Implant Stability Quotient Research Articles

Comparative evaluation of hard and soft tissue parameters by using short implants and standard long implants with sinus lift for prosthetic rehabilitation of posterior maxilla.

The objective is to compare and evaluate the hard and soft tissue parameters by using short and standard long implants with sinus lifting in the posterior maxilla. Eleven patients with complaints of missing upper back teeth were enrolled in the study for implant-supported rehabilitation and were categorized into two groups: Group long (GL): longer implant (>8 mm) placement, preceded by Sinus Augmentation. Group short (GS): short implant (≤8 mm) placement, without sinus augmentation. The primary outcome measured was cumulative survival rate (CSR) in the compromised partial edentulous posterior maxilla. Secondary outcomes measured were implant stability (IS), marginal bone level alterations (MBL), pocket probing depth (PPD), crown-to-implant ratio, and any complications. The difference in CSR between the groups was not statistically significant (P = 0.317). High stability was achieved immediately after the placement of the implants, in both groups (GS: 64 ± 4.07, GL: 65.58 ± 9.75); this difference in the mean ISQ (IS quotients) values was not found to be statistically significant at implant placement (P = 0.7). The mean MBL reported in the study at the end of 12 months of prosthesis function was - 0.762 ± 0.48 mm and - 0.7 ± 0.34 mm for GS and GL, respectively. The mean PPD measurements in GS and GL groups were 1.917 ± 0.68 mm and 1.833 ± 0.38 mm, respectively, and it was not statistically significant (P = 0.8). Within the limitations of the present study, the obtained results indicate that short implants provided a similar clinical and radiographic performance compared to long implants placed in combination with a sinus augmentation procedure (lateral window) up to 12 months after prosthetic loading.

РОЛЬ ЧАСТОТНО- РЕЗОНАНСНОГО АНАЛИЗА В ИССЛЕДОВАНИИ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ, УСТАНОВЛЕННЫХ В РЕКОНСТРУИРОВАННЫЕ АЛЬВЕОЛЯРНЫЕ ОТРОСТКИ С НЕБОЛЬШИМ ОБЪЕМОМ КОСТИ ЧЕЛЮСТЕЙ

The use of dental implants being the intraosseous artificial fixtures is often required for orthopedic rehabilitation of completely edentulous patients; for their placement, adequate amount of bone tissue is needed, which in many cases is insufficient due to physiological bone loss, long-term wearing of full dentures, the duration of edentulism and complex clinical situations caused by maxillofacial injuries or general somatic diseases. Implant placement in the above situations requires timely preparation of deficient alveolar ridge by means of osteoplastic surgery. In its turn, the newly formed regenerated bone by its histological, physicomechanical and structural-functional properties can only approach the recipient bone tissue; therefore, the issue of implant osseointegration and its functional loading in regenerated bone remains debatable. This research uses the method of frequency-resonance analysis showing implant stability coefficient numerically equal to the ISQ (Implant stability Quotient) values and reflecting the percentage of the osseointegration area of the intraosseous part of the implant. The results of research obtained by means of frequency-resonance analysis have proved that with the timely start of implant usage and adequate functional loading, ISQ values increase, that is, increases the osseointegration area along the interface of the intraosseous part of the implant placed in regenerated bone. Comparative results of research reflecting ISQ values in 12 months after implant placement in bone augmented using various forms of autogenous bonegrafts, have been presented; therefore, a conclusion can be made that there is a direct relationship between osseointegration under conditions of functional chewing load and the shape and size of autogenous bonegrafts.

A Comparative Study of Two Resonance Frequency Analysis Instruments

Primary implant stability (PIS) depends on the surgical technique, implant design, and the characteristics of the recipient bone, among other factors. This paper aims to study different parameters (recipient bone characteristics like bone density (BD) and mean alveolar crest width (MACW)) that may be related to implant primary stability outcomes. With that, it can be determined if they are reliable PIS methods and guide treatment decisions for successful implant outcomes. Thirty-five dental implants (25 BTI Interna® CORE and 10 Bioner Top DM) were placed in 10 patients in 2022 and 2023. All of them underwent Cone Beam Computed Tomography (CBCT) scans to obtain values for MACW and BD. PIS measurements used were implant stability quotient (ISQ) obtained through different resonance frequency analysis (RFA) methods (Osstell® ISQ and Penguin RFA®) and insertion torque (IT). The results for the following variables showed significance at p<0.001 and p<0.05. Highly significant relationships were observed between Osstell and Penguin RFA values (p<0.001). Regarding IT, a direct proportional relationship with ISQ was observed (p<0.05). PIS, as measured by ISQ and IT, did not show a significant correlation with the mean alveolar crest width of the edentulous ridge measured by CBCT, suggesting that wide or narrow alveolar crests did not have an effect on rotational or lateral PIS in both implant groups. The most significant predictor of lateral and rotational PIS in our patients was the Hounsfield Units (HU) value 0.5 mm away from the implant placement area (p<0.001) and (p<0.05), respectively. In conclusion, non-invasive PIS methods could be considered as a guide for clinicians in treatment decision-making and implant success. However, further research is needed to predict PIS.

