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.

Role of Anteromedial Cortical Support for Unstable Intertrochanteric Fractures Being Treated With Cephalomedullary Nails.

INTRODUCTION: Reduction quality is of paramount importance for an optimal outcome in unstable pertrochanteric fractures. The non-anatomical functional anteromedial buttress is proposed to prevent impending mechanical complications. We aimed to evaluate the role of anteromedial cortical support in preventing mechanical complications following fixation with the cephalomedullary nail. MATERIALS AND METHODS: A prospective, single-arm interventional study was conducted in the Orthopaedics Department of a Combined Military Hospital (CMH) in Rawalpindi. The duration of the study was 24 months. Patients were recruited by the purposive sampling technique as per inclusion/exclusion criteria. Preoperatively, the reduction was categorized as per Baumgartner's and Chang's criteria. Post-operatively, weight bearing as tolerated was advised. Radiographs prior to discharge for loss of reduction were evaluated. Follow-up radiographic measurements of neck length, neck shaft angle, and their loss as per protocol were done at three and six months. RESULTS: A total of 202 patients were operated on from October 21 until August 23. Mortality at six months in 39 patients (19.3%) and loss to follow-up in 31 patients (15.3%) resulted in 132 patients with complete follow-up and having developed complications in 12 patients (9.09%). The mean age was 76.3 ± 7.98 years; males were 105 (79.5%), and females were 27 (20.5%). Closed reduction was 58 (43.9%), and additional manoeuvres were required in 74 (56.1%). The mean tip apex distance (TAD) was 24.56 ± 2.76, and the Calcar gap was 5.16 ± 1.27. Cleveland zone centre-centre in 54 (40.9%), inferior-centre in 65 (49.2%), and inferior-posterior (9.9%) were statistically significant for mechanical complications (p≤0.001). There was a significant association between the grading of Chang's and Baumgartner's poor groups for the development of mechanical complications (p≤0.001). The mean time to full weight bearing without support was 21 ± 1.22 weeks. The mean Hip Harris score at six months was 69.27 ± 7.68. CONCLUSION: Results suggest that anteromedial cortical support can lead to fewer potential mechanical complications at six months. A higher Chang's grade drives surgeons to engage in additional manoeuvres. Anteromedial cortical support is worth consideration for unstable pertrochanteric fractures.

Comparative evaluation of implant stability and crestal bone level between tapered and cylindrical implants in the posterior regions of the mandible: A prospective, randomized, split-mouth clinical trial.

Purpose: To compare the clinical outcome of tapered and cylindrical implants placed in the posterior region of mandible by measuring implant stability and crestal bone level at the healing period. Materials and Methods: A prospective clinical study was conducted on 15 patients who were included in the study based on the inclusion and exclusion criteria. A total of 30 dental implants were placed in both groups: 15 implants in Group I (tapered implants) and 15 implants in Group II (cylindrical implants) in the posterior region of mandible. Implant stability assessment by periotest was done at the time of implant placement (baseline) and after 3 months. The crestal bone level was measured with the help of radiovisiography (RVG) at the time of implant placement (baseline) and at 3 and 6 months. Results: At baseline, there was statistically significant (P < 0.01) difference in primary implant stability. Tapered implants had higher primary implant stability than cylindrical implants. However, at 3 months, there was no statistically significant (P > 0.05) difference in the secondary implant stability of both the groups. Also, the crestal bone level on the mesial and distal sides of dental implant for tapered and cylindrical implants was statistically nonsignificant (P > 0.05) at all time intervals, that is, at baseline and at 3 and 6 months. Conclusion: Tapered implants had higher primary stability than cylindrical implants, and no difference was found in secondary stability. The crestal bone level was similar for both groups during early healing and early post-loading periods.

Development and validation of an algorithm to determine the minimal factors needed for non-invasive measurement of the in vivo primary stability of cementless hip implants.

