Abstract
This study investigated the clinical utility of an ultrasound axial transmission device in preoperative evaluation of bone quality for dental implantation, by clarifying the relationship between cortical bone speed of sound (cSOS), insertion torque values (ITV), and implant stability quotient (ISQ) in porcine femur bone. Eleven fresh porcine femurs, without soft tissue, were prepared. The cSOS of these bones were measured using the axial transmission device. Bone mineral density (BMD) and porosity (Po) were measured in cortical bone samples obtained from the region of ultrasound measurements by X‐ray microcomputed tomography. Thirty‐three implants were inserted into these samples (three implants per bone sample), and ITV and ISQ were measured for all implants. Then, cortical bone thickness (CbTh) of the area for implantation was measured for all implants using a micrometer. The mean cSOS was 3962 m/s; mean BMD and Po were 0.822 g/cm2 and 0.185%, respectively. cSOS and BMD values were positively correlated, and cSOS values and Po values were negatively correlated. Mean ITV, ISQ, and CbTh were 37.95 Ncm, 71.172, and 2.869 mm, respectively. There was a positive correlation between cSOS values and ISQ values. The cSOS of each bone did not correlate with ITV for all of the bone samples. However, when the CbTh ranges from 3.0 to 3.5 mm, ITV are correlated with cSOS. These findings suggest that cSOS, which reflects the cortical bone quality, may be clinical utility as a preoperative diagnosis of the implant.
Highlights
Primary stability is regarded as an important factor for success in dental implant treatments and one of the most important prerequisites for osseointegration (Beer, Gahleitner, Holm, Tschabitscher, & Homolka, 2003; Gömez‐Polo et al, 2016)
The aim of this study was to investigate the clinical utility of an axial transmission device in preoperative measurement of bone quality for dental implantation, by clarifying the relationship between cortical bone speed of sound (cSOS) values, insertion torque values (ITV), and implant stability quotient (ISQ) values in porcine femur bone
Ultrasound measurements were performed using the axial transmission device (Furuno Electric, Hyogo, Japan). This device can calculate cSOS value from the propagation time difference and the propagation distance by irradiating a pulse with the center frequency 3.0 MHz from the emitter and receiving a leaky surface wave propagated through cortical bone with receiver. cSOS values, propagated from the proximal to the distal region of the bone, were measured at room temperature in a container filled with water (Figure 1a,b)
Summary
Primary stability is regarded as an important factor for success in dental implant treatments and one of the most important prerequisites for osseointegration (Beer, Gahleitner, Holm, Tschabitscher, & Homolka, 2003; Gömez‐Polo et al, 2016). It has been shown that primary stability is influenced by the geometry of an implant (i.e., the length, diameter, shape, and thread), the placement technique, and bone quantity and quality in the area targeted for implantation (Beer et al, 2003; Klein, Grötz, Manefeld, Kann, & Al‐Nawas, 2008; Toyoshima et al, 2011). Quantitative computed tomography (qCT) has been used as a traditional preoperative evaluation for measuring bone quality. Bone mineral density (BMD) values measured by qCT have been shown to be capable of predicting primary stability Insertion torque values (ITV), measured intraoperatively, and resonance frequency analysis (RFA), performed postoperatively, have been used to evaluate primary stability (Lozano‐Carrascal et al, 2016), but these procedures cannot be performed preoperatively
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