A resonance frequency analysis to investigate the impact of implant size on primary and secondary stability.

Objective: Recent years have seen a rise in the usage of dental implants to restore lost teeth. The stability of a dental implant is the main factor in determining its success. Implant stability is influenced by various factors. Several approaches have been employed clinically to evaluate stability at different time intervals. One non-invasive way to assess implant stability is by resonance frequency analysis. Utilizing the resonance frequency analysis method, this study seeks to understand how implant length and diameter affect primary and secondary stability. Methods: The current prospective study was conducted in the Prosthodontics Department of Institute of Dentistry, CMH Lahore Medical College. The duration of the study was six months. A total of 90 implants of sizes 4.5 x 8.5 mm and 4 x 10mm were placed. Resonance frequency measurements were recorded using Osstell™ AB device for primary stability at implant insertion and at 12 weeks for secondary stability. All the measurements were carried out by only one of the researchers to minimize inter-observer bias. Results: The average primary stability was 70.33±6.60, and the average secondary stability was 71.43±5.44. The data was stratified for age, gender, and implant site, and the mean primary and secondary stability of both sizes didn't show any statistically significant differences. Conclusion: Without forfeiting implant stability, both implant sizes (4 x 10mm and 4.5 x 8.5mm) can be used interchangeably, depending on available space and anatomical constraints.

Influence of Multiple Sterilization on Performance of Titanium Pegs When Measuring Implant Stability With Resonance Frequency Analyses.

This in vitro study was conducted to investigate the repeatability of the implant stability quotients (ISQ) measured with multipegs after numerous sterilizations and to detect the exact time when the readings start to deviate. Multipegs were sterilized with 3 different methods (autoclaved, autoclaved + ultrasonic cleaner, chemical disinfection + autoclaved) and grouped according to the method applied. All specimens were put into the autoclave with sealed packages every time they were sterilized. Each specimen was sterilized 50 times according to the technique described in its group after an ISQ measurement was performed. Results of the 2-way analysis of variance showed that neither the sterilization method nor the cycles, nor their interaction, were statistically significant. A multipeg may be reused multiple times after sterilization procedures and may be more cost-effective than a disposable smartpeg for checking implant stability after confirming these results in further investigations.

Comparison of Implant Stability Between Conventional Drilling and Piezosurgical Implant Bed Preparation Techniques.

This prospective study compared the stability of implants placed using piezoelectric surgery (piezo group) and those placed using conventional rotary drills (bur group) during the first 90 days postoperatively. Teeth in the posterior maxillary regions of 21 patients were randomly assigned to 2 groups. The implant stability quotient (ISQ) was measured at days 0, 7, 14, 21, 28, 42, 56, and 90 postoperatively. Twenty-eight of 29 implants were successfully integrated at day 90 (1 implant in the test group was lost). Although both groups showed a significant overall increase in implant stability with time (P < .0001) and a high final mean ISQ value, no statistically significant difference in stability was seen between the groups. The bur group showed greater variance in ISQ values than the piezo group did (P < .001) at all time points. Long-term studies with larger samples are needed to investigate the bone response to the use of piezoelectric surgery for implant preparation.

Intra- and inter-operator concordance of the resonance frequency analysis. A cross-sectional and prospective clinical study.

