Comparação da expansão óssea promovida pela técnica de osseodensificação com dois tipos de conjunto de fresas / Comparison of bone expansion promoted by the osseodensification technique with two types of drill sets

Introdução: A estabilidade primária é um importante indicador de sucesso da osseointegração. Porém, fatores locais com osso de baixa intensidade podem interferir negativamente na obtenção da estabilidade primária. Objetivo: O presente estudo avaliou o efeito de diferentes direções, velocidades de rotação e sistemas de fresagem na expansão de perfurações e estabilidade de implantes instalados em blocos mimetizando osso do tipo IV. Material e método: Foram instalados 50 implantes em blocos de poliuretano sólido rígido. Esses implantes foram igualmente divididos em cinco grupos (n = 10): 1) Fresa Maximus (utilizadas no sentido horário a 1200rpm); 2) Fresa Maximus (utilizadas no sentido horário a 600rpm); 3) Fresa Neodent (utilizadas no sentido horário a 800rpm); 4) Fresa Neodent (utilizadas no sentido anti-horário a 800rpm); 5) Fresa Neodent (utilizadas no sentido anti-horário a 600rpm). Foram executadas análises de estabilidade dos implantes através de testes de torque de inserção e remoção, além das análises de frequência de ressonância. Adicionalmente, a expansão associada às perfurações promovida pelas brocas foi avaliada por meio de análises tomográficas. Resultado: Verificou-se que os implantes instalados após o preparo da perfuração com as brocas Maximus a 600rpm apresentaram valores de torque de inserção maiores, quando comparados ao grupo de implantes instalados em perfurações confeccionadas com brocas Neodent. Ademais, as brocas Maximus apresentaram valores de expansão maiores que as brocas Neodent. Conclusão: As brocas Maximus são mais eficientes em promover a osseodensificação, e sua utilização está associada ao aumento da estabilidade dos implantes instalados em blocos mimetizando osso do tipo IV.

Introduction: Primary stability is an important indicator to obtain a successful osseointegration. However, local factors like bone with low density can negatively interfere in obtaining primary stability. Objective: This study assessed the effect of different drilling systems, speeds, and movement directions on the expansion of perforations and the stability of implants placed in blocks that mimicked type IV bone. Material and method: Fifty implants were installed in rigid solid polyurethane blocks and equally divided into the following five groups (n = 10): 1) Maximus Driller (on a clockwise direction at 1200rpm); 2) Maximus Driller (on a clockwise direction at 600rpm); 3) Neodent Driller (on a clockwise direction at 800rpm); 4) Neodent Driller (on a counter clockwise direction at 800rpm); 5) Neodent Driller (on a counter clockwise direction at 600rpm). The stability analyses of the implants were performed through insertion and removal torque testing, in addition to resonance frequency analysis. Additionally, the expansion promoted by the drills associated with the perforations was assessed through tomographic analysis. Result: We found that implants placed after drilling preparation with Maximus drills at 600 rpm had higher values of insertion torque than the group of implants installed in drillings made with Neodent drills. In addition, the maximus drills showed higher expansion values than the Neodent drills. Conclusion Maximus drills are more efficient in promoting osseodensification and their use was associated with increased stability of implants installed in blocks that mimicked type IV bone.

The significance and parameter standards of the implant primary stability / 口腔疾病防治

@#The nature, significance, parameters, influencing factors and testing of implant primary stability were studied by a literature review. Primary stability is a kind of anchorage force at the interface between the implant and bone, and it is merely mechanical. The significance of primary stability is to keep the implant unmovable so that the new bone can grow undisturbed on the surface of the implant without interference from fibrous tissue. The implant is finally bound to the bone by osseointegration. The most common assessments of primary stability are insertion torque (IT), the implant stability quotient (ISQ) of the resonance frequency analysis (RFA) and Periotest. IT is more commonly used to directly imply initial stability. At present, no consensus has been reached regarding the concrete parameters of primary stability to predict osseointegration. Implant osseointegration could be developed through all phases of primary stability. However, the excessive primary stability would cause mini-bone fractures, followed by bone necrosis at the interface and the final failure of implantation. Primary stability is influenced by three factors: implant design, bone condition of alveolar bone, and surgical technique. Under the condition of a lack of primary stability and immediate implantation, there may be the possibility of successful osseointegration. Therefore, it is necessary to re-examine the accuracy of the current elaboration on the primary stability. It is related directly to whether the clinic can choose the appropriate implant treatment path.