Resonance frequency analysis – indicator of post-implantation morphology of mandibular bone tissue

This article describes the role of resonance frequency analysis (RFA) as an indicator of the quality of primary implant stability, which is the basis of the goal and confirmed by the results of a clinical case – odontological implantation on edentulous segments of atrophied bone tissue on the right side of the mandible, taking into account the topographic features of its canal, using ultra-short (h = 5.5 mm) implants.
 Aim. To highlight the role of resonance frequency analysis during surgical interventions using short (ultrashort) implants in predicting their primary stability and preserving the normal morphology of the mandibular bone tissue.
 Materials and methods. The primary stability of 17 dental implants in seven patients was determined using the Penguin Instruments (RFA) technique in declarative units of measurement – the implant stability quotient (ISQ). Values in the range of 75 ISQ meant that the implant had adequate primary stability and could receive and distribute the immediate load on the bone tissue of the edentulous segment.
 Results. Following the stages of preparation, 17 ultra-short (h = 5.5 mm × b = 4.0 mm) implants were placed on the edentulous segments of the mandible without an incisional osteotomy path according to the patient rehabilitation protocol. We used the method of resonance frequency analysis to obtain a value of high primary stability of two short subcortical implants in the projection of tooth 4.7 – 92 ISQ and the projection of tooth 4.6 – 90 ISQ. On the 3rd day of the clinical stage of fixation of the supraconstruction, RFA measurements were performed, the values of which showed a significant decrease in the stability quotient of the installed implants in the projection of tooth 4.7 – 61 ISQ and in tooth 4.6 – 74 ISQ. This result made it necessary to revise the rehabilitation plan, adjust the medical prescription sheet and decide to postpone the placement of the all-milled restorative structure on the implants.
 Conclusions. The RFA study indicates not only the primary stability of implants but also a full-fledged stage-bystage clinical prognosis of the further functionality of a prosthetic structure based on short implants with proper preservation of the morphological functionality of bone tissue.

Influence of chitosan and Cissus quandrangularis coating on osseointegration in titanium implants in rabbits: A preclinical in vivo study

BackgroundTitanium (Ti) implants has been criticized for the tiring wait for osseointegration, often making the patient reconsider implant treatment. Surface treated Ti implants are emerging as a promising solution with superior osseointegration, early loading protocols and shortened period of edentulousness. The aim of this study is to assess the osseointegration of Ti surface coated with novel Cissus quandrangularis Chitosan Hydrogel (CqChH) compared to Commercially pure (Cp) implants. Methods24 Cp Ti implants were divided into 2 subgroups (n = 12). The test group consisted of Ti implants surface treated with the novel hydrogel and control group consisted of Cp Ti implants. 3 % CqChH was prepared and was coated on the Ti implants prior to placement in the femur and tibial heads of rabbits. Implant Stability Quotient (ISQ) was recorded at the 6th and 12th week. Animals were sacrificed and subjected to Removal Torque Quotient (RTQ). The samples were retrieved en bloc and stained for histopathologic analysis. The collected data was subjected to statistical analysis using Unpaired student t-Test. ResultsAt the end of 6th week CqChH coated implants did not show any statistically significant difference in both ISQ and RTQ values compared to Cp ones. However, at the end of the 12th week CqChH coated implants demonstrated significantly higher ISQ (73.91 ± 4.39) and RTQ (75.96 ± 14.10) compared to Cp ones. ConclusionsThis study demonstrated that the novel hydrogel coating applied to the implant's surface exhibited not only enhanced bone regeneration but also elicited a new bone formation.

Effect of Residual Bone Height and Implant Macro-Design on Primary Stability in Sinus Floor Elevation: An Ex Vivo Study.