OBJECTIVE: Resonance frequency analysis (RFA) provides an evaluation of implant stability over time. This analysis is a non-invasive, precise, and objective method. Several studies compare the RFA system with other devices. However, few investigations analyze repeatability and reproducibility between different operators. The aim of this study was to evaluate the intra- and inter-operator concordance of the Osstell® ISQ. MATERIAL AND METHODS: RFA measurements were performed with Osstell® ISQ in a total of 37 implants placed in 21 patients. At the time of implant placement, 6 measurements per implant were taken by three different experienced operators. Three measurements were carried out consecutively and three by removing and placing the SmartPeg-Osstell® to assess intra-operator and inter-operator agreement. RESULTS: Intra-operator concordance according to the intraclass correlation coefficient (ICC) showed high concordance. The ICC values were higher than 0.9 (p < 0.0001) for consecutive measures and alternative measures, being almost perfect of Landis & Koch classification. For inter-operator concordance The ICC was 0.709 (p < 0.0001) and 0.670 (p < 0.0001) for consecutive and alternative measures, respectively, both estimates being in the substantial category. In torque and ISQ values, no statistically significant differences were observed when operators and measurements were compared. CONCLUSIONS: Osstell® ISQ system was stable both in intra-operator and inter-operator measurements. This device has excellent repeatability and reproducibility, demonstrating reliability to measure the stability of dental implants. CLINICAL RELEVANCE: Resonance frequency analysis (RFA) is a non-invasive, objective, and reliable diagnostic method to determine the ideal moment to load the implant, as well as to predict possible failures.

Validation of an implant stability measurement device using the percussion response: a clinical research study.

BACKGROUND: Several devices have been developed to measure implant-bone stability as an indicator of successful implant treatment; these include Osstell®, which measures the implant stability quotient (ISQ), and the more recent AnyCheck®, which relies on percussion for the implant stability test (IST). These devices make it possible to measure implant stability. However, no studies have compared the performance of AnyCheck® and Osstell® (i.e., IST and ISQ values) in clinical practice. Therefore, this study aimed to determine the correlation between primary and secondary implant stability using the Osstell® and AnyCheck® devices. METHODS: Ten patients (7 women; age [mean ± standard deviation]: 49.1 ± 13.3 years) with partially edentulous jaws who received a total of 15 implants were included. IST (AnyCheck®) and ISQ (Osstell®) values were measured immediately after implantation and at 1, 2, 3, 4, and 6 weeks post-implantation. Each measurement was performed three times, and the average value was used as the result. The correlation between measurements obtained using the two devices was determined using Spearman's rank correlation coefficient. RESULTS: The IST values ranged from 79.1 ± 2.87 to 82.4 ± 2.65. The ISQ values ranged from 76.0 ± 2.8 to 80.2 ± 2.35. Spearman's rank correlation coefficient was r = 0.64 immediately after implantation, r = 0.29 at 1 week, r = 0.68 at 2 weeks, r = 0.53 at 3 weeks, r = 0.68 at 4 weeks, and r = 0.56 at 6 weeks. A positive correlation was found in all cases, except at week 1 when the correlation was weak; the IST and ISQ values decreased the most during the first postoperative week and increased during the second week. The IST values were also slightly higher at all measurement points. CONCLUSION: The ability to assess implant stability without removing the abutment during healing is essential for determining the timing of loading without the risk of bone resorption. The results of this study suggest that AnyCheck® is useful for determining primary and secondary implant stability.

EXPERIMENTAL STUDY OF BONE REBUILDING IN THE PERIIMPLANTATION AREA UNDER IMMEDIATE LOADING ON DENTAL IMPLANTS.

OBJECTIVE: The aim: Study of the dynamics of morphological rearrangement of bone under conditions of immediate occlusive functional load and the effect of splinting of implants with temporary orthopedic structures with the analysis of the coefficient of stability of implants during immediate implantation in the experiment. PATIENTS AND METHODS: Materials and methods: A series of experiments was performed on 6 male Duroc pigs at the age of 6 months and weighing 40-60 kg. In the course of recent advances, the following methods have been used: the clinical protocol of immediate - implantation of time-consuming clothes, the definition of COEFICIENT, morphometry and light microscopy of the slides, statistical analysis. RESULTS: Results: By morphometric examination after 3 months the BIC in the series with splinting was 1.68 times higher compared to 1 month. studies, in a series of experiments without splinting - 1.9 times, after 3 months. the difference between implantation experiments with splinting components and without splinting is 1.6 times. During the functional study of the resonant - frequency analyzer, there is an increase in the ISQ in the second and third months after surgery, but this figure is higher in the study using the splint component. CONCLUSION: Conclusions: Stagnation of the shingle component in the case of intrinsic intraoperative functional juvenile implantation accelerates the dynamics of osteointegration, so that high indicators of the efficiency of the implant stability can be achieved.