Estabilidad primaria en implantes inmediatos versus implantes colocados en hueso maduro: un estudio clínico retrospectivo / Primary stability in immediate implants versus implants placed in mature bone: a retrospective clinical study

La estabilidad primaria es un requisito importante para la supervivencia y éxito de los implantes durante la osteointegración. En los últimos años, los implantes inmediatos postextracción han demostrado ser una opción de tratamiento exitosa y predecible para la reposición de dientes con mal pronóstico, pero surge la duda de si dichos implantes alcanzan valores de estabilidad primaria comparables a aquellos colocados en hueso maduro. Comparar la estabilidad primaria de implantes inmediatos colocados en alveolos postextracción con la de implantes colocados en hueso maduro. Se llevó a cabo un estudio clínico retrospectivo, con los datos recogidos sobre 175 implantes, colocados en 175 pacientes. Todos los implantes colocados pertenecían al modelo Essential Cone (Klockner Implant System) y se dividieron en dos grupos: implantes inmediatos (Grupo A, n=31) e implantes colocados en hueso maduro (Grupo B, n=144). La estabilidad primaria de todos los implantes se midió mediante torque de inserción y análisis de frecuencia de resonancia con Osstell ISQ. No se encontraron diferencias estadísticamente significativas respecto a la estabilidad medida a través del torque de inserción (26,29+10,07 Vs 25,76+9,72 N/cm) pero sí que se encontraron diferencias significativas en la medida de la estabilidad primaria mediante AFR, siendo inferiores los valores correspondientes a los implantes colocados en los alveolos post exodoncia (60,74 ± 6,17 en sentido VL y 62,19 ± 7.64 en sentido MD frente a 68,34 ± 6.26 en sentido VL y 69,29 ± 7.98 en sentido MD obtenidos en los implantes colocados en hueso maduro). El torque de inserción de los implantes inmediatos es similar al de los implantes colocados en hueso maduro, pero sus valores ISQ son significativamente inferiores, lo que demuestra un mayor grado de micromovimiento, y por consiguiente, un mayor riesgo de fracaso durante el período de osteointegración.

Primary stability is an important requirement for the survival and success of implants during osseointegration. In recent years, immediate post-extraction implants have proven to be a successful and predictable treatment option for the replacement of teeth with a poor prognosis, but the question arises as to whether these implants reach primary stability values comparable to those placed in mature bone. The objective of the study was to compare the primary stability of immediate implants placed in post-extraction alveoli with that of implants placed in mature bone. A retrospective clinical study was carried out, with data collected on 175 implants, placed in 175 patients. All implants placed belonged to the Essential Cone model (Klockner Implant System) and were divided into two groups: immediate implants (Group A, n = 31) and implants placed in mature bone (Group B, n = 144). The primary stability of all implants was measured by insertion torque and resonance frequency analysis with Osstell ISQ. No statistically significant differences were found regarding the stability measured through the insertion torque (26.29 + 10.07 Vs 25.76 + 9.72 N / cm) but significant differences were found in the measurement of primary stability by means of AFR, the values corresponding to implants placed in the post-exodontic alveoli being lower (60.74 ± 6.17 in the VL direction and 62.19 ± 7.64 in the MD direction versus 68.34 ± 6.26 in the VL direction and 69.29 ± 7.98 in the MD direction obtained in implants placed in mature bone). The insertion torque of immediate implants is similar to that of implants placed in mature bone, but their ISQ values are significantly lower, which demonstrates a higher degree of micromotion, and therefore, a greater risk of failure during the period of osseointegration.

Comparison of implant stability measurements between a resonance frequency analysis device and a modified damping capacity analysis device: an in vitro study