Aseptic loosening is a frequent cause for revision of endoprosthesis. X-ray examinations like Radio-Stereometry-Analysis (RSA) are among the most widely used in vivo methods for its detection. Nevertheless, this method is not used routinely because of bone marker and related radiation exposure. This work aims at creating a new in vivo concept to detect implant stability measuring micromotions without x-ray and to develop a corresponding algorithm. Based on the assumption of contactless measurement, the input parameters for the algorithm are the distances of each ultrasound sensor to the object (prosthesis and bone) and its position. First, the number of parameters necessary for a precise reconstruction and measurement of micromotions between objects had to be defined. Therefore, the algorithm has been tested with simulations of these parameters. Two experimental measurements, either using contact sensors or ultrasound, were used to prove the accuracy of the algorithm. Simulations indicate a high accuracy with three distances as initial parameters for each object. Contact measurements show precise representation of micromotion, and the contactless measurements show the possibility of detecting various materials with a high resolution. This work lays the foundations for non-invasive detection of micromotions between the implant-bone interface.

Survival rate and stability of surface-treated and non-surface-treated orthodontic mini-implants: a randomized clinical trial

ABSTRACT Objectives: This clinical trial was conducted to evaluate the stability and failure rate of surface-treated orthodontic mini-implants and determine whether they differ from those of non-surface-treated orthodontic mini-implants. Trial Design: Randomized clinical trial with a split-mouth study design. Setting: Department of Orthodontics, SRM Dental College, Chennai. Participants: Patients who required orthodontic mini-implants for anterior retraction in both arches. Methods: Self-drilling, tapered, titanium orthodontic mini-implants with and without surface treatment were placed in each patient following a split-mouth design. The maximum insertion and removal torques were measured for each implant using a digital torque driver. The failure rates were calculated for each type of mini-implant. Results: The mean maximum insertion torque was 17.9 ± 5.6 Ncm for surface-treated mini-implants and 16.4 ± 9.0 Ncm for non-surface-treated mini-implants. The mean maximum removal torque was 8.1 ± 2.9 Ncm for surface-treated mini-implants and 3.3 ± 1.9 Ncm for non-surface-treated mini-implants. Among the failed implants, 71.4% were non-surface-treated mini-implants and 28.6% were surface-treated mini-implants. Conclusion: The insertion torque and failure rate did not differ significantly between the groups, whereas the removal torque was significantly higher in the surface-treated group. Thus, surface treatment using sandblasting and acid etching may improve the secondary stability of self-drilling orthodontic mini-implants. Trial registration: The trial was registered in the Clinical Trials Registry, India (ICMR NIMS). Registration number: CTRI/2019/10/021718

RESUMO Objetivos: Este ensaio clínico foi conduzido para avaliar a estabilidade e a taxa de falha de mini-implantes ortodônticos com superfície tratada, e determinar se elas diferem das dos mini-implantes ortodônticos sem superfície tratada. Desenho do estudo: Ensaio clínico randomizado com desenho de boca dividida. Instituição: Department of Orthodontics, SRM Dental College, Chennai/India. Participantes: Pacientes que necessitavam de mini-implantes ortodônticos para retração anterior em ambas as arcadas. Métodos: Mini-implantes ortodônticos autoperfurantes, cônicos, de titânio com ou sem tratamento de superfície, foram colocados em cada paciente, seguindo um desenho de boca dividida. Os torques máximos de inserção e de remoção foram medidos para cada mini-implante, usando um torquímetro digital. As taxas de falha foram calculadas para cada tipo de mini-implante. Resultados: O valor médio do torque máximo de inserção foi de 17,9 ± 5,6 Ncm para mini-implantes com superfície tratada e 16,4 ± 9,0 Ncm para mini-implantes sem superfície tratada. O valor médio do torque máximo de remoção foi de 8,1 ± 2,9 Ncm para mini-implantes com superfície tratada e 3,3 ± 1,9 Ncm para mini-implantes sem superfície tratada. Entre os implantes que falharam, 71,4% eram mini-implantes sem superfície tratada e 28,6% eram mini-implantes com superfície tratada. Conclusão: O torque de inserção e a taxa de falha não diferiram significativamente entre os grupos; porém, o torque de remoção foi significativamente maior no grupo com superfície tratada. Assim, o tratamento de superfície com jateamento e condicionamento ácido pode melhorar a estabilidade secundária dos mini-implantes ortodônticos autoperfurantes. Registro do estudo: Esse estudo foi registrado no Clinical Trials Registry, Índia (ICMR NIMS). Número de registro: CTRI/2019/10/021718

Immediate flapless implant placement in a smoker patient: A challenge for optimum aesthetics and secondary stability: A case report.