Primary stability and healing outcomes of apically tapered and straight implants placed into fresh extraction sockets. A pre-clinical in vivo study.

OBJECTIVES: To compare the stability of apically tapered and straight (non-tapered cylindrical) implants at the time of immediate placement and to histologically evaluate the healing outcomes after 6 weeks. MATERIALS AND METHODS: The second maxillary incisors were extracted bilaterally in nine dogs. After randomization, apically tapered and straight implants with a 3.3 mm shoulder diameter were inserted into the extraction sockets. The implant stability quotient (ISQ) of the implants was recorded after placement. Peri-implant defects on the buccal aspect were filled with deproteinized bovine bone mineral and covered with resorbable type I/III porcine collagen matrix. After 6 weeks of healing, sections were prepared for histological and morphometric analysis. RESULTS: All implant sites healed uneventfully. The apically tapered implants had significantly higher ISQ values compared to straight implants at placement (p = .009). The histomorphometric outcomes 6 weeks following implant placement in both experimental groups were similar, except in the apico-palatal region. Apically tapered implants demonstrated significantly less percentage bone-to-implant contact (p = .035) in the apico-palatal region. At both implant types, substantial corono-apical resorption of the buccal bone wall was noted in the coronal 2 mm of the implant. CONCLUSION: Apically tapered implants had significantly higher ISQ values at immediate placement compared to straight implants. The healing outcomes and remodelling of the buccal bone wall were similar for both implant designs. In the apico-palatal region, there was less %BIC at the implant surface at apically tapered implants compared to straight implants.

Alveolar Bone Density and Width Affect Primary Implant Stability.

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.

Histological and histomorphometric analyses of narrow implants, crestal and subcrestally placed in severe alveolar atrophy: a study in foxhound dogs.

BACKGROUND: Narrow-diameter implants provide an alternative to the horizontal augmentation techniques situations severe bone atrophy. Lack of bone width and interdental space has been regarded as an encumbrance in the case selection for prosthetic rehabilitation using dental implants. OBJECTIVE: The aim of the study was to evaluate bone-to-implant contact and marginal bone loss of two different narrow implants in resorbed ridges at different crestal positions. MATERIAL AND METHODS: 48 Bredent Narrow(®) implants (24 MiniSky(®) and NarowSky(®) ) were placed at crestal and subcrestal levels in healing bone of atrophic alveolar ridge of 6 American foxhounds. Histological and histomorphometric analyses of osseointegration were carried out at 4 and 8 weeks. RESULTS: Modeling in the marginal defect region was accompanied by marked decreases in the dimensions of both the buccal and the more lingual bone walls. Relative to BIC, significant differences were found in favor of subcrestal group, for both Narrow Sky and MiniSky. Linear measurements showed to be slightly high in the crestal group. With significant differences for PM-IS (peri-implant mucosa to implant shoulder) and IS-BC (implant shoulder to buccal bone crest). CONCLUSIONS: Within the limitations of animal study, it can be stated that the NarrowSky(test group) crestal and subcrestal implants showed less crestal bone resorption, higher ISQ values and most BIC at 4 and 8 weeks of evaluation compared with MiniSky implants (control group). The design of the implants plays an important role in peri-implant mucosa and crestal bone maintenance at 8-week follow-up period.

Loading of osseointegrated implants for bone conduction hearing at 3 weeks: 3-year stability, survival, and tolerability.