The objective was to evaluate the influence of residual bone height (RBH) and implant macro-design on the primary stability (PS) of implants using a simultaneous sinus floor elevation (SFE) and implant insertion model. Fresh bovine rib samples that resembled type-IV density that were confirmed by computerized tomography were prepared to represent 4 groups of varying RBHs (3, 6, 9, 15 mm). To simulate simultaneous implant insertion with SFE, 120 implants in different macro-designs (group R: NobelReplace; group P: NobelParallel; group A: NobelActive, Nobel Biocare, Gothenburg, Sweden) were randomly inserted at RBHs of 3, 6, 9, and 15 mm in each rib. The implant stability quotient (ISQ) was measured immediately after implant insertion. RBH and implant macro-design have an impact on ISQ values (P < .001). ISQ values were the highest with RBH of 15 mm, followed by RBHs of 9, 6, and 3 mm. (P < .001). There was no statistically significant difference between different implant macro-designs at RBHs of 3 and 15 mm regarding ISQ values (P = .111, P = .551). ISQ values of group P were higher than those of group R and group A at an RBH of 6 mm (P = .049, P = .029). ISQ values were also higher in group P compared to group A at an RBH of 9 mm (P = .006). A higher PS may be expected in sites with higher RBH, regardless of the macro-design. In addition, cylindric implant design may enhance the PS at RBHs of 6 and 9 mm in simultaneous implant insertion with SFE.

Osseodensification versus lateral window technique for sinus floor elevation with simultaneous implant placement: A randomized clinical trial on patient-reported outcome measures.

To compare patient-reported outcome measures and additional surgical outcomes after sinus floor elevation (SFE) with osseodensification (OD) versus lateral window (LW), both with simultaneous implant placement. Twenty participants requiring single-implant rehabilitation with residual bone height (RBH) ≤4 mm were enrolled. Pain experience, quality of life (QoL) via the Oral Health Impact Profile-14 (OHIP-14), analgesics intake, and other symptoms were self-reported for a week on a daily basis. Surgery duration, complications, and implant stability quotient at baseline (ISQ T0 ) and after 6 months (ISQ T6 ) were registered. Participants were followed up for 1 year. From Day 0 (day of surgery) to Day 3, pain experience was significantly lower (p < 0.05) in the OD group. OHIP-14 score was significantly lower (p < 0.05) in the OD group on all postoperative days, except on Day 5. Average analgesics intake was significantly lower (p < 0.001) in the OD group. Surgery mean duration was significantly higher (p < 0.001) in LW compared to OD (71.1 ± 10.4 vs. 32.9 ± 5.3 min). After osseointegration period, all implants were successfully restored with screw-retained crowns. Within the limitations of this study, it can be concluded that OD and LW techniques were similarly effective in SFE with simultaneous implant placement when RBH ≤ 4 mm. However, OD significantly outperformed LW in pain experience, impact on self-perceived QoL, surgery duration, postoperative edema, and analgesics intake.

Evaluation of different surface treated implants after provisionalization: A 6-month prospective study.

Replacing missing teeth with dental implants has become the best treatment option; therefore, clinicians need to understand the predictability of the treatment. Surface treatment of implants is one of the methods to improve osseointegration, thus improving the quality of treatment. Increasing esthetic awareness among patients has led to the popularity of immediate provisionalization of dental implants. This study investigated the effect of surface treatment on implant stability when loaded with immediate non-functional temporary prostheses and compared the superiority of one surface treatment over the other in terms of osseointegration by evaluating implant stability quotient (ISQ). Twenty implants with different surface treatments were placed, i.e., resorbable blast media (RBM) surface and alumina blasted/acid-etched (AB/AE) surfaces. All the implants were non-functionally loaded, and ISQ was measured immediately after implant placement and 6 and 12 weeks after non-functional loading. Crestal bone levels, mPI, mSBI, and peri-implant probing depths were compared for both groups at 1, 3, and 6 months. At 12 weeks, all the implants showed desirable ISQ, indicating successful osseointegration. The increase in ISQ at 12 weeks was significantly higher for RBM implants compared to baseline, indicating a more predictable course of osseointegration. Crestal bone levels recorded at 1, 3, and 6 months did not significantly differ between the groups. All other parameters showed comparable values for both groups at all intervals. Replacing missing teeth with dental implants with immediate non-functional restorations is a predictable treatment option.