The objective of this case report was to restore the young patient with missing teeth and extruded tooth using an immediate implant and synthetic bone graft material for the esthetic and comfort purpose. A 21-year young man reported extrusion of a tooth as well as missing teeth. Clinical examination revealed missing teeth in relation to (irt) 11 and 21, extrusion of tooth in relation to (irt) 12, patient had generalized fluorosis, and localized marginal gingivitis with melanin pigmentation. The patient is a known smoker, and he was advised the cessation of smoking before the treatment. This paper describes a step-by-step approach to different treatment phases, starting with surgical guide fabrication, immediate implant surgical procedures, bone grafting procedure, and later prosthesis fabrication. Follow-up resulted in a satisfactory outcome.

Cylindrical Implant Versus Tapered Implant: A Comparative Study.

AIMS AND OBJECTIVES: The aim of this study is to compare the efficacy of tapered implants with cylindrical implants by evaluating the implant stability using the Osstell implant stability quotient (ISQ) instrument (W&H Dental India PVT Ltd., Bangalore, India) postoperative pain using the visual analog scale (VAS) score, and the peri-implant health using implant mobility scale. MATERIALS AND METHODS: This study included 30 patients who were partially edentulous with single or bilateral missing teeth and received 30 tapered implants on the one side and 30 cylindrical implants on the other side. Implant stability, postoperative pain, and peri-implant health were evaluated. RESULTS: In the evaluation of 30 tapered implants and 30 cylindrical implants, the implant stability quotient (ISQ) value for the tapered implants was higher when compared to that of cylindrical implants, and the group that received tapered implants had the least pain and good peri-implant health than the group that received cylindrical implants. CONCLUSION: On the basis of our clinical findings, it can be concluded that tapered implants provide greater primary stability than cylindrical implants. With the popularity of loading protocols in implant dentistry, the implant surgeon can increase predictability and success by selecting a tapered implant.

MH cortical screws, a revolutionary orthodontic TADs design.

OBJECTIVE: MH cortical screws were designed to combine the advantages of thick mini-implants with the versatility of micro-screws while avoiding the disadvantages of both. MATERIALS AND METHODS: An MH cortical screw (MH is an abbreviation for the author's name) was made from titanium material. The screw has a 3 mm-long amphora-shaped shank of 2 mm thickness at its thinnest and 3 mm at its thickest part. Uniform 4 mm diameter threads blend into a 1 mm cutting tip. An external hexagonal head with side retentive ligature holes and a central hole for attachments was fabricated on a saucer-shaped gingival collar. Multiple attachments have been prepared for amending to the central hole. RESULTS: The shank design allowed cortical plate retention. The uniform threads and the amphora design provided maximum primary and secondary stability, respectively. The self-drilling tip allowed for a flapless technique, while the hexagonal head with side holes facilitated screwdriver control and allows for ligature wire anchorage. Cleats and buttons facilitated the use of elastics and springs, together with bracket-heads and eyelets for titanium molybdenum alloy and nickel-titanium wires inclusion. Adjustable hooks and chains provided versatility of line of action. Cover screws to retain extra-tissue mini-plates applied skeletal anchorage and long-term retention with flapless manipulations. CONCLUSION: MH cortical screws are a novel and important introduction to orthodontic anchorage. They combine primary and secondary stability with avoidance of root damage together with insertions into attached gingiva only. Multiple and versatile attachments allow for the application of biomechanical techniques according to the clinician's preferences. Extra-tissue mini-plates facilitate maximum anchorage for skeletal control and long-term retention without surgery.

Stability of Dental Implants and Thickness of Cortical Bone: Clinical Research and Future Perspectives. A Systematic Review.

Dental surgery implantation has become increasingly important among procedures that aim to rehabilitate edentulous patients to restore esthetics and the mastication ability. The optimal stability of dental implants is correlated primarily to the quality and quantity of bone. This systematic literature review describes clinical research focusing on the correlation between cortical bone thickness and primary/secondary stability of dental fixtures. To predict successful outcome of prosthetic treatment, quantification of bone density at the osteotomy site is, in general, taken into account, with little attention being paid to assessment of the thickness of cortical bone. Nevertheless, local variations in bone structure (including cortical thickness) could explain differences in clinical practice with regard to implantation success, marginal bone resorption or anchorage loss. Current knowledge is preliminarily detailed, while tentatively identifying which inconclusive or unexplored aspects merit further investigation.

Correlation between Primary, Secondary Stability, Bone Density, Percentage of Vital Bone Formation and Implant Size.