The objective of this study was to ascertain the long-term safety of loading osseointegrated implants for bone conduction hearing 3 weeks post-surgery. Thirty consecutive adult patients were implanted with the Baha BI300 (Cochlear Bone Anchored Solutions) in our tertiary referral center. Implants were loaded with the sound processor 3 weeks post-surgery. Follow-up examinations were performed at 10 days; 3, 4, 6, 8, and 12 weeks; 6 months; and 1, 2, and 3 years after implant surgery. At each follow-up visit, implant stability quotient (ISQ) values were recorded by means of resonance frequency analysis, and soft tissue status was evaluated according to Holgers' classification. ISQ trends, implant survival, and soft tissue reactions were compared to a population of 52 patients with the same type of implants loaded from 6 weeks post-surgery as part of another study. Subjective benefit was measured by means of the Glasgow Benefit Inventory (GBI). After an initial dip in ISQ at 10 days after implantation, a gradually increasing trend in ISQ was found until 6 months in both populations, after which ISQ values remained above baseline values. Implant survival was 97 % in the study population and 96 % in the comparison population. Clinically relevant soft tissue reactions were found in 0.9 % (study population) and 1.7 % (comparison population) of all visits. Patients reported subjective benefit; the mean GBI score was 22.8. In conclusion, loading these implants at 3 weeks post-surgery is safe based on the current study, as long-term results show high ISQ values and good implant survival and tolerability.

Stability, survival, and tolerability of a 4.5-mm-wide bone-anchored hearing implant: 6-month data from a randomized controlled clinical trial.

The objective of this study was to compare the stability, survival, and tolerability of 2 percutaneous osseointegrated titanium implants for bone conduction hearing: a 4.5-mm diameter implant (test) and a 3.75-mm diameter implant (control). Fifty-seven adult patients were included in this randomized controlled clinical trial. Sixty implants were allocated in a 2:1 (test-control) ratio. Follow-up visits were scheduled at 7, 14, 21, and 28 days; 6 and 12 weeks; and 6 months. At every visit, implant stability quotient (ISQ) values were recorded by means of resonance frequency analysis (RFA) and skin reactions were evaluated according to the Holgers classification. Implants were loaded with the bone conduction device at 3 weeks. Hearing-related quality of life was evaluated using the Abbreviated Profile of Hearing Aid Benefit (APHAB), the Glasgow Benefit Inventory (GBI), and the Glasgow Health Status Inventory (GHSI). ISQ values were statistically significantly higher for the test implant compared to the control implant. No implants were lost and soft tissue reactions were comparable for both implants. Positive results were reported in the hearing-related quality of life questionnaires. These 6-month results indicate that both implants and their corresponding hearing devices are safe options for hearing rehabilitation in patients with the appropriate indications. Loading at 3 weeks did not affect the stability of either implant.

ISQ as a Diagnostic Tool in Implants Affected with Bone Loss: An In Vitro Experimental Study.

PURPOSE: To determine the relationship between bone loss that occurs during the peri-implantitis process and variations in implant stability using resonance frequency analysis (RFA) measurement methods. MATERIALS AND METHODS: Forty selftapping implants were placed in cow ribs, and study scenarios were established according to the affected implant side and bone loss depth (n = 10 implants per group): Case 1 = bone loss on one side (vestibular); Case 2 = bone loss on two opposite sides (buccal and lingual); Case 3 = bone loss on two adjacent sides (buccal and mesial); and Case 4 = foursided bone loss (circumferential). For each group of 10 implants, first a bone loss of 0 mm was evaluated, then 4-mm defects (simulating 1/3 of bone loss) were created and evaluated, and finally 8-mm defects (simulating 2/3 of bone loss) were created and evaluated. Osteotomy measurements were made with a periodontal probe. For each implant, RFA was measured by the same operator using the Beacon system (Osstell). RESULTS: The initial implant stability quotient (ISQ) values of the 40 implants exceeded 70, reflecting an average of 73 in the buccolingual (VL) and 74.8 in the mesiodistal (MD) directions. ISQ measurements in the 10 implants in which bone dehiscence was performed on the vestibular aspect reflected a decrease in ISQ values as bone loss increased. When generating bone loss in two opposite sides (buccal and lingual), a greater decrease in ISQ values was observed when 2/3 of the implant were affected. The average VL ISQ measurement was less than 70 when at sites with 2/3 of bone loss. CONCLUSIONS: When bone loss occurs on only one side of the implant, the ISQ values decrease, but the implant maintains good stability. The same occurs when two opposite sides of the implant are affected, as the unaffected side has the least decrease in ISQ value.