PURPOSE: A stability-measuring device that utilizes damping capacity analysis (DCA) has recently been introduced in the field of dental implantology. This study aimed to evaluate the sensitivity and reliability of this device by measuring the implant stability of ex vivo samples in comparison with a resonance frequency analysis (RFA) device.METHODS: Six implant beds were prepared in porcine ribs using 3 different drilling protocols to simulate various implant stability conditions. Thirty-six pork ribs and 216 bone-level implants measuring 10 mm in height were used. The implant beds were prepared using 1 of the following 3 drilling protocols: 10-mm drilling depth with a 3.5-mm-diameter twist drill, 5-mm drilling depth with a 4.0-mm-diameter twist drill, and 10-mm drilling depth with a 4.0-mm-diameter twist drill. The first 108 implants were external-connection implants 4.0 mm in diameter, while the other 108 implants were internal-connection implants 4.3 mm in diameter. The peak insertion torque (PIT) during implant placement, the stability values obtained with DCA and RFA devices after implant placement, and the peak removal torque (PRT) during implant removal were measured.RESULTS: The intraclass correlation coefficients (ICCs) of the implant stability quotient (ISQ) results obtained using the RFA device at the medial, distal, ventral, and dorsal points were 0.997, 0.994, 0.994, and 0.998, respectively. The ICCs of the implant stability test (IST) results obtained using the DCA device at the corresponding locations were 0.972, 0.975, 0.974, and 0.976, respectively. Logarithmic relationships between PIT and IST, PIT and ISQ, PRT and IST, and PRT and ISQ were observed. The mean absolute difference between the ISQ and IST values on a Bland-Altman plot was −6.76 (−25.05 to 11.53, P<0.05).CONCLUSIONS: Within the limits of ex vivo studies, measurements made using the RFA and DCA devices were found to be correlated under a variety of stability conditions.

Comparative evaluation of implant stability in two different implant systems at baseline and 3–4 months intervals using RFA device (OSSTELL ISQ)

Introduction: Osseointegration as formulated by Alberktson is crucial for implant survival and success. Osseointegration is a measure of implant stability. Measuring implant stability helps to arrive at decisions as to loading of an implant, allows protocol choice on a patient to patient basis and provides enhanced case documentation. The RFA technique provides with clinically relevant information about the state of the implant–bone interface at any stage after implant placement. Aim: Evaluation of primary and secondary stability between implants of two different systems by resonance frequency analysis device. Methodology: This study was conducted among 17 patients divided into two groups. Group 1 (n = 10) receiving 20 MIS seven implants and Group 2 (n = 7) received 20 Alphadent active implants. The primary implant stability was measured at the time of implant placement and secondary stability is measured at 3–4 months interval using RFA device OSSTELL ISQ. Statistical analysis was performed using paired t test for intra group and independent sample test for intergroup comparisons. Results: No statistically significant differences in primary and secondary stabilities were found between the implant systems at either time intervals (P > 0.05). A positive correlation was noticed between mesiodistal stability and implant diameter in MIS seven group (P < 0.05). A positive correlation was noticed between mesiodistal, labiolingual stabilities and implant diameter in Alphadent group (P = 0.03). A positive correlation was noticed between mesiodistal, labiolingual stabilities and implant length in Alphadent group (P = 0.03). Conclusion: From the present data, it can be concluded that within the limitations of study, implant systems used and their design features showed no significant correlation to implant stability between the groups. More studies are required to assess the effect of implant designs and surface conditions on implant stability on a long-term basis.

Protocolo Clínico para Control de Prótesis Fija Total con Carga Inmediata / Clinical Protocol for Control of an Immediately Loaded Implant-Supported Prosthesis

RESUMEN: Los protocolos odontológicos de controles son guías que tienen por objetivo optimizar la calidad de atención y estandarizar ciertos procedimientos para poder establecer mejores pronósticos. Varias complicaciones se pueden presentar posterior a la instalación de una prótesis fija total con carga inmediata (PFTC), desde el daño de la estructura protésica provisoria hasta la pérdida de la oseointegración de los implantes dentales. La escasa evidencia sobre el comportamiento clínico que se debe tener posterior a este tipo de tratamiento indica la necesidad de confección de un protocolo para poder mejorar las tasas de éxito. Para confeccionar el protocolo clínico se realizó una revisión sistemática de la literatura en la base de datos PubMed. Los filtros de búsqueda fueron ajustados de la siguiente manera. Se utilizaron los términos de búsqueda "immediate loading" AND "full arch" AND "Resonance frequency analysis". Los que fueron sometidos a los criterios de inclusión y exclusión, dando como resultado un total de 15 estudios. Todos los estudios seleccionados son ensayos clínicos controlados donde se encontraron complicaciones como fracturas, desalojos y desgaste de la estructura protésica, entre otros. En los resultados encontrados no existe evidencia sobre el número y rango de sesiones necesarias para el control clínico de una PFTCI. El momento más indicado para la extracción de la prótesis provisoria e instalación de la prótesis definitiva es durante el 3° y 4° mes posterior a la carga inmediata. Existe escasa evidencia sobre el número, momento y tipo de examen imageneológico a solicitar. Por lo que este protocolo clínico será una guía para los controles que se realicen posterior a una instalación de una PFTCI.

