement and healing periods by the Osstell mentor. The ISQ value ranges showed a significant increase during the healing period. Except for the initial measurement, the posterior maxilla had the lowest ISQ values, and there was no significant difference among anterior mandible, posterior mandible, and anterior maxilla (P < .05). Implant length did not have a significant influence on ISQ value (P > .05). The second measurement was significantly higher in men compared with women (P < .05). The second measurement was significantly higher than the others at 4.8 mm, and for the final measurement, there were no significant differences between 4.8 and 4.1 mm, which were higher than 3.3 mm (P < .05). When comparing sandblasted, large-grit, acid-etched (SLA) and SLActive surface implants, there were no significant differences for insertion measurements, but for second measurements, SLActive was significantly higher (P = 0), and for the final measurement, there was no significant difference. It appears that repeated ISQ measurements of a specific implant have some diagnostic benefit, and the factors that affect implant stability during the healing period are presented.
Implant stability quotient
Resonance frequency analysis
Anterior maxilla
Mandible (arthropod mouthpart)
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Citations (44)
Background: Implant stability is considered one of the most important factors affecting healing and successful osseointegration of dental implants. The aims of the study were to measure the implant stability quotient (ISQ) values during the healing period and to determine the factors that affect implant stability.
Materials and methods: Thirty patients enrolled in the study (17 female, 13 male). They received 44 Implantium® Dental Implants located as the following: 22 implants in maxillary jaw, 22 implants in mandibular jaw from them 17 implants in segment and 27 in posterior segment. The bone density determined using interactive CT scan and classified according to the Misch bone density classification (29 implants in (D3), 15 implants in (D4)). Resonance frequency analysis was used for direct measurement of implant stability on the day of implant placement and 8, 16 and 24 weeks after implant placement.
Results: The lowest mean of average ISQ was at the 8th week (69.5) and then the mean increased to reach at the 24th week (76.8). Mandibular implants showed significantly higher ISQ values than maxillary implants. Implants placed in the posterior segment of the jaw had significantly higher ISQ values than implants in the segment. A significant, positive linear correlation was observed between the implant diameter and the implant stability (r=0.343 p<0.001).
Conclusion: Resonance frequency analysis was non-invasive diagnostic tool for detecting changes in implant stability during the healing period. The factors that affect implant stability were implant diameter and implant location (maxilla mandible, anterior posterior).
Resonance frequency analysis
Implant stability quotient
Mandible (arthropod mouthpart)
Initial stability
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Citations (3)
The aim of the present study was to monitor implant stability after sinus floor elevation with two biomaterials during the first 6 months of healing by a resonance frequency analysis (RFA), and how physico-chemical properties affect the implant stability quotient (ISQ) at the placement and healing sites. Bilateral maxillary sinus augmentation was performed in 10 patients in a split-mouth design using a bobine HA (BBM) as a control and porcine HA (PBM). Six months after sinus lifting, 60 implants were placed in the posterior maxilla. The ISQ was recorded on the day of surgery from RFA at T1 (baseline), T2 (3 months), and T3 (6 months). Statistically significant differences were found in the ISQ values during the evaluation period. The ISQ (baseline) was 63.8±2.97 for BBM and 62.6±2.11 for PBM. The ISQ (T2) was ~ 73.5±4.21 and 67±4.99, respectively. The ISQ (T3) was ~ 74.65±2.93 and 72.9±2.63, respectively. All the used HAs provide osseointegration and statistical increases in the ISQ at baseline, T2 and T3 (follow-up), respectively. The BBM, sintered at high temperature with high crystallinity and low porosity, presented higher stability, which demonstrates that variations in the physico-chemical properties of a bone substitute material clearly influence implant stability.
Implant stability quotient
Resonance frequency analysis
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(1) Background: implant surface topology and active hydrophilic ions could have some benefit on implant osteointegration and stability; (2) methods: 40 adult patients, suffering from a single missing tooth in the aesthetic zone, were enrolled in the study. Each patient had a single titanium implant (Thommen SPI®lement) inserted. The implant surface was obtained through conditioning using the Apliquiq system. Patients were divided into two equal groups depending on the implant’s diameter (3.5 and 4.0 mm). Each implant was loaded within four weeks. Stability levels, using the Ostell device, were checked immediately after implant placement and in four weeks; additionally, marginal bone loss (MBL) was calculated based on 12 months; (3) results: all implants survived the study. The average primary stability achieved for both groups was initially 71.59 ISQ (±4.04) and declined to 69.94 ISQ (±3.29) in four weeks. The average MBL was 0.2 mm (±0.88). There were no statistically important differences between groups. There was a positive correlation between the patient’s age and implant stability quotient (ISQ) values; (4) conclusions: hydrophilic surface implants can be used in a protocol for early functional occlusal loading. Higher values of primary stability positively influence the values of secondary stability, and the age of the patient affects the values of implant stability.