Implant Stability After Graftless Motor-Driven Crestal Sinus Elevation: A Cohort Study.

Graftless motor-driven crestal sinus elevation may be a preferable alternative to conventional methods due to the reduction of postsurgical complications and lower cost. This prospective cohort study evaluated the stability of implants installed using this technique. Twenty-nine Straumann BLT (bone level tapered) implants in 29 patients were included in the sample. Average implant stability quotients (ISQ) were measured immediately after surgery (mean: 73.5 ± 9.2) and after a period of healing (mean: 77.1 ± 4.5) using resonance frequency analysis (RFA). There was a significant increase in implant stability after healing (P = .035). The healing duration did not significantly influence how implant stability increased (P =.373). The mean ISQ after healing was significantly higher than the clinically acceptable stability value of 65 ISQ (P < .001). Implant length and width were not significantly correlated with ISQ increase (P = .764 and P = .085, respectively). In addition, there were no significant differences in average ISQ values measured immediately postsurgery (at baseline) or after healing between implants with and without registered perforations during surgery (P = .118 and P = .366, respectively). The posthealing stability of 4 implants that did not achieve primary stability was not significantly less stable after the healing period than those that had achieved primary stability (P = .086). Moreover, the level of insertion torque significantly impacted implant stability immediately postsurgery (P < .001), but the ISQ values measured after healing were not significantly different based on the initial insertion torque values (P = .131). This study suggests that implants installed using graftless motor-driven crestal sinus elevation may achieve clinically acceptable stability as measured by RFA.

A Comprehensive Study on Implant Stability Quotient (ISQ) in View of Resonance Frequency and Spectrum Analysis.

PURPOSE: To investigate how well an implant stability quotient (ISQ) represents resonance frequency. MATERIALS AND METHODS: Benchtop experiments on standardized samples that replicated a mandibular premolar site were conducted to correlate an ISQ value and a resonance frequency to synthetic bone density and an incremental insertion torque; then, a frequency spectrum analysis was performed to check the validity of the resonance frequency analysis (RFA). Brånemark Mk III implants (4 × 11.5 mm; Nobel Biocare) were placed in Sawbones test models of five different densities (40, 30, 40/20, 20, and 15 PCF). An incremental insertion torque was recorded during implant placement. To perform stability measurements, the test models were partially clamped in a vise (unclamped volume: 10 × 20 × 34 mm). A MulTipeg (Integration Diagnostics) was attached to the implants, and a Penguin (Integration Diagnostics) RFA measured ISQ. Simultaneously, the MulTipeg motion was monitored via a laser Doppler vibrometer and processed by a spectrum analyzer to obtain the resonance frequency. Tightness of the clamp was adjusted to vary the resonance frequency. A statistical analysis produced a linear correlation coefficient (R) among the measured ISQ, resonance frequency, and incremental insertion torque. RESULTS: The resonance frequency had high correlation to the incremental insertion torque (R = 0.978), confirming the validity of using RFA for this study. Measured ISQ data were scattered and had low correlation to the resonance frequency (R = 0.214) and the incremental insertion torque (R = 0.386). The spectrum analysis revealed the simultaneous presence of multiple resonance frequencies. CONCLUSIONS: For the designed benchtop tests, resonance frequency does indicate implant stability in view of Sawbones density and incremental insertion torque. However, ISQ measurements do not correlate to the resonance frequency and may not reflect the stability when multiple resonance frequencies are present simultaneously.

The relationship between subjective difficulty in interoceptive processing and accuracy of heartbeat perception in autistic individuals.

