Effects of different loading protocols on the secondary stability and peri-implant bone density of the single implants in the posterior maxilla.

BACKGROUND: Immediate or early loading of dental implants becomes a clinically feasible concept. PURPOSE: The aim was to evaluate the effects of different loading protocols (immediate, early, and delayed) on secondary stability and peri-implant bone density of single implants in the posterior maxilla. MATERIALS AND METHODS: Thirty-nine implants (Dentium, South-Korea) were placed in 39 patients. After placement, implant stability values (ISQ) and baseline peri-implant bone density values derived from cone-beam computed tomography were recorded. Thirteen implants were included randomly in each loading groups. The secondary ISQ values were recorded during follow-up visits. Peri-implant bone density values were measured 1 year after placement again. Data was statistically analyzed. RESULTS: Immediate-loaded group showed the lowest ISQ values, 1 month after placement. During the next follow-up visits, delayed-loaded group showed the lowest ISQ values while other groups showed comparable results. Early loading increased the peri-implant bone density greater than the other groups. CONCLUSIONS: The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement. Density increment can be judged as the radiological findings of loaded-bone, which may also reduce the need for histomorphometric analysis of human biopsy to evaluate the bone reaction around the implants.

Does cone beam computed tomography-derived bone density give predictable data about stability changes of immediately loaded implants?: A 1-year resonance frequency follow-up study.

The aim of this clinical study was to evaluate whether preoperative bone density value derived from cone-beam computed tomography (CBCT) gives predictable data about primary and secondary stability characteristics of immediately loaded dental implants under different clinical variables. A total of 77 immediately loaded implants placed in 23 patients were included the study. Bone density values of the implant recipient sites were recorded using CBCT. The maximum insertion torque values (ITVs) of the implants were recorded using a digital torque meter during surgery. Resonance frequency measurements were taken using the Osstell Mentor at 4 time points; immediately after surgery (implant stability quotient [ISQ]0) and after 1 (ISQ1), 3 months (ISQ3), and 12 months (ISQ12) of loading. Data were analyzed statistically. The mean bone density and ITVs of all implants were 565 ± 81 and 36.8 ± 3.8 N · cm, respectively. The mean ISQ values were 73.6 ± 5.8 at baseline, 71.1 ± 6.5 after 1 month, 74.8 ± 5.6 after 3 months, and 76.6 ± 5.1 after 12 months of loading. Statistically significant differences were observed between ISQ0 and ISQ1 (P < 0.001), and ISQ0 and ISQ12 (P < 0.001), but not between ISQ0 and ISQ3 (P > 0.05). In regard to stability changes over time, statistically significant correlations were found between bone density values from CBCT and ISQ follow-up measurements, and between ITV and ISQ follow-up measurements in all examination periods. Thus, it is possible to predict primary and secondary stability characteristics of immediately loaded implants by using preoperative CBCT scan and perioperative ITV.

Evaluation of relationship between preoperative bone density values derived from cone beam computed tomography and implant stability parameters: a clinical study.

OBJECTIVES: The aim of this study was to explore the efficacy of bone density value derived from cone beam computed tomography (CBCT) by evaluating its correlation with implant stability parameters including insertion torque value (ITV) and radiofrequency analysis in relation to different clinical variables including location, gender, age, bone quality, and implant diameter. MATERIAL AND METHODS: A total of 65 implants were placed in 17 patients. The bone densities of implant recipient sites were preoperatively recorded using CBCT. Bone quality was subjectively assessed, which depends on the stiffness of the jawbone according to the Lekholm and Zarb index during drilling procedure. The maximum ITV of each implant was recorded using a digital torque meter during implant placement. Resonance frequency measurements were taken using an Osstell Mentor immediately after implant placement. Data were analyzed statistically. RESULTS: The mean bone density, insertion torque, and implant stability quotient values of all implants were 556 ± 80, 37.4 ± 3.3 Ncm, and 73.8 ± 7.2, respectively. Statistically significant correlations were found between bone density values from CBCT and implant stability parameters in relation to all variables. CONCLUSION: Bone density assessment using CBCT is an efficient method and significantly correlated with implant stability parameters and Lekholm and Zarb index. Thus, it is possible to predict initial implant stability and possibility of immediate or early loading using CBCT scans prior to implant placement.