Endo-sinus bone gain following sinus membrane elevation without graft compared with sinus floor augmentation and a composite graft: a one-year single-blind randomized controlled trial

The objective of this study was to assess endo-sinus bone gain (ESBG) and bone density (BD) following maxillary sinus membrane elevation without graft (test) compared with maxillary sinus floor augmentation and 1:1 ratio of autogenous bone from the buccal antrostomy and deproteinized porcine bone mineral (control) using two- and three-dimensional radiographic methods. Forty healthy patients were randomly allocated to the test and control groups. Cone beam computed tomography scans were obtained at enrolment (T0), immediately after surgery (T1), at delivery of the prosthetic rehabilitation (T2), and 1 year after functional implant loading (T3). Mean differences were expressed with the 95% confidence interval. Significance was set at ≤ 0.05. ESBG and BD were significantly higher in the control group than test group at T1, T2, and T3 (P < 0.001). A significant decrease in ESBG and increase in BD was observed from T1 to T3 with both treatments (P < 0.001). There was a non-significant positive correlation of ESBG with implant protrusion length and non-significant negative correlation with residual bone height. In conclusion, test was associated with significantly lower ESBG and BD compared with control. However, the lower ESBG and BD did not appear to negatively affect the implant stability quotient or implant treatment outcome after 1 year of functional implant loading.

Radiographic alveolar bone assessment in correlation with primary implant stability: A systematic review and meta-analysis.

The radiographic examination of alveolar bone using 3D radiographic examination is essential in dental implant treatment planning. Our study aimed to systematically review and quantitatively analyze the correlation between alveolar bone parameters, specifically bone density and cortical bone thickness, assessed using cone beam computed tomography (CBCT) and/or multidetector computed tomography (MDCT); and primary implant stability (PIS) determined using implant stability quotient (ISQ), Periotest® value (PTV), and insertion torque value (ITV). This review was registered in the PROSPERO database (registration number CRD42022307245). An electronic literature search was conducted on the PubMed, SCOPUS, and Web of Science databases for papers published until February 2022. The Quality Assessment in Prognostic Studies (QUIPS) tool was used to assess risk of bias. Meta-analyses were conducted to calculate the estimated average correlation coefficient based on a multilevel random-effects model, followed by subgroup analysis. Twenty-six studies were included in this review, consisting of 17 prospective cohort studies, eight retrospective cohort studies, and one nonrandomized controlled trial. A total of 3109 implants placed in 1171 subjects were analyzed. Twenty-three studies were evaluated using meta-analysis. The alveolar bone condition was significantly correlated with ISQ (r = 0.60; p < .001), IT (r = 0.52; p < .001), and PTV (r = -0.42; p < .05). Alveolar bone condition is significantly associated with PIS. Low bone density and thin cortical bone can lead to low PIS; therefore, modification of treatment planning and surgical procedures might be needed to avoid poor osseointegration.

Usefulness of Wedge-Shaped Implants in the Full-Arch Rehabilitation of Severe Maxillary Atrophy: A Case Report.

The management of marked horizontal bone atrophy represents a critical challenge for traditional implantology procedures. For this purpose, clinicians have developed several protocols and procedures to allow the most suitable and accurate surgical and prosthetic implant rehabilitation. Despite the development of guided bone regeneration methods and the use of small-diameter implants, the rehabilitation of thin bone areas is a clinical dilemma for the medium- and long-term survival of implant-prosthetic therapies. This clinical case evaluates the use of wedge-shaped implants for the full-arch rehabilitation of an atrophic maxilla with a thin ridge. This treatment choice allowed a minimally invasive rehabilitation, avoiding regenerative bone surgery, while respecting biologic and prosthetic limits. Furthermore, evaluation of the implant stability quotient and marginal bone loss values during the first year of follow-up allowed analysis of the behavior of this rehabilitation in fullarch maxillary cases.

Low Bone Density Predictability of CBCT and Its Relation to Primary Stability of Tapered Implant Design: A Pilot Study.