BACKGROUND: This study aims to evaluate whether there is a correlation between implant stability, bone density, vital bone formation and implant diameter and length. METHODS: Ninety patients were enrolled in this study. They underwent a socket preservation procedure with allograft or PRF and after 4 months, a total of 90 implants were placed. CBCT scans were assigned prior to implant placement in order to assess the bone density. During the surgical re-entry, a bone biopsy was harvested with a trephine drill. Immediately after implant insertion, the primary stability was measured. The secondary stability was measured 4 months after implant placement. RESULTS: Primary stability showed a significant positive linear correlation with bone density (r = 0.471, p < 0.001) as well as with percentage of new bone formation (r = 0.567, p < 0.001). An average significant association of secondary stability with bone density (rs = 0.498, p < 0.001) and percentage of newly formed bone (r = 0.477, p < 0.001) was revealed. The mean values of primary stability in all three implant sizes, regarding the diameter of the implants, were similar (narrow 67.75; standard 66.78; wide 71.21) with no significant difference (p = 0.262). The same tendency was observed for secondary stability (narrow 73.83; standard 75.25; wide 74.93), with no significant difference (p = 0.277). CONCLUSIONS: The study revealed a high correlation between primary and secondary implant stability, and bone density, as well as with the percentage of vital bone formation. Implant length and diameter revealed no linear correlation with the implant stability.

Effect of undersized drilling on the stability of immediate tapered implants in the anterior maxillary sector. A randomized clinical trial / Efecto de una perforación de tamaño insuficiente sobre la estabilidad de los implantes cónicos inmediatos en el sector anterior del maxilar. Un ensayo clínico aleatorizado

Background: To evaluate the effect of undersized drilling on the primary and secondary stability of immediateimplants placed in the anterior maxilla.Material and methods: A comparative randomized clinical trial was carried out in 30 healthy adults. Thirty ta-pered implants, 16 involving conventional drilling and 14 undersized drilling, were placed immediately afteranterior maxillary tooth removal. Insertion torque and implant stability assessed by resonance frequency analysis(RFA) were evaluated at three different timepoints: at implant placement and 6 and 12 weeks post-implantation.The results were compared using parametric statistical tests.Results: All implants showed adequate stability during follow-up. At implant placement, the undersized drillinggroup exhibited greater insertion torque values than the conventional drilling group, but stability assessed by RFAshowed greater mean values in the conventional group. After 6 and 12 weeks of follow-up, both groups showedimproved stability, though the RFA values remained comparatively higher in the conventional group. The differ-ences were not statistically significant.Conclusions: Based on the results obtained, undersized drilling does not appear to afford significantly improvedstability of immediate implants placed in the anterior zone of the maxilla during the osseointegration period.(AU)

Comparison of different surgical procedures on the stability of dental implants in posterior maxilla: A randomized clinical study.

BACKGROUND: Stability of a dental implant is very important when planning immediate loading and design of a final restoration. The aim of this study was to compare the primary and the secondary stability of dental implants inserted by three different surgical techniques: conventional (standard) technique using a sequence of drills for implant bed preparation, osteotome technique using tapered hand instruments for creating implant sites by condensing the bone and guided flapless implant surgery with surgical templates. MATERIAL AND METHODS: The study included 150 patients (80 males and 70 females), 46-71 years old, who required implant supported fixed partial dentures in the posterior maxilla of D3 or D4 bone density. Patients were randomly assigned into one of the three surgical insertion technique groups. All patients received tapered implants of the same manufacturer of the same length and two different widths (3.3 × 11.5 mm or 4.2 × 11.5 mm). Primary and secondary implant stability were measured by means of resonance frequency analysis (RFA) at the time of implant placement and 5 months after surgery using the Ostell ISQ device (Osstell AB, Sampgatan, Goteborg, Sweden). Statistical analysis included one-sample Kolmogorov Smirnov test, descriptive statistics, multivariate analysis (Bonferoni post-hoc tests) and paired t-tests. RESULTS: Patients in the osteotome group exhibited higher primary stability (P < 0.01) than in the conventional and surgically guided flapless groups. There were no significant differences in the secondary stability (p > 0.05). Wider implants presented higher ISQ values (P<0.01). CONCLUSION: The osteotome technique led to the highest implant primary stability, therefore it can be recommended when immediate loading is planned or for one-piece implant insertion.