Most autistic people experience difficulties in sensory processing, including interoceptive processing. For example, they often report subjective difficulties in the interoceptive processing of interoceptive input, such as difficulty in interpreting bodily signals, including hunger, thirst, and fatigue. However, whether these subjective interoceptive difficulties are from underlying problems in interoceptive accuracy remains unclear. This study investigated the relationship between subjective interoceptive difficulty and behavioral interoceptive accuracy in autistic adults and a control group. Subjective interoceptive accuracy was measured using an interoceptive sensitivity questionnaire, and behavioral interoceptive accuracy was measured using a heartbeat counting task. The results showed no significant relationship between subjective interoceptive difficulty and behavioral interoceptive accuracy in the autistic or control groups. This suggests that subjective interoceptive difficulty and behavioral interoceptive accuracy reflect different aspects of interoceptive processing. One possible interpretation is that autistic adults can identify individual local sensory inputs, such as heartbeats, however, they have difficulty integrating multiple inputs and recognizing internal body states such as hunger and fatigue.

Correlation Between Implant Stability Quotient and Percussion Sound Frequency.

OBJECTIVES: To determine the correlation between the primary implant stability quotient and the implant percussion sound frequency. MATERIALS AND METHODS: A total of 14 pigs' ribs were scanned using a dental cone beam computed tomography (CBCT) scanner to classify the bone specimens into three distinct bone density Hounsfield units (HU) value categories: D1 bone: >1250 HU; D2: 850-1250 HU; D3: <850 HU. Then, 96 implants were inserted: 32 implants in D1 bone, 32 implants in D2 bone, and 32 implants in D3 bone. The primary implant stability quotient (ISQ) was analyzed, and percussion sound was recorded using a wireless microphone connected and analyzed with frequency analysis software. RESULTS: Statistically significant positive correlations were found between the primary ISQ and the bone density HU value (r = 0.719; p < 0.001), and statistically significant positive correlations between the primary ISQ and the percussion sound frequency (r = 0.606; p < 0.001). Furthermore, significant differences in primary ISQ values and percussion sound frequency were found between D1 and D2 bone, as well as between D1 and D3 bone. However, no significant differences were found in primary ISQ values and percussion sound frequency between D2 and D3 bone. CONCLUSION: The primary ISQ value and the percussion sound frequency are positively correlated.

An eight-year retrospective study on the clinical outcomes of laser surface-treated implants.

PURPOSE: To retrospectively evaluate peri-implant bone loss and health status associated with the long-term use of laser surface-treated implants. METHODS: For control study, total of 23 titanium ASTM F136 grade 23 implants were placed in the edentulous molar area of the mandible. When the Implant Stability Quotient (ISQ) ≥ 70 and insertion torque value (ITV) ≥ 35-50 Ncm at the insertion site, an immediate provisional restoration was connected to the implant within a week after surgery. The definitive restorations were placed 2 months after surgery for all implants. 13 implants were immediately loaded, while 10 implants were conventionally loaded. For comparative study, Radiographs were taken from third years for and then annually for the subsequent eight years to monitor marginal bone loss. RESULTS: After eight year of implant installation, the average change in vertical bone loss was 0.009 mm (P < 0.001), while the average change in horizontal bone loss 8 year after implant placement was 0.026 mm (P < 0.001). The mean marginal bone loss was < 0.2 mm on average. CONCLUSIONS: In this retrospective study, laser-treated implants exhibit a low rate of bone absorption around the implants.

Influence of Implant Macro-Design, -Length, and -Diameter on Primary Implant Stability Depending on Different Bone Qualities Using Standard Drilling Protocols-An In Vitro Analysis.

