scholarly journals Bone Density and Implant Primary Stability. A Study on Equine Bone Blocks

2019 ◽  
Vol 7 (3) ◽  
pp. 73 ◽  
Author(s):  
Francesco Orlando ◽  
Federico Arosio ◽  
Paolo Arosio ◽  
Danilo Alessio Di Stefano
Keyword(s):  
Mechanical Properties ◽  
Bone Density ◽  
Alveolar Bone ◽  
Linear Regression Analysis ◽  
Primary Stability ◽  
Insertion Torque ◽  
Implant Stability ◽  
Primary Implant ◽  
Physical Density ◽  
Equine Bone

Previous results on synthetic blocks mimicking bone indicate that bone density can be measured by the friction encountered by a rotating probe while it descends into bone, and that primary implant stability may be measured through the integral (I) of the torque–depth curve at implant insertion. This study aims to repeat those tests on collagen-preserving equine bone blocks as they better reproduce the mechanical properties of natural bone. Fifteen cancellous equine blocks had their density measured using a measuring probe. This was compared to their known physical density through linear regression analysis. Implant placement was carried out into six cancellous equine blocks and primary stability was measured using (I), as well as the insertion torque (IT), the implant stability quotient (ISQ), and the reverse torque (RT). The relation between (I), (IT), (ISQ), and (RT) was investigated by correlation analysis. Bone density measured using the probe correlated significantly with actual density, both with (r = 0.764) and without irrigation (r = 0.977). (I) correlated significantly with IT and RT under all irrigation conditions, and with ISQ only without irrigation (r = 0.886). The results suggest that the probe provides actual bone density measurements. They also indicate that (I) measures primary implant stability and is more sensitive to density variations than IT, RT, and ISQ. Results are consistent with those obtained on synthetic blocks but suggest that equine bone blocks may better reproduce the mechanical properties of human cancellous alveolar bone. This should be the subject of additional studies.

Alveolar Bone Density and Width Affect Primary Implant Stability

2020 ◽  
Vol 46 (4) ◽  
pp. 389-395 ◽  
Author(s):  
Joaquín de Elío Oliveros ◽  
Alejandra del Canto Díaz ◽  
Mariano del Canto Díaz ◽  
Clara Jacobo Orea ◽  
Mariano del Canto Pingarrón ◽  
...  
Keyword(s):  
Bone Density ◽  
Alveolar Bone ◽  
Implant Design ◽  
Insertion Torque ◽  
Alveolar Ridge ◽  
Implant Stability ◽  
Convenience Sample ◽  
Surgical Guide ◽  
Implant Placement ◽  
Primary Implant

Primary implant stability (PIS) depends on surgical technique, implant design, and recipient bone characteristics, among other factors. Bone density (BD) can be determined in Hounsfield units (HUs) using cone beam computerized tomography (CBCT). Reliable prediction of PIS could guide treatment decisions. We assessed whether PIS was associated with recipient bone characteristics, namely, BD and alveolar ridge width (ARW), measured preoperatively by CBCT. We studied a convenience sample of 160 implants placed in 48 patients in 2016 and 2017. All underwent CBCT with a radiologic/surgical guide yielding values for ARW and BD. PIS measures used were the implant stability quotient (ISQ) from resonance frequency analysis and insertion torque (IT). IT was most influenced by the HU value at 0.5 mm outside the implant placement area, followed by the value within this area, and ISQ by the HU value at 0.5 mm outside the placement area, followed by implant placement site and apical ARW. ISQ values were significantly related to ARW in coronal (P < .05), middle (P < .01), and apical (P < .01) thirds. ISQs were higher with larger-diameter implants (P < .01). ISQ and IT were strongly correlated (P < .001). PIS in terms of ISQ and IT is positively correlated with edentulous alveolar ridge BD measured by CBCT, implying that implant stability may be predicted preoperatively. Wide alveolar ridges favored lateral PIS but did not affect rotational PIS. The most significant predictor of lateral and rotational PIS in our patients was the HU value at 0.5 mm outside the implant placement area.

scholarly journals New Implant Design with Midcrestal and Apical Wing Thread for Increased Implant Stability in Single Postextraction Maxillary Implant

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Scarano ◽  
Bartolomeo Assenza ◽  
Francesco Inchingolo ◽  
Filiberto Mastrangelo ◽  
Felice Lorusso
Keyword(s):  
Cortical Bone ◽  
Dental Implant ◽  
Alveolar Bone ◽  
Primary Stability ◽  
Implant Design ◽  
Insertion Torque ◽  
Fixture Design ◽  
Implant Stability ◽  
Implant Placement ◽  
Immediate Placement