Factors Affecting Implant Stability Quotients at Immediately and Conventionally Loaded Implants in the Posterior Maxilla: A Split-Mouth Randomized Controlled Trial.

PURPOSE: To assess primary and secondary stability of variable-thread tapered implants in the posterior maxilla and analyze the impact of various factors on implant stability quotients (ISQs). MATERIALS AND METHODS: Twenty-six subjects received 3-4 adjacent implants in the maxillary premolar-molar sextants to replace bilateral tooth loss. The implants on one side were immediately loaded with a provisional fixed prosthesis regardless of their primary stability. The contralateral control implants were conventionally loaded. Bone quality was subjectively recorded and primary stability was assessed by means of insertion torque values (ITVs) and ISQs in 4 directions. Secondary stability was measured by ISQ at definitive prosthesis delivery (3-3.5 months postoperatively), and 12 months after definitive loading. The impact of measurement direction, loading protocol, time, site-related (bone quality, implant position, crestal buccal bone thickness, apical cortical anchorage), and implant-related (implant dimensions, abutment height) variables on ISQs was assessed. RESULTS: For logistic reasons, ISQs were obtained for only 18 patients with 60 test and 60 control implants. Most of the implants (82%) at baseline had their lowest ISQ on the buccal aspect. There were no significant differences between ISQs measured in the buccal and palatal directions, or between ISQs in the mesial and distal directions. The mean of buccal and palatal ISQs was significantly lower than the mean of the 2 interproximal measurements at all evaluation periods. ISQs were not significantly different between the 2 loading groups at any time point. All implants showed a time-dependent increase in ISQs. Baseline ISQ correlated weakly with bone quality and ITV. None of the variables had a significant impact on baseline ISQs, except for implants in second molar sites which showed poorer primary stability than first premolars. CONCLUSION: Measurement direction and time are the most significant parameters affecting ISQs of variable-thread tapered implants in the posterior maxilla.

Relationship between Implant Length and Implant Stability of Single-Implant Restorations: A 12-Month Follow-Up Clinical Study.

Background and Objectives: Implant stability in vivo is contingent on multiple factors, such as bone structure, instrument positioning and implant surface modifications, implant diameter, and implant length. Resonance-frequency analysis is considered a non-invasive, reliable, predictable, and objective method by which to evaluate implant stability, due to its correlation with bone-to-implant contact. The purpose of this study was to evaluate the effect of implant length on the primary and secondary stability of single-implant crown rehabilitations, as measured by resonance-frequency analysis at different times. Materials and Methods: Implants of 10 and 11.5 mm were placed, and the resonance frequency was measured at the time of surgery (T0), as well as at 3 (T1), 6 (T2), and 12 (T3) months post-surgery. Results: A total of 559 implants were placed in 195 patients. Significant differences were observed when comparing the implant stability quotient (ISQ) values at T1, with values for 10-mm implants being greater than those for 11.5-mm implants (p = 0.035). These differences were also observed when comparing ISQ values for buccal and lingual areas. At T0, T2, and T3, no significant differences in ISQ values were observed. The use of 10-mm implants in the anterior maxilla yielded significantly greater values at T0 (p = 0.018) and T1 (p = 0.031) when compared with 11.5-mm implants. Significant differences in measurements were observed only for buccal areas (p = 0.005; p = 0.018). When comparing the sample lengths and sex, women with 11.5-mm implants showed significantly lower results than those with 10-mm implants (p < 0.001). Conclusions: There is a direct relationship between implants of a smaller length and greater ISQ values, with this relationship being most evident in the maxilla and in women.

Three-Dimensional Finite Element Analysis of Osseointegrated Implants Placed in Bone of Different Densities With Cemented Fixed Prosthetic Restoration.

A key factor for a successful dental implant is the manner in which stresses are transferred to the surrounding bone. Strength of bone is directly related to its density. Maximum stresses are reported to be incurred by the crestal cortical bone surrounding the implant. Displacement of implants is significantly higher in soft cancellous bone than dense bone. Implants are often placed in bone of different densities to support fixed dental prostheses. This study was aimed at assessing stress and deformation generated by osseointegrated implants placed in bone of different densities on a cemented fixed prosthesis when subjected to static and dynamic loading. A 3-dimensional finite element analysis was done on a computer-aided design model simulating maxillary bone segment with 2 different bone densities (D2 and D4). The effect of loading was evaluated at the implant-bone interface, implant-abutment interface, abutment, implant abutment connecting screw, cementing medium, and fixed prosthesis. Stresses were calculated using von Mises criteria calibrated in megapascals and deformation in millimeters. These were represented in color-coded maps from blue to red (showing minimum to maximum stress/deformation), depicted as contour lines with different colors connecting stress/deformation points. The study found greater von Mises stress in D2 than D4 bone, and in D2 bone the component with higher stress was the implant. Deformation was greater in D4 than D2 bone, and in D4 bone the abutment-prosthesis interface showed more deformation.