ABSTRACT: Dental protocols are guidelines used to optimize service quality and to standardize procedures to establish a better prognosis. There are many complications that can occur after installation of a an immediately loaded implant-supported prosthesis for rehabilitation. These may generate damage to the provisional structure and even loss of osseointegration from the dental implants. Limited evidence on the clinical approach required to monitor these procedures, makes it necessary to establish clinical protocols for treatment control, and increases the success rate. In order to develop such protocols a systematic research was carried out in the Pubmed database. The filters used were "immediate loading", "full arch" and "Resonance frequency analysis". The results were subject to the inclusion and exclusion criteria. A total of 15 studies were selected. All of the studies were randomized clinical trials. An important number of complications were recorded, such as fractures, dislodgment and wear of the prosthesis structure. There is no evidence about the number and range of sessions needed to assess the clinical control of an immediate loading fixed rehabilitation. The best time to remove the provisional prosthesis and install the restorative rehabilitation is during the third and fourth month following immediate loading. Limited evidence was found regarding the number, time and type of radiological images requested for clinical support. Therefore, the clinical protocol developed by the authors will be a guide for future controls related to an immediately loaded implant-supported prosthesis.

Control Clínico en Pacientes Rehabilitados Mediante Prótesis Fija Total con carga Inmediata. Revisión de la Literatura / Clinical Control of Patients Treated with an Immediately Loaded Implant-Supported Prosthesis. A Systematic Review

RESUMEN: Son varias las complicaciones que se pueden presentar posterior a la instalación de una prótesis fija total con carga inmediata (PFTCI), estas pudiesen generar desde el daño de la estructura protésica provisoria hasta la pérdida de la oseointegración de los implantes dentales. La escasa evidencia sobre el comportamiento clínico que se debe tener posterior a este tipo de tratamiento indica la necesidad de controlar mejor estas complicaciones. En esta revisión narrativa, el 3 de marzo de 2016 se realizó una búsqueda electrónica en la base de datos PubMed. Para poder efectuar una investigación acabada los filtros de búsqueda fueron ajustados de la siguiente manera. Se utilizaron los términos de búsqueda "immediate loading" AND "full arch" AND "Resonance frequency analysis". Los que fueron sometidos a los criterios de inclusión y exclusión, dando como resultado un total de 15 estudios. Todos los estudios eran ensayos clínicos controlados, donde se encontraron complicaciones como fracturas, desalojos y desgaste de la estructura protésica, entre otros. Se pudo observar que desde el día de la carga hasta un mes después el valor ISQ (cociente de estabilidad del implante) disminuye, para luego aumentar paulatina y progresivamente. En conclusión, no existe evidencia sobre el número y rango de sesiones necesarias para el control clínico de una PFTCI. El momento más indicado para la extracción de la prótesis provisoria e instalación de la prótesis definitiva es durante el 3° y 4° mes posterior a la carga inmediata. Existe escasa evidencia sobre el número, momento y tipo de examen imageneológico a solicitar. La presencia de complicaciones protésicas posterior a una PFTCI hace necesaria la confección de un protocolo de control clínico para este tipo de tratamiento.

ABSTRACT: There are many complications that can occur following placement with an immediately loaded implant-supported prosthesis in rehabilitation, these may generate damage to the provisional structure and even loss of the osseointegration from the dental implants. Limited evidence about clinical behavior post-installation, creates the need to better assess possible future complications that may arise. In this review, a systematic research was made in the PubMed database. The filters used were "immediate loading", "full arch" and "Resonance frequency analysis". The results were subject to the inclusion and exclusion criteria. A total of 15 studies were selected. All of the studies were randomized clinical trials, many complications were recorded, such as fractures, dislodgement and wear of the prosthesis structure. It was observed that from the first day of immediate loading until the first month, Implant Stability Quotient value decreases, subsequently, progressively increasing. There is no evidence about the number and range of sessions needed to assess the clinical control of a immediate loading fixed rehabilitation. The ideal time for removal of the provisional prosthesis and installation of the restorative rehabilitation, is during the third and fourth month after the immediate loading. Limited evidence was found regarding the number, the time and type of radiological images for clinical support. The possibility of several complications after an installation of a immediately loaded implant-supported prosthesis are very real, therefore is necessary to establish a clinical protocol for controls regarding this treatment.