(1) Background: Primary implant stability is vital for successful implant therapy. This study explores the influence of implant shape, length, and diameter on primary stability in different bone qualities. (2) Methods: Three implant systems (two parallel-walled and one tapered) with various lengths and diameters were inserted into polyurethane foam blocks of different densities (35, 25, 15, and 10 PCF) using standard drilling protocols. Primary stability was assessed through insertion torque (IT) and resonance frequency analysis (RFA). Optimal ranges were defined for IT (25 to 50 Ncm) and RFA (ISQ 60 to 80). A comparison of implant groups was conducted to determine adherence to the optimal ranges. (3) Results: Implant macro-design, -length, and -diameter and bone block density significantly influenced IT and RFA. Optimal IT was observed in 8/40 and 9/40 groups for the parallel-walled implants, while the tapered implant achieved optimal IT in 13/40 groups (within a 25-50 Ncm range). Implant diameter strongly impacted primary stability, with sufficient stability achieved in only one-third of cases despite the tapered implant's superiority. (4) Conclusions: The findings highlight the need to adapt the drilling protocol based on diverse bone qualities in clinical practice. Further investigations should explore the impact of these adapted protocols on implant outcomes.

Implant stability and marginal bone level changes: A 2-year prospective pilot study.

Background/purpose: Implant stability is crucial for successful osseointegration. Marginal bone level is considered an important indicator of long-term implant success and stability. The purposes of this study were to investigate 1) the effect of age, gender, bone density, implant length, and implant diameter on insertion torque (IT), primary implant stability quotient (ISQ), and secondary ISQ, 2) the impact of age, gender, bone density, implant length, implant diameter, IT, and ISQ on marginal bone loss (MBL). Materials and methods: Ninety patients who needed implant therapy were enrolled and overall 156 implants were installed to support single crowns. IT and ISQ were recorded for all implants during surgery and ISQ measurements were performed at follow-up visits. Age, gender, bone density, implant length and diameter were also registered. Radiographic evaluation of MBL was performed postoperative immediate (baseline), 3, 6, 9, 12, 18, and 24 months using digital periapical radiographs. Results: Age had little effect on IT and primary ISQ (P > 0.05). Generally, males had higher IT and primary ISQ, but no significant differences between genders were detected. Bone density showed significant effects on IT and primary ISQ. Correlation analysis revealed high positive correlations between IT/bone density and primary ISQ/implant diameter. Significant impacts of bone density and IT on MBL were found. Conclusion: Implant diameter had a more profound impact than length on IT/primary ISQ. Bone density played a considerable role in IT/primary ISQ determination. Bone density and IT had more impacts than primary ISQ on MBL.

A Comparative Assessment of Primary Implant Stability Using Osseodensification vs. Conventional Drilling Methods: A Systematic Review.

Osseodensification is a novel biomechanical bone preparation technique that has been established to replace conventional bone drilling and therefore will optimize the implant site. The purpose of this systematic review was to compare the implant stability obtained by osseodensification drilling to those associated with conventional drilling techniques. An electronic search was performed in the PubMed, Scopus, EMBASE, Cochrane Oral Health Group, and Dentistry and Oral Science Source databases searched through Elton B. Stephens Company (EBSCO) for potentially relevant publications in the English language from January 2013 to December 2022. Randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs), contrasting osseodensification drilling with conventional drilling, studies documenting implant stability quotient (ISQ), and studies reporting the immediate outcome and at least three months of follow-up after dental implant placement were included. Two independent investigators evaluated the quality of the reviewed studies to determine the risk of bias using the version 2 of Cochrane risk-of-bias (RoB) tool for RCTs (RoB 2) and RoB for NRSIs (ROBINS-I). Majority of the studies showed that bone density was significantly higher in the osseodensification group. The overall RoB for the NRSIs was reported to be low with respect to confounding, selection, classification, incomplete data, deviance from interventions, outcome evaluation, and selective reporting. The quality assessment of the RCT studies included in the review using the RoB 2 tool showed a high overall risk. The findings of the current review reveal that osseodensification drilling exhibited higher resonance frequency analysis (RFA) and ISQ values than conventional drilling protocols. Similarly, when osseodensification regions were contrasted with traditional drilling, bone density at the implant surface was augmented.