Background. The immediate placement of a dental implant could represent an option treatment for the rehabilitation of a postextractive missing tooth socket to replace compromised or untreatable teeth, with the advantage of single-session surgery. In this way, the anatomy of the alveolar bone defect, the preservation of the buccal cortical bone, and the primary stability of the fixture represent the critical factors that consent a precise implant placement. Objective. This case report describes a novel fixture design for postextractive alveolar socket immediate implant. Methods. Two patients (25 and 31 years old) were treated for postextractive dental implant placement to replace both central upper incisor teeth with four implants. The residual bone implant gap was not filled with graft or bone substitute. The restoration was provided following a standard loading protocol by a cement-sealed prosthetic abutment. Results. Clinically, all implants positioned showed an excellent insertion torque. No postoperative complications were reported. At 6 months of healing, the buccal cortical bone and the implant stability were present and well maintained. Conclusion. The evidence of this study allows us to underline the possible advantages of this new fixture design for postextractive implant technique.

scholarly journals Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants

Materials ◽  
2019 ◽  
Vol 12 (15) ◽  
pp. 2398 ◽  
Author(s):  
Christian Makary ◽  
Abdallah Menhall ◽  
Carole Zammarie ◽  
Teresa Lombardi ◽  
Seung Yeup Lee ◽  
...  
Keyword(s):  
Bone Density ◽  
Primary Stability ◽  
Stability Loss ◽  
Insertion Torque ◽  
Implant Stability ◽  
Marginal Bone Loss ◽  
Early Loading ◽  
Bone Level ◽  
Implant Therapy ◽  
Provisional Restoration

Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according to the bone density of the implant site. Materials and Methods: Patients needing implant therapy for fixed prosthetic rehabilitation were treated by inserting fixtures with four different thread diameters, selected based on clinical assessment of bone quality at placement (D1, D2, D3, and D4, according to Misch classification). Final insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and ISQ measurements repeated after one, two, three, and four weeks. At the three-week measurement (four weeks after implant replacement), implants with ISQ > 70 Ncm were functionally loaded with provisional restorations. Marginal bone level was radiographically measured 12 months after implant insertion. Results: Fourteen patients were treated with the insertion of forty implants: Among them, 39 implants showing ISQ > 70 after 3 weeks of healing were loaded with provisional restoration. Mean IT value was 82.3 ± 33.2 Ncm and varied between the four different types of bone (107.2 ± 35.6 Ncm, 74.7 ± 14.0 Ncm, 76.5 ± 31.1 Ncm, and 55.2 ± 22.6 Ncm in D1, D2, D3, and D4 bone, respectively). Results showed significant differences except between D2 and D3 bone types. Mean ISQ at baseline was 79.3 ± 4.3 and values in D1, D2, D3, and D4 bone were 81.9 ± 2.0, 81.1 ± 1.0, 78.3 ± 3.7, and 73.2 ± 4.9, respectively. Results showed significant differences except between D1 and D2 bone types. IT and ISQ showed a significant positive correlation when analyzing the entire sample (p = 0.0002) and D4 bone type (p = 0.0008). The correlation between IT and ISQ was not significant when considering D1, D2, and D3 types (p = 0.28; p = 0.31; p = 0.16, respectively). ISQ values showed a slight drop at three weeks for D1, D2, and D3 bone while remaining almost unchanged in D4 bone. At 12-month follow-up, all implants (39 early loading, 1 conventional loading) had satisfactory function, showing an average marginal bone loss of 0.12 ± 0.12 mm, when compared to baseline levels. Conclusion: Matching implant macro-geometry to bone density can lead to adequate implant stability both in hard and soft bone. High primary stability and limited implant stability loss during the first month of healing could allow the application of early loading protocols with predictable clinical outcomes.

scholarly journals Evaluation of Insertion Energy as Novel Parameter for Dental Implant Stability

2020 ◽  
Vol 9 (9) ◽  
pp. 2977
Author(s):  
Tanja Grobecker-Karl ◽  
Anthony Dickinson ◽  
Siegfried Heckmann ◽  
Matthias Karl ◽  
Constanze Steiner
Keyword(s):  
Resonance Frequency ◽  
Frequency Analysis ◽  
Primary Stability ◽  
Insertion Torque ◽  
Resonance Frequency Analysis ◽  
Implant Stability ◽  
Time Curve ◽  
Trapezoidal Formula ◽  
Primary Implant ◽  
Reliable Parameter