Relationship between cortical bone thickness and implant stability at the time of surgery and secondary stability after osseointegration measured using resonance frequency analysis

PURPOSE: It has been suggested that resonance frequency analysis (RFA) can measure changes in the stability of dental implants during osseointegration. This retrospective study aimed to evaluate dental implant stability at the time of surgery (primary stability; PS) and secondary stability (SS) after ossseointegration using RFA, and to investigate the relationship between implant stability and cortical bone thickness. METHODS: In total, 113 patients who attended the Tohoku University Hospital Dental Implant Center were included in this study. A total of 229 implants were placed in either the mandibular region (n = 118) or the maxilla region (n = 111), with bone augmentation procedures used in some cases. RFA was performed in 3 directions, and the lowest value was recorded. The preoperative thickness of cortical bone at the site of implant insertion was measured digitally using computed tomography, excluding cases of bone grafts and immediate implant placements. RESULTS: The mean implant stability quotient (ISQ) was 69.34±9.43 for PS and 75.99±6.23 for SS. The mandibular group had significantly higher mean ISQ values than the maxillary group for both PS and SS (P < 0.01). A significant difference was found in the mean ISQ values for PS between 1-stage and 2-stage surgery (P < 0.5). The mean ISQ values in the non-augmentation group were higher than in the augmentation group for both PS and SS (P < 0.01). A weak positive correlation was observed between cortical bone thickness and implant stability for both PS and SS in all cases (P < 0.01). CONCLUSIONS: Based on the present study, the ISQ may be affected by implant position site, the use of a bone graft, and cortical bone thickness before implant therapy.

Evaluation of the stability of sandblasted, large-grit, acid-etched implants with tapered straight body design

PURPOSE: Implant surface modification and implant design are the principle targets for achieving successful primary stability. The aim of this study was to measure implant stability quotient (ISQ) values of sandblasted, large-grit, acid-etched (SLA) implants with tapered straight body design during the healing period, and to determine the various factors affecting implant stability. MATERIALS AND METHODS: To measure implant stability, resonance frequency analysis (RFA) was performed in 26 patients (13 women and 13 men) with 44 SLA implants with tapered straight body design. Implant stability (ISQ values) was evaluated at baseline and healing abutment connection (12 weeks), and the correlations between RFA and insertion torque (IT), bone quality, and jawbone were determined. RESULTS: The mean ISQ value of the implants was 69.4 ± 10.2 at the time of implant placement (baseline) and 81.4 ± 6.9 at the time of healing abutment connection (P 0.05). CONCLUSION: ISQ values of SLA implants with tapered straight body design were high at baseline and healing abutment connection. It was concluded that SLA implants with tapered straight body design show improved primary and secondary stability, and that immediate or early loading may be applicable.

A 3 year prospective study of survival rate of narrow diameter implants

PURPOSE: The purpose of present study was to retrospectively analyze the survival rate of narrow diameter implant less than 3.6 mm by initial stability and radiographic measurements. MATERIALS AND METHODS: In total, 24 patients who received 38 narrow diameter implants (≤ 3.6 mm in diameter, ≥ 7 mm in length) were enrolled in this retrospective study. The cumulative survival rate was calculated and various factors were investigated according to the implant platform diameter, body diameter, length, position, concomitant use of guided bone regeneration in implant placement and final prosthesis type. Initial stability was investigated with implant stability quotient (ISQ) value. The mesial and distal marginal bone level (MBL) change was calculated with radiography. RESULTS: The overall survival rate was 92.11%. Mean ISQ value and MBL change of survival implants was 66.26 and 0.14 ± 0.31 mm, respectively. None of the implants with platform diameters larger than the body diameter failed. CONCLUSION: In conclusion, the findings of present study suggest that narrow diameter implant could be predictable treatment in narrow alveolar ridge.