Research regarding bone density assessment using cone beam computed tomography (CBCT) in low bone density regions is sparse. This in vitro study aimed to evaluate the predictability of CBCT for low bone density regions and its correlations with primary implant stability when placing tapered design implants with a stepped osteotomy. Eighteen porcine mandibular condyles were used as simulated low bone density regions. Hounsfield units (HU), obtained via multislice computed tomography, and gray values (GVs), obtained via CBCT, were measured 3 times at 1-month intervals. The maximum implant insertion torque (MIT) and implant stability quotient (ISQ) were recorded as the taper design implants were placed using a stepped osteotomy. Hounsfield units and GV were measured as 335.05-803.07 and 389.98-906.40, respectively. For repeated measurements of HU and GV, the intraclass correlation coefficients were 0.989 and 0.980; the corresponding value for mean HU and GV was 0.768. Bland-Altman plots showed a mean difference between HU and GV of -78.15. Pearson correlation coefficients revealed a strong correlation between HU and GV (r = 0.91, P < .01). The mean ± SD values for MIT and ISQ were 36.44 ± 6.64 Ncm and 80.85 ± 2.03, respectively, but no statistically significant correlations were found with GV and HU. Within the study's limitations, GV showed similar bone density estimation compared with HU in soft bones. Tapered implant placement with a stepped osteotomy achieved stable primary implant stability in soft bones. However, these in vitro results need to be approved in further clinical studies.

Influence of Multiple Sterilization on Performance of Titanium Pegs When Measuring Implant Stability With Resonance Frequency Analyses.

This in vitro study was conducted to investigate the repeatability of the implant stability quotients (ISQ) measured with multipegs after numerous sterilizations and to detect the exact time when the readings start to deviate. Multipegs were sterilized with 3 different methods (autoclaved, autoclaved + ultrasonic cleaner, chemical disinfection + autoclaved) and grouped according to the method applied. All specimens were put into the autoclave with sealed packages every time they were sterilized. Each specimen was sterilized 50 times according to the technique described in its group after an ISQ measurement was performed. Results of the 2-way analysis of variance showed that neither the sterilization method nor the cycles, nor their interaction, were statistically significant. A multipeg may be reused multiple times after sterilization procedures and may be more cost-effective than a disposable smartpeg for checking implant stability after confirming these results in further investigations.

Effect of Implant Macro-Design and Magnetodynamic Surgical Preparation on Primary Implant Stability: An In Vitro Investigation.

Macro-geometry and surgical implant site preparation are two of the main factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to assess the initial stability of various implant macro-designs using both magnetodynamic and traditional osteotomy techniques in low-density bone. The parameters examined included peak insertion torque (PIT), implant stability quotient (ISQ), and peak removal torque (PRT). Four groups of 34 implants each were identified in accordance with the surgery and implant shape: T5 group (Five implant and osteotomy using drills); M5 group (Five implant and magnetodynamic osteotomy using Magnetic Mallet); TT group (TiSmart implant and osteotomy with drills); and MT group (TiSmart implant and magnetodynamic osteotomy). Every implant was placed into a low-density bone animal model and scanned using CBCT. The PIT and PRT were digitally measured in Newton-centimeters (Ncm) using a torque gauge device. The ISQ was analyzed by conducting resonance frequency analysis. The PIT values were 25.04 ± 4.4 Ncm for T5, 30.62 ± 3.81 Ncm for M5, 30 ± 3.74 Ncm for TT, and 32.05 ± 3.55 Ncm for MT. The average ISQ values were 68.11 ± 3.86 for T5, 71.41 ± 3.69 for M5, 70.88 ± 3.08 for TT, and 73 ± 3.5 for MT. The PRT values were 16.47 ± 4.56 Ncm for T5, 26.02 ± 4.03 Ncm for M5, 23.91 ± 3.28 Ncm for TT, and 26.93 ± 3.96 Ncm for MT. Based on our data analysis using a t-test with α = 0.05, significant differences in PIT were observed between TT and T5 (p < 0.0001), M5 and T5 (p < 0.0001), and MT and TT (p = 0.02). Significant differences in the ISQ were found between TT and T5 (p = 0.001), M5 and T5 (p < 0.001), and MT and TT (p = 0.01). The PRT also exhibited significant differences between TT and T5, M5 and T5, and MT and TT (p < 0.0001). Our data showed favorable primary implant stability (PS) values for both implant macro-geometries. Furthermore, the magnetodynamic preparation technique appears to be more effective in achieving higher PS values in low-density bone.

