Analysis of correlation between hounsfield units of CBCT scans and implant primary stability in implant stability quotient (ISQ)

The primary objective of the present in vitro study was to evaluate the influence of implant site preparation technique (drills vs ultrasonic instrumentation) on the primary stability of short dental implants with two different designs inserted in simulated low-quality cancellous bone. Eighty implant sites were prepared in custom-made solid rigid polyurethane blocks with two different low cancellous bone densities (5 or 15 pounds per cubic foot [PCF]), equally distributed between piezoelectric (Surgysonic Moto, Esacrom, Italy) and conventional drilling techniques. Two short implant systems (Prama and Syra, Sweden & Martina) were tested by inserting 40 fixtures of each system (both 6.0 mm length and 5.0 mm diameter), divided in the four subgroups (drills/5 PCF density; drills/15 PCF density; piezo/5 PCF density; piezo/15 PCF density). Insertion torque (Ncm), implant stability quotient values, removal torque (Ncm), and surgical time were recorded. Data were analyzed by 3-way ANOVA and Scheffé's test (α = 0.05). With slight variations among the considered dependent variables, overall high primary implant stability was observed across all subgroups. Piezoelectric instrumentation allowed for comparable or slightly superior primary stability in comparison with the drilling procedures in both implant systems. The Prama implants group showed the highest mean reverse torque and Syra implants the highest implant stability quotient values. Piezoelectric implant site preparation took prolonged operative time compared to conventional preparation with drills; among the drilling procedures, Syra system required fewer surgical steps and shorter operative time.

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Developing Stability of Posterior Mandibular Implants Placed With Osteotome Expansion Technique Compared With Conventional Drilling Techniques

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-16-00101 ◽

2017 ◽

Vol 43 (2) ◽

pp. 131-138 ◽

Cited By ~ 1

Author(s):

Yen-Ting Lin ◽

Adrienne Hong ◽

Ying-Chin Peng ◽

Hsiang-Hsi Hong

Keyword(s):

Bone Density ◽

Surgical Techniques ◽

Primary Stability ◽

Conventional Technique ◽

Implant Stability ◽

Implant Stability Quotient ◽

Expansion Technique ◽

The Stability ◽

Conventional Drilling ◽

Secondary Stability

Clinical decisions regarding the stability and osseointegration of mandibular implants positioned using the bone expansion techniques are conflicting and limited. The objective was to evaluate the stability of implants placed using 2 surgical techniques, selected according to the initial width of the mandibular posterior edentulous ridge, with D3 bone density, during a 12-week period. Fifty-eight implants in 33 patients were evaluated. Thirty-two implants in 24 patients were positioned using the osteotome expansion technique, and 26 fixtures in 17 patients were installed using the conventional drilling technique. The implant stability quotient values were recorded at weeks 0, 1, 2, 3, 4, 6, 8, 10, and 12 postsurgery and evaluated using analysis of variance, independent, and paired t tests. Calibrated according to the stability reading of a 3.3-mm diameter implant, the osteotome expansion group was associated with a lower bone density than the conventional group (64.96 ± 6.25 vs 68.98 ± 5.06, P = .011). The osteotome expansion group achieved a comparable primary stability (ISQb-0, P = .124) and greater increases in secondary stability (ISQb-12, P = .07) than did the conventional technique. A D3 quality ridge with mild horizontal deficiency is expandable by using the osteotome expansion technique. Although the 2 groups presented similar implant stability quotient readings during the study period, the osteotome expansion technique showed significant improvement in secondary stability. The healing patterns for these techniques are therefore inconsistent.

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Effects of Different Undersizing Site Preparations on Implant Stability

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238965 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8965

Author(s):

Bernardo Ferreira Lemos ◽

Paula Lopez-Jarana ◽

Carlos Falcao ◽

Blanca Ríos-Carrasco ◽

Javier Gil ◽

...

Keyword(s):

Primary Stability ◽

Immediate Loading ◽

Insertion Torque ◽

Bovine Bone ◽

Preparation Technique ◽

Standard Protocol ◽

Implant Stability ◽

Implant Stability Quotient ◽

Surgical Preparation ◽

Implant System

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant (p < 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully.

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Does the Osseodensification Technique Allow for the use of a Healing Chamber with Primary Stability in Low-Density Bone? An in Vivo Study

10.21203/rs.3.rs-462910/v1 ◽

2021 ◽

Author(s):

Rafael Coutinho Mello-Machado ◽

Suelen Cristina Sartoretto ◽

Jose Mauro Granjeiro ◽

José Albuquerque Calasans-Maia ◽

Marcelo Jose Guedes Pinheiro Uzeda ◽

...