Stability and bone loss around submerged and non-submerged implants in diabetic and non-diabetic patients: a 7-year follow-up

Abstract To evaluate peri-implant bone loss (PIBL) and stability around submerged and non-submerged dental implants in patients with and without type 2 diabetes mellitus (T2DM). Thirty-five T2DM and non-diabetic (NT2DM) patients were included in this study. Demographic data were recorded using a questionnaire and PIBL was measured on digital radiographs. Resonance frequency analysis (RFA) was carried out for each implant at the time of fixture placement and at 3 months in both groups. P values less than 0.05 were considered statistically significant. One hundred and eighteen dental implants with a mean height of 10 to 12 mm and 3.3 to 4.1 mm in diameter were placed. The comparison of the mean RFA values at baseline and at 3 months was statistically significant (p = 0.008) in T2DM patients. The inter-group mean RFA values at baseline and at 3 months were not significant (p > 0.05). PIBL was significantly high in T2DM as compared to NT2DM patients at each follow-up (p < 0.05). At 2, 3, and 7 years, non-submerged dental implants showed significantly high PIBL in T2DM patients as compared to NT2DM individuals (p<0.05). The results of the present clinical study demonstrate increased PIBL around non-submerged single-tooth implant-supported restorations in T2DM patients, which may be due to the immune inflammatory status.

Evaluation of Dental Implants Stability in Patients with Lipid Metabolism Disorder / 中国医科大学学报

Objective To study the expression of inflammatory factors in the saliva and the stability of implants after implant denture repair in pa-tients with dysplasia of the dentition defect ,and to analyze the prognosis of patients with lipid metabolic disorder. Methods The dentition defect patients with lipid metabolism disorder were selected as the experimental group. Patients with lipid defect were selected as the control group. Saliva was collected before implantation,1 month and 3 months after implantation. ELISA method was used to detect IL-6,IL-1βand TNF-α. Osstell ISQTM radio frequency analyzer was used to detect the stability of the implants and the periodontal status was detected by Florida probe. Re-sults There were no significant differences in the depth of implant probing(PD),bleeding index(BI)and ISQ between the two groups by radio frequency analyzer(all P>0.05). The levels of IL-6,IL-1βand TNF-αin the pre-implantation,1 month and 3 months after implantation were sig-nificantly higher than those in the control group(all P0.05). Conclusion The patients with dyslipidemia after implantation have good implant stability as those with normal blood lipid ,and the patients with dyslipidemia can also obtain good prognosis.

Evaluación y comparación de la estabilidad de implantes dentales en el maxilar y la mandíbula en tres tiempos distintos, mediante análisis de frecuencia de resonancia / Comparison of dental implants stability in maxilla and mandible at three different times using resonance frequency analysis

El propósito de este estudio fue medir y comparar la estabilidad de implantes dentales en maxilar y mandíbula en tres tiempos distintos, mediante análisis de resonancia de frecuencia (RFA). Mediante un diseño no experimental prospectivo, fueron evaluados 103 Implantes 3i Osseotite en 57 pacientes (50 en el maxilar y 53 en mandíbula). Mediante un dispositivo electrónico (Osstell-Mentor®) se registró el coeficiente de estabilidad para cada implante (ISQ) al momento de la cirugía de implantes, a las 6 semanas y a las 8 semanas siguientes. Respecto al maxilar, las medianas aumentan progresivamente después de la cirugía de implantes. En la mandíbula, parecen ser similares entre la primera y la tercera medición, pero decrecen en la segunda. Independiente tanto para el maxilar como para la mandíbula, los valores de las medianas fueron altamente significativas, lo cual indica que estas difieren en los tres tiempos estudiados (p<0,001). Se encontró diferencia significativa entre las medianas del maxilar y la mandíbula solamente al momento de la colocación de implantes. En los demás tiempos evaluados, no se observaron diferencias significativas (p>0,05). En el maxilar, la estabilidad de los implantes aumenta con el tiempo. En la mandíbula, disminuye en la sexta semana y aumenta en las 8 siguientes, alcanzando valores similares a los iniciales. La estabilidad de los implantes es mayor en la mandíbula que en el maxilar, solo al momento de la cirugía. A las 8 semanas, la estabilidad alcanzada por los implantes en el maxilar y la mandíbula son similares.

The aim of this study was to test and compare dental implant stability placed in the maxilla and the mandible during three time periods, by resonance frequency analysis (RFA). Using a non experimental prospective study we evaluated 103 3i Biomet Osseotite Implants in 90 patients (50 in maxilla and 53 in mandible). An electronic RFA device (Osstell Mentor®) was used to record the Implant Stability Quotient (ISQ values) at implant surgery, at six weeks and at eight weeks. Concerning the maxilla, median values increase continuously after implant placement. In the mandible, median values seem to be similar in mandibular at the first and the third evaluation time, but decrease in the second one. Separately for both maxilla and mandible, the median values were highly significant, indicating that these differ in the three time periods studied (p<0.001). Significant difference between the median of the maxilla and mandible was found only at the time of implant placement. At 6 and 8 weeks, no significant differences were observed (p>0.05). In the maxilla, the initial stability of implants is increased in time. In the mandible, initial stability decreases at 6 weeks but increases again at 8 weeks, reaching values similar to the initial. The implant stability was higher in mandible than maxilla only at implant placement. At 8 weeks the stability achieved by the implants in the maxilla and mandible was similar.