Intertrochanteric Femur Fracture Treatment in Asia: What We Know and What the World Can Learn.

Hip fractures are of great interest worldwide as the geriatric population continues to increase rapidly. Currently, surgeons prefer to use cephalomedullary nail for internal fixation of pertrochanteric/intertrochanteric fractures. This article summarizes 10 concepts in hip fracture treatment over the past 20 years, including fracture line mapping, proximal lateral wall and anterior cortex, posteromedial lesser trochanter-calcar fragment, anteromedial cortex support reduction, changes of fracture reduction after sliding and secondary stability, nail entry point and wedge-open deformity, tip-apex distance and calcar-referenced tip-apex distance, femoral anterior bowing and nail modification, long nails for wide medullary canal and large posterior coronal fragment, and postoperative stability score.

Is a two-month healing period long enough to achieve osseointegration? A prospective clinical cohort study.

The aim of this study was to evaluate the effectiveness of loading at 2 months after the surgical placement of implants. A tapered implant was used. Implant stability was determined using resonance frequency analysis at implant insertion (T0; primary stability), after 2 months (T1), and at the 6-month follow-up (T2). Descriptive statistics and the t-test were used. Significance was at P ≤ 0.05. A total of 268 implants were inserted in 142 patients. No patient dropped out and no implant had failed at the 6-month follow-up. The mean implant stability quotient value (ISQ) increased over time, with a statistically non-significant difference for T0 vs. T1 (P = 0.08) and a statistically significant difference for T1 vs. T2 (P = 0.0018) and T0 vs. T2 (P = 0.000). Only 99 implants, characterized by an extremely high mean primary stability value (80.34), did not have a recorded increase in ISQ at T1. A 2-month healing period allowed the implant to achieve secondary stability, confirming the effectiveness of the loading protocol at 2 months.

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.

Can Osseointegration Be Achieved Without Primary Stability?

The osseointegration and survival of dental implants are linked to primary stability. Good primary stability relies on the mechanical friction between implant surface and surrounding bone with absence of mobility in the osteotomy site immediately after implant placement. Several factors have been found to affect implant primary stability, including bone density, implant design, and surgical technique. Various methods have been used to assess implant primary stability including insertion torque and resonance frequency analysis. This article aims to evaluate the success of osseointegration in the absence of primary stability and to propose recommendations to manage implants that lack primary stability.

Study to assess the relationship between insertion torque value and implant stability quotient and its influence on timing of functional implant loading.

PURPOSE: One of the crucial requirements for the success of implants is to achieve good stability. Two well-accepted quantitative methods to assess implant stability, the insertion torque value (ITV), and resonance frequency analysis (RFA) can be a valuable adjunct to radiological and clinical examination. This study was conducted to assess the relationship between ITVs and implant stability quotient (ISQ) and its influence on timing of functional implant loading, as well as to determine the effect of some of the factors on the stability of implants. MATERIALS AND METHODS: Forty implants were inserted in 37 patients in the posterior mandibular region according to conventional protocol and allowed to heal by placing a healing abutment at the time of placement. For each implant, ITV was measured at the time of the implant placement by manual torque wrench (Nobel Biocare), and the ISQ value was measured by using resonance frequency analyzer (Osstell-ISQ; Integration Diagnostics) at the baseline levels, 3rd week, 7th week, 11th week, and 15th week interval. RESULTS: The correlation between ITV and ISQ was found to be moderately positive and significant (r = 0.399) (P = 0.000). The correlation of ITV value at baseline and ISQ values recorded at the subsequent weeks was also found to be statistically significant at week 3 (r = 0.376) (P = 0.000) and week 7 (r = 0.327) (P = 0.000). CONCLUSION: It can be concluded from this study that there is a positive and statistically significant correlation between the ITV and ISQ values.