Keyword(s):

Bone Remodeling ◽

Bone Growth ◽

Primary Stability ◽

Insertion Torque ◽

Low Density ◽

Implant Stability ◽

Bone Implant ◽

Implant Stability Quotient ◽

Implant Bed

Abstract This study aimed to investigate in vivo the hypothesis that the osseodensification technique, through a wider osteotomy, produce healing chambers at the implant-bone interface with no impact on primary stability osseointegration in low-density bone. Twenty implants (3.5 x 10 mm) presenting nanohydroxyapatite (nHA) surface were inserted in the ilium of ten sheep, after preparation of a 2.7-mm wide implant bed with conventional subtractive drilling (SCD) or a 3.8-mm wide implant bed with an osseodensification bur system (OBS) (n = 5/group/period). The final insertion torque (IT) and implant stability quotient (ISQ) evaluated the primary implant stability. After 14 and 28 days, the bone samples containing the implants were processed for histological and histomorphometric evaluation of bone implant contact (BIC) and bone area fraction occupancy (BAFO). No significant differences occurred between the implant bed preparations regarding IT and ISQ (P > 0.05). Histological analysis showed bone remodeling, and bone growth in all samples with no inflammatory infiltrate. BIC values were higher for SCD after 14 and 28 days (p < 0.05), however BAFO values were similar on both groups (p > 0.05). It was possible to conclude that the osseodensification technique allowed a wider implant bed preparation with no prejudice on primary stability and bone remodeling.

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Effect of Rotating Osteotomes on Primary Implant Stability—An In Vitro Investigation

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-10-00007 ◽

2013 ◽

Vol 39 (1) ◽

pp. 52-57

Author(s):

Philipp Kreißel ◽

Felix Kölpin ◽

Friedrich Graef ◽

Manfred Wichmann ◽

Matthias Karl

Keyword(s):

Bone Density ◽

Primary Stability ◽

Surrogate Models ◽

Poor Quality ◽

Cortical Layer ◽

Implant Stability ◽

Implant Stability Quotient ◽

Primary Implant ◽

In Vitro Investigation

Achieving sufficient primary implant stability in poor-quality bone is difficult. Other than for conventional osteotomes, little is known about the effectiveness of screw-shaped spreaders in condensing bone and increasing primary stability. Therefore, implant stability quotient (ISQ) measurements of implants placed in bone surrogate models were conducted. Whereas bony microarchitecture had no effect on implant stability, initial bone density, presence of a cortical layer, and the use of screw-shaped spreaders significantly increased ISQ levels.

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Improvement in the Initial Implant Stability Quotient Through Use of a Modified Surgical Technique

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-16-00159 ◽

2017 ◽

Vol 43 (3) ◽

pp. 186-193 ◽

Cited By ~ 4

Author(s):

Rosa-María Díaz-Sánchez ◽

José-María Delgado-Muñoz ◽

Pilar Hita-Iglesias ◽

Kyle T. Pullen ◽

María-Ángeles Serrera-Figallo ◽

...

Keyword(s):

Primary Stability ◽

Titanium Implants ◽

Implant Design ◽

Prospective Clinical Study ◽

Implant Stability ◽

Implant Stability Quotient ◽

Implant Placement ◽

Cone Beam Computerized Tomography ◽

Surrounding Bone ◽

Type Classification

To ensure similar primary implant stability measured by resonance frequency analysis (RFA) could be obtained in different jawbone densities by using a specific surgical drilling protocol and, to correlate those RFA measurements with factors related to the implant design, width, and length, we are performed a 1-year prospective clinical study was carried out using 27 subjects. A total of 67 hydrophilic titanium implants were placed using a standard 2-stage implant placement protocol. The bone type at each implant site was determined by evaluation of a preoperative, high-resolution cone beam computerized tomography (CBCT) scan. A modified drilling protocol was used in softer bone (types 2, 3, and 4) that allowed for greater implant thread contact with the surrounding bone. The implant stability quotient (ISQ) was measured at 4 different times during the study: initially it was determined immediately after implant placement, then again at stage 2 uncovering surgery, then at 6 months' postplacement and, and finally at 1 year postplacement. Data collected immediately after implant surgery demonstrated a high correlation (R2 = .99) between the ISQ and bone type classification. An overall trend toward a higher ISQ was found over the 1-year study period for all types of bone. Implants remained clinically and radiographically stable during the 1-year study period. Our data allow conclude that the primary stability of 2-staged loaded implants placed in different bone types can be optimized by applying this surgical drilling protocol during the implant placement. The ISQ method was found to be a reliable predictor of implant stability.

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Influence of Implant Dimensions and Position on Implant Stability: A Prospective Clinical Study in Maxilla Using Resonance Frequency Analysis

Applied Sciences ◽

10.3390/app9050860 ◽

2019 ◽

Vol 9 (5) ◽

pp. 860 ◽

Cited By ~ 4

Author(s):

Antonio Nappo ◽

Carlo Rengo ◽

Giuseppe Pantaleo ◽

Gianrico Spagnuolo ◽

Marco Ferrari

Keyword(s):

Resonance Frequency ◽

Dental Implant ◽

Frequency Analysis ◽

Primary Stability ◽

Prospective Clinical Study ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Implant Stability Quotient ◽