Evaluación de torque de remoción en implantes dentales 3i, B&W y tree-oss. estudio experimentalen conejos / Evaluation of removal torque in 3i, B&W and tree-oss dental implants. an experimental study in rabbits

Objetivo: evaluar el torque de remoción de tres implantes con superficies diferentes, a los 60 días de inserción. Materiales y métodos: se midió la frecuencia de resonancia inicial y final y torque de remoción a los 60 días en 18 implantes: Biomet 3i (Palm Beach Gardens, FL, Estados Unidos); n=6; B&W (Buenos Aires, Argentina), n=6; Tree-Oss (Buenos Aires, Argentina), n=6; todos de 8,5 mm de longitud y 4 mm de diámetro. Los datos fueron sometidos al test no paramétrico de Mann-Whitney, al de Kruskal-Wallis y al de Wilcoxon. Resultados: la media de torque de remoción fue de 82,58 Ncm para implantes Biomet 3i; de 78,08 Ncm para B6W; y de 69 Ncm para Tree-Oss, sin diferencias estadísticamente significativas (p=0,220). La media de ISQ inicial y final fue de 57, 17 y 70,33 para Biomet 3i; de 56,33 y 62,07 para B6W y de 58,17 y 54,5 para Tree-Oss. Conclusión: los tres grupos de implantes presentan valores de torque de remoción similares, sin diferencias estadísticamente significativas pero con diferencias significativas en relación a ISQ final.

Aim: to evaluate the removal torque of three implants with different surfaces placed in rabbit femur, 60 days afterinsertion and to compare the implant stability quotient rightafter insertion and 60 days later.Materials and methods: Initial and final resonance frequency analysis and removal torque were measured at day60, in 18 parallel wall implants: Biomet 3i (Palm Beach Gardens, FL, USA), n=6; B&W (Buenos Aires, Argentina), n=6; Tree-Oss (Buenos Aires, Argentina), n=6; of 8.5 mm in lengthand 4 mm in diameter, placed in the femur of 6 rabbits. Datacollected were analyzed by nonparametric Mann-Whitney, Kruskal-Wallis and Wilcoxon tests. Results: The mean removal torques were 82,58 Ncm forBiomet 3i, 78,08 Ncm for B&W and 69 Ncm for Tree-Oss. Differences were not statistically significant (p=0.220). Inassessing initial and final ISQ, the averages obtained for Biomet3i were 57.17 and 70.33, respectively; for B&W 56.33 and62.67, and 58.17 and 54.5 for Tree-Oss. Conclusion: It is concluded that the three groups presented similar removal torque values with no statistically significant differences between them, but there were significant differences in relation to final ISQ.

Assessment of Implant Stability: Methods and Recent Advances.

Achieving primary stability is of greatest importance, at the time of implant placement. A rigid fixation of implant within the host bone, in absence of micromotion is the most critical factor for successful osseointegration. Over the years, several authors have reported various methods in literature to monitor implant stability, which include, tapping the abutment with a metallic instrument, histomorphometry test, removal torque test, cutting torque test, radiography, periotest, and resonance frequency analysis. Resonance frequency analysis (RFA) offers a clinical, objective way to measure stability and presumed osseointegration of implants. The review focuses on different methods used to assess implant stability and recent advances in this field.

Accuracy of resonance frequency analysis by third generation Osstell® / Precisión del análisis de frecuencia de resonancia mediante Osstell® de tercera generación

The Resonance Frequency Analysis by Osstell® is used in the assessment of primary and secondary implant stability. The aim of this study was to determine its accuracy as a method of testing, checking its repeatability and reproducibility. A pilot study was performed whereby implants were placed in a cow rib to compare several ISQ measurements with the same SmartPeg transducer (repeatability), or with different SmartPegs (reproducibility). Statistical analysis of the data showed a high correlation of the ISQ values obtained in both assays, which suggests that Osstell®analysis can provide high repeatability and reproducibility.