Insertion Torque (IT) and Implant Stability Quotient (ISQ) Assessment in Dental Implants with and without Healing Chambers: A Polyurethane In Vitro Study

Primary Stability (PS) depends on different factors, such as bone structure (quality and density), implant characteristics (macro and micro), and the relationship between thread shape and implant insertion hole size. PS is crucial for the prognosis and success of dental implants. The use of healing chambers, which create empty spaces between the implant and peri-implant bone, helps reduce the risk of compressive bone necrosis. High Insertion Torque (IT) values could potentially lead to the deterioration of the implant-abutment connection. However, the optimal implant macro-structure and IT values remain unknown. In this study, implants with healing chambers (Test) and without (Control) were inserted into polyurethane blocks with densities of 10, 20, 30, and 40 pounds per cubic foot (PCF). In blocks with densities of 30 and 40 PCF, Control implants had significantly higher IT values than Test implants. Additionally, Control implants exhibited significantly higher Removal Torque (RT) values than Test implants, but only in the 30 PCF density block (p &lt; 0.0001). However, no differences were found between the implants in the 10, 20, and 40 PCF density blocks. Similarly, no significant differences were observed in the Implant Stability Quotient (ISQ) values between the Test and Control implants. The results of the present study confirm that adding healing chambers to the macro-structure of dental implants can significantly reduce IT values without affecting ISQ values. This suggests the potential for avoiding compression and damage to peri-implant bone while maintaining consistent levels of PS.

The effect of leukocyte- and platelet-rich fibrin on the bone loss and primary stability of implants placed in posterior maxilla: a randomized clinical trial

PurposeIn this study, we investigated the effects of leukocyte- and platelet-rich fibrin (L-PRF) on implant stability and alterations in the marginal bone surrounding posterior maxillary implants.MethodsThis randomized clinical trial was conducted to compare the variable of L-PRF placement around maxillary implants. Resonance frequency analysis (RFA) was used to evaluate the implant stability immediately after surgery and at 1, 2, 4, 6, 8, and 12 weeks after surgery (t0 to t6, respectively). In addition, the amount of marginal bone changes around the implant at t6 was compared with the baseline using periapical radiography.ResultsThe RFA outcomes were statistically significant within each group (P < 0.001, Eta2 = 0.322); however, in none of the follow-ups and immediately after the surgery, there was a significant difference between the two groups in terms of the implant stability quotient (ISQ) scores (P > 0.05). At t0, the test and control groups' respective mean levels of marginal bone loss around the implants were 0.4836 mm and 0.7343 mm, significantly different from the corresponding values at t6. On the other hand, marginal bone loss around the implant was not significantly different between the two groups in t0 and t6 (P = 0.532).ConclusionsL-PRF did not improve the RFA outcomes of implants three months after implant placement, and changes in the ISQ values over time were the same in both groups. In addition, L-PRF had no superior effect on the marginal bone loss around the implants.Trial registration number: The research was registered in the Iranian Registry of Clinical Trials on 22 December 2020 (No: IRCT20200624047906N1), available at http://www.irct.ir

Cumulative success rate and marginal bone loss for immediate and early loading protocols in a single implant-supported crown: A randomized controlled split-mouth clinical trial

Statement of problemNew loading protocols with reduced treatment time have gained popularity because of their advantages. However, whether the success rate with immediate loading (IL) is worse than with early loading (EL) is still unclear. PurposeThe purpose of this randomized controlled trial with a split-mouth design was to evaluate the marginal bone loss and the cumulative success rate (CSR) 1 year after an IL protocol in single implant-supported crowns. The test groups were loaded after less than 24 hours (test group) and EL at 60 days (control group). Material and methodsSeventeen participants received 34 implants. The recall appointments were at baseline, 30 days, 60 days, and 1 year. The outcome measures evaluated were pain, implant clinical mobility, probing depth measurements, peri-implant disease, marginal bone loss, implant insertion torque, implant stability quotient (ISQ) value, and the CSR. A 2-way repeated measures ANOVA identified the significant differences for probing depth and ISQ. A 3-way repeated measures ANOVA followed by a pairwise t test analyzed marginal bone loss, and a nonparametric Wilcoxon test analyzed insertion torque (α=.05). ResultsNo differences were found between the insertion torque, ISQ, and marginal bone loss values (P>.05). When analyzing probing depth, no differences were found when comparing IL versus EL at baseline, 30 days, and 1 year (P>.05). The global CSR was 91.17%, 88.23% for the IL group and 94.11% for the EL group. ConclusionsWhen analyzing marginal bone loss, the groups were similar. The global CSR was 91.17%, 88.23% for the IL group, and