Implant stability quotient
Resonance frequency analysis
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Characteristics of the implant surface may benefit osseointegration, and the knowledge of this process in diverse clinical situations may play a role in implant dentistry practice.The aim of the present study was to compare the stability of dental implants with different types of surface treatment.Fifty-five implants were placed in the mandibles of 11 fully edentulous patients. Group 1 (G1) consisted of 27 implants with a hydrophilic surface. Group 2 (G2) consisted of 28 implants (double sandblasting and acid etching). Implants were distributed randomly; equal surfaces were not placed contiguously. Measurements were taken after surgery (baseline) and 10, 30, 60, and 90 days, 4 and 8 months after surgery. Resonance frequency analysis (RFA) was used for determining the stability.No statistically significant differences were found. The largest difference in implant stability quotient (ISQ) between groups occurred at the first evaluation (ISQ ≈ 69.8 in G1 and ≈ 68.4 in G2). Reductions in stability were more accentuated in the first month, returning to values similar to baseline in the subsequent months, with peak stability reached at 8 months (ISQ ≈ 69.8 in G1 and ≈ 69.8 in G2).No statistically significant differences were found in the stability of the implants placed in edentulous mandibular arch, submitted to immediate loading analyzed using RFA.
Resonance frequency analysis
Implant stability quotient
Acid etching
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Implant stability quotient
Resonance frequency analysis
Beagle
Initial stability
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Successful dental implant treatment is directly related to osseointegration. In achieving osseointegration, the surface property of the implant is of great importance. Sandblasting is the most commonly used basic method for modifying the surface. Many companies use different sand particles for surface roughening and claim their sand is the best. This leads clinicians to mix their minds in product selection. In this study, we tried to find the appropriate sand material by working objectively without praising any brand. We believe that the results of the study will help clinicians choose the right dental implant. In this study, machined-surfaced implants and implants sandblasted with Aluminum oxide (Al2O3), Titanium dioxide (TiO2) and Silicon dioxide (SiO2) were compared via biomechanical testing.For the study, four 2 year-old sheep, weighing 45 kilograms (kg), were used. Eight implants (Al2O3, TiO2, and SiO2 sandblasted implants and machined-surfaced implants), each with different surface characteristics, were inserted into the bilateral tibia of each sheep under general anesthesia. Results of the initial Resonance Frequency Analysis (RFA) were recorded just after implant insertion. The sheep were then randomly divided into two groups, each with 2 sheep, to undergo either a 1-month or a 3-month assessment. At the end of the designated evaluation period, RFA and removal torque tests were performed.Although there were no statistically significant differences between the groups, the implants sandblasted with Al2O3 showed a higher Implant Stability Quotient (ISQ) and removal torque value at the end of the 1st and 3rd month.In short, the results of the study demonstrate that Aluminum oxide is superior to other sand particles.
Implant stability quotient
Resonance frequency analysis
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Citations (30)
Primary and secondary implant stability is of high importance for survival and success of dental implants in the short and long term. Measurements of implant stability during healing provide the opportunity to monitor the course of the osseointegration process.To compare implant stability quotient (ISQ) by resonance frequency analysis (RFA), recorded with two different devices after implant placement.Patients with the need of single tooth extraction in posterior sites of the maxilla and the mandible were treated in a surgical center. All patients received additional augmentation with a bovine bone substitute and platelet-rich fibrin (PRF) after atraumatic tooth extraction. After a healing period of 10 weeks, 28 self-tapping titanium-implants were placed. Implant stability was recorded with two different devices (Osstell and Penguin) at the time of implant insertion (T0), 10 days later (T1), and after 7 (T2), or 17 weeks (T3).No implant was lost, and no postoperative complication occurred during follow-up. Patient cohort comprised 9 female (32.1%) and 19 male patients (67.9%), with a mean age of 52.8 years, 64.3 years, respectively. Mean overall insertion torque was 43.6 Ncm at implant placement with no significant difference between implant location, age, or gender. No patient dropped out. During observation period, a significant increase in mean ISQ was recorded with both devices. Significant positive correlations between insertion torque and ISQ were recorded with both devices at T0, T2, and T3. No significant differences were observed in ISQ-values between both devices, and measuring directions at any point of measurement.Within the limitations of this cohort study, both devices were suitable for RFA-measurement and revealed comparable results. Due to the cordless design, handling of the Penquin device was more comfortable. Reusability of the Penguin MultiPeg-transducers may offer an additional benefit with regard on ecological aspects.
Implant stability quotient
Resonance frequency analysis
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Background: The healing period for bone–implant contact takes 3–6 months or even longer. Application of Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2) to implant surfaces has been of great interest on osseointegration due to its osteoinductive potential. The objective of this study was to evaluate the effect of ErhBMP-2 on implant stability.
Materials and methods: A total of 48 dental implants were inserted in 15 patients. Twenty four implants coated with 0.5 mg/ml ErhBMP-2 (study group). The other 24 implants were uncoated (control group). Each patient was received at least two dental implants at the same session. Both groups were followed with repeated implant stability measurements by means of resonance frequency analysis at different time intervals (at the time of surgery, then at 6th and 12th week postoperatively).
Results: there was no obvious statistically significant difference in mean of implant stability quotient ISQ between study and control groups (P > 0.05) at time of surgery, whereas the mean of ISQ values at 6th and at 12th week postoperatively were statistically highly significant in the study group compared to the control group (p < 0.01).
Conclusion: The results of this study reveal that coating dental implants with ErhBMP-2 increases stability when compared with uncoated implants.
Implant stability quotient
Resonance frequency analysis
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