El análisis de frecuencia de resonancia (AFR) por Osstell® se utiliza en la evaluación de la estabilidad primaria y secundaria del implante. El objetivo del presente estudio fue establecer la precisión del AFR mediante Osstell©, como método de prueba empleado en la determinación de la estabilidad implantaria. Se realizó un estudio experimental in vitro, en el que se colocaron implantes en una costilla de vaca y compararon diferentes mediciones del coeficiente de estabilidad del implante (ISQ) obtenidas sobre estos implantes con un mismo transductor SmartPeg (repetibilidad) o con diferentes SmartPegs (reproductibilidad). El análisis estadístico de los datos mostró una elevada correlación de los ISQ obtenidos en ambos ensayos, lo cual sugiere una reproductibilidad y repetibilidad elevada del análisis mediante Osstell.

Determination of bone metabolic marker levels in perio-implant crevicular fluid and analysis of dental implants stability by resonance frequency in the early stage of healing / 北京大学学报(医学版)

Objective: To investigate the changes of osteoprotegerin ( OPG) and receptor activator of nuclear factor kappa B ligand ( RANKL) level in perio-implant crevicular fluid ( PICF) and to monitor the development of the stability of Straumann ? tissue-level implants by resonance frequency analysis ( RFA) during the early phases of healing .Methods: A total of 35 implants ( length 10 mm ) were placed.PICF samples were collected with filter paper strips at baseline , 1, 2, 3, 4, 6, 8, and 12 weeks post-surgery, respectively.The OPG, RANKL levels were determined by ELISA method .At the same time points, the implant stability quotient (ISQ) values were determined with Osstell TM mentor.Results:During healing , PICF-OPG levels increased significantly 2 weeks after surgery when compared with the 4th-, 6th-, 8th-and 12th-week reevaluation (P<0.05).The OPG/RANKL ratio in PICF was significantly higher ( P<0 .05 ) than that in gingival crevicular fluid at 1 week post-surgery .ISQ slightly fluctuated within the first 4 weeks after installation .Following this, the ISQ values increased steadily for all the implants and up to 12 weeks.Significant differences were noted between the mean ISQ values at the 12th-week and other observation time points .Conclusion: The PICF-OPG levels may be effective in monito-ring the process of osseointegration .All the ISQ values indicated the stability of Straumann ? implants over a 12-week healing period .RFA is a reliable and effective assistant to monitor implant stability .

Influence of insertion torque on primary stability of dental implants in beagle / 实用医学杂志

Objective To investigate the correlation between the insertion torque values and primary stability of dental implants using different insertion torque values ,and search for the best insertion torque values that can acquire good primary stability. Methods Six male pure beagles were selected, and the first molars and four premolars of bilateral mandibulars were extracted. Three months later, a total of 48 XIVE dental implants were inserted. All implants were divided into group A, group B, group C, and group D based on the insertion torque value (ITV): group A, 0 0.05). Conclusion With the limitations of the study, it was concluded the primary stability does not simply depend on the insertion torque;When the insertion torque value was no less than 20Ncm, the dental implant can acquire good primary stability.

In vitro evaluation of resonance frequency analysis values to different implant contact ratio and stiffness of surrounding material

PURPOSE: The present study was aimed to evaluate the influence of implant contact ratio and stiffness of implant-surrounding materials on the resonance frequency analysis (RFA) values. MATERIALS AND METHODS: Seventy resin blocks that had the different amounts (100, 50, 30, 15%) of resin-implant contact (RIC) were fabricated. Ten silicone putty blocks with 100% silicone-implant contact were also made. The implants with O5.0 mm x 13.0 mm were placed on eighty specimen blocks. The RFA value was measured on the transducer that was connected to each implant by Osstell Mentor. Kruskal-Wallis and Scheffe's tests (alpha=.05) were done for statistical analysis. RESULTS: The control resin group with 100% RIC had the highest RFA value of 83.9, which was significantly different only from the resin group with 15% RIC among the resin groups. The silicone putty group with 100% contact had the lowest RFA value of 36.6 and showed statistically significant differences from the resin groups. CONCLUSION: Within the limitations of this in vitro study, there was no significant difference in the RFA values among the resin groups with different RIC's except when the RIC difference was more than 85%. A significant increase in the RFA value was observed related to the increase in stiffness of material around implant.