Abstract
BackgroundThe aim of the present clinical study was to determine the local bone density in dental implant recipient sites using computerized tomography (CT) and to investigate the influence of local bone density on implant stability parameters and implant success.MethodsA total of 300 implants were placed in 111 patients between 2003 and 2005. The bone density in each implant recipient site was determined using CT. Insertion torque and resonance frequency analysis were used as implant stability parameters. The peak insertion torque values were recorded with OsseoCare machine. The resonance frequency analysis measurements were performed with Osstell instrument immediately after implant placement, 6, and 12 months later.ResultsOf 300 implants placed, 20 were lost, meaning a survival rate of %. 93.3 after three years (average 3.7 ± 0.7 years). The mean bone density, insertion torque and RFA recordings of all 300 implants were 620 ± 251 HU, 36.1 ± 8 Ncm, and 65.7 ± 9 ISQ at implant placement respectively; which indicated statistically significant correlations between bone density and insertion torque values (p < 0.001), bone density and ISQ values (p < 0.001), and insertion torque and ISQ values (p < 0.001). The mean bone density, insertion torque and RFA values were 645 ± 240 HU, 37.2 ± 7 Ncm, and 67.1 ± 7 ISQ for 280 successful implants at implant placement, while corresponding values were 267 ± 47 HU, 21.8 ± 4 Ncm, and 46.5 ± 4 ISQ for 20 failed implants; which indicated statistically significant differences for each parameter (p < 0.001).ConclusionCT is a useful tool to determine the bone density in the implant recipient sites, and the local bone density has a prevailing influence on primary implant stability, which is an important determinant for implant success.
Highlights
The aim of the present clinical study was to determine the local bone density in dental implant recipient sites using computerized tomography (CT) and to investigate the influence of local bone density on implant stability parameters and implant success
The volume of bone available and quality of the bone are highly associated with the type of surgical procedure and the type of implant, and both of these factors play a vital role in the success of dental implant surgery [6]
Because mechanical behavior of bone seems to be a vital factor in the achievement of osseointegration, several classification systems and procedures were suggested for assessing bone quality [11,12,13,14,15]
Summary
The aim of the present clinical study was to determine the local bone density in dental implant recipient sites using computerized tomography (CT) and to investigate the influence of local bone density on implant stability parameters and implant success. Johansson and Strid described a technique whereby bone quality as a function of density and hardness could be derived from the torque forces needed during implant insertion [12] They postulated that the energy used in tapping the site, before or during implant placement, is a combination of the thread placement force from the tip of the instrument and the friction created as the remaining part of a tap or implant enters the site. It has been demonstrated in ex vivo human preparations that the cutting resistance during implant installation correlates well with the bone density as assessed by microradiography [13]. CT enables the evaluation of proposed implant sites and provides diagnostic information that other imaging methods could not [22]
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