Implant Placement ◽

Implant System

Implant stability is relevant for the correct osseointegration and long-term success of dental implant treatments. The aim of this study has been to evaluate the influence of implant dimensions and position on primary and secondary stability of implants placed in maxilla using resonance frequency analysis. Thirty-one healthy patients who underwent dental implant placement were enrolled for the study. A total of 70 OsseoSpeed TX (Astra Tech Implant System—Dentsply Implants; Mölndal, Sweden) implants were placed. All implants have been placed according to a conventional two-stage surgical procedure according to the manufacturer instructions. Bone quality and implant stability quotient were recorded. Mean implant stability quotient (ISQ) at baseline (ISQ1) was statistically significant lower compared to 3-months post-implant placement (ISQ2) (p < 0.05). Initial implant stability was significantly higher with 4 mm diameter implants with respect to 3.5 mm. No differences were observed within maxilla regions. Implant length, diameter and maxillary regions have an influence on primary stability.

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Validation of Resonance Frequency Analysis by Comparing Implant Stability Quotient Values With Histomorphometric Data

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-09-00137 ◽

2011 ◽

Vol 37 (3) ◽

pp. 301-308 ◽

Cited By ~ 9

Author(s):

Ashish Thomas Kunnekel ◽

K. Chandrasekharan Nair ◽

E. Munirathnam Naidu ◽

Gomathinayagam Sivagami

Keyword(s):

Resonance Frequency ◽

Frequency Analysis ◽

Primary Stability ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Implant Stability Quotient ◽

The Relationship

Abstract The study was designed to determine the relationship between implant stability quotient (ISQ) values measured using resonance frequency analysis (RFA) and implant-bone distance measured histomorphometrically. Ten identical implants were equally divided into 2 groups based on primary stability at placement. Osteotomies were prepared in harvested goat femurs. ISQ values were measured and compared with implant-bone distance determined by micrometry. Based on the results, it was concluded that RFA can be used to measure implant stability reliably.

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Primary Stability of Dental Implants in Low-Density (10 and 20 pcf) Polyurethane Foam Blocks: Conical vs Cylindrical Implants

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17082617 ◽

2020 ◽

Vol 17 (8) ◽

pp. 2617 ◽

Cited By ~ 1

Author(s):

Luca Comuzzi ◽

Margherita Tumedei ◽

Ana Emilia Pontes ◽

Adriano Piattelli ◽

Giovanna Iezzi

Keyword(s):

Primary Stability ◽

Insertion Torque ◽

Low Density ◽

Implant Stability ◽

Implant Stability Quotient ◽

Pull Out ◽

Group A ◽

Group B ◽

Torque Values ◽

Clinical Conditions

Background: The aim of the present study was to compare, in low-density polyurethane blocks, the primary implant stability values (micromobility) and removal torque values of three different implant geometries in two different bone densities representing the structure of the human posterior jaws. Methods: A total of 60 implants were used in the present investigation: twenty implants for each of three groups (group A, group B, and group C), in both polyurethane 10 pcf and 20 pcf densities. The insertion torque, pull-out torque, and implant stability quotient (ISQ) values were obtained. Results: No differences were found in the values of Group A and Group B implants. In both these groups, the insertion torques were quite low in the 10 pcf blocks. Better results were found in the 20 pcf blocks, which showed very good stability of the implants. The pull-out values were slightly lower than the insertion torque values. High ISQ values were found in Group A and B implants. Lower values were present in Group C implants. Conclusions: The present investigation evaluated implants with different geometries that are available on the market, and not experimental implants specifically created for the study. The authors aimed to simulate real clinical conditions (poor-density bone or immediate post-extraction implants) in which knowledge of dental implant features, which may be useful in increasing the primary stability, may help the oral surgeon during the surgery planning.

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Preoperative Computed Tomography-Derived Bone Densities in Hounsfield Units at Implant Sites Acquired Primary Stability

ISRN Dentistry ◽

10.5402/2011/678729 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Kyou Hiasa ◽

Yasuhiko Abe ◽

Yohei Okazaki ◽

Keisuke Nogami ◽

Wataru Mizumachi ◽

...

Keyword(s):

Primary Stability ◽

Multiple Comparisons ◽

Implant Stability ◽

Hounsfield Units ◽

Anterior Maxilla ◽

Posterior Maxilla ◽

Preoperative Ct ◽

The Mean ◽

Ct Data ◽

Anterior Mandible

The purpose of this study was to evaluate preoperative CT-derived bone densities in Hounsfield units (HU) at implant sites that acquired primary stability, and to compare these values to the optimal bone densities proposed in the literature. Fifty-one patients, 18 males (37 implant sites) and 33 females (67 implant sites) between 2003 and 2010 were assessed. CT data for different jaw sections, regions, and operating procedures were compared using the Kruskal-Wallis test and Scheffe's test for multiple comparisons (P<0.05). The mean bone density in the maxilla was significantly lower than that in the mandible (P<0.05); the mean bone densities in the 4 jaw regions decreased in the following order: anterior mandible > anterior maxilla > posterior mandible > posterior maxilla. The bone densities assessed by HU fell into the range of optimal bone densities associated with acquired primary implant stability proposed in the literature.

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