Insertion energy has been advocated as a novel measure for primary implant stability, but the effect of implant length, diameter, or surgical protocol remains unclear. Twenty implants from one specific bone level implant system were placed in layered polyurethane foam measuring maximum insertion torque, torque–time curves, and primary stability using resonance frequency analysis (RFA). Insertion energy was calculated as area under torque–time curve applying the trapezoidal formula. Statistical analysis was based on analysis of variance, Tukey honest differences tests and Pearson’s product moment correlation tests (α = 0.05). Implant stability (p = 0.01) and insertion energy (p < 0.01) differed significantly among groups, while maximum insertion torque did not (p = 0.17). Short implants showed a significant decrease in implant stability (p = 0.01), while reducing implant diameter did not cause any significant effect. Applying the drilling protocol for dense bone resulted in significantly increased insertion energy (p = 0.02) but a significant decrease in implant stability (p = 0.04). Insertion energy was not found to be a more reliable parameter for evaluating primary implant stability when compared to maximum insertion torque and resonance frequency analysis.

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

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.

scholarly journals Applicability of cone beam computed tomography gray values for estimation of primary stability of dental implants

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Mahnaz Sheikhi ◽  
Mehdi Karami ◽  
Somayeh Abbasi ◽  
Amirhossein Moaddabi ◽  
Parisa Soltani
Keyword(s):  
Computed Tomography ◽  
Bone Density ◽  
Dental Implants ◽  
Cone Beam Computed Tomography ◽  
Primary Stability ◽  
Cone Beam ◽  
Insertion Torque ◽  
Implant Stability ◽  
Preoperative Selection ◽  
Gray Values

Objective: To evaluate the relationship between bone density measured by computed tomography (CT) and cone beam computed tomography (CBCT) (Sirona’s Galileos scanner) with primary stability of dental implants. Material and methods: 20 fresh bovine femoral heads were prepared by removal of soft tissue, sectioning of the bone, and placement of markers for location and angulation of implants. Bone density of peri-implant areas was determined preoperatively by CT and CBCT scanning of the prepared bone samples represented by Hounsfield units (HUs) and gray values (GVs), respectively. Then, 60 implants in three sizes (diameter = 4 mm, length = 8, 10, and 12 mm) were inserted into the bones and maximum insertion torque (IT) was recorded. Osstell device was also used for determining the implant stability quotient (ISQ) for each implant. Statistical analysis was performed on the data (alpha = 0.05). Results: Mean ± SD values of GV, HU, and ISQ were 1592.75 ± 231.82, 675.26 ± 115.38 and 61.90 ± 10.14, respectively. Moreover, the most frequent IT limit was 30-35 Ncm (41.4%). Significant relationships were observed between HU and IT, GV and IT, HU and ISQ, GV and ISQ, and IT and ISQ in all implant sizes. Moreover, GV and HU also significantly correlated to each other. Conclusion: Bone density values in CBCT and CT scans are positively associated to primary stability of dental implants. Therefore, GVs obtained from Galileos CBCT scanner can be used for preoperative selection of edentulous sites which allow for better implant stability or locations which require further procedures for enhancing the success rate of dental implants.  KEYWORDSComputed tomography; Cone beam computed tomography; Dental implant.

scholarly journals How Do Parameters of Implant Primary Stability Correspond with CT-Evaluated Bone Quality in the Posterior Maxilla? A Correlation Analysis

Materials ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 270
Author(s):  
Ji-Hyun Kim ◽  
Young-Jun Lim ◽  
Bongju Kim ◽  
Jungwon Lee
Keyword(s):  
Bone Density ◽  
Bone Quality ◽  
Objective Assessment ◽  
Primary Stability ◽  
Insertion Torque ◽  
Hounsfield Units ◽  
Stability Parameters ◽  
Posterior Maxilla ◽  
Different Types ◽  
Edentulous Patients

The aim of the present study was to evaluate correlations between bone density and implant primary stability, considering various determinants such as age, gender, and geometry of implants (design, diameter). Bone density of edentulous posterior maxillae was assessed by computed tomography (CT)-derived Hounsfield units, and implant primary stability values were measured with insertion torque and resonance frequency analysis (RFA). A total of 60 implants in 30 partially edentulous patients were evaluated in the posterior maxilla with two different types of dental implants. The bone density evaluated by CT-derived Hounsfield units showed a significant correlation with primary stability parameters. The bone quality was more influenced by gender rather than age, and the type of implant was insignificant when determining primary stability. Such results imply that primary stability parameters can be used for objective assessment of bone quality, allowing surgical modifications especially in sites suspected of poor bone quality.

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

2017 ◽  
Vol 43 (2) ◽  
pp. 131-138 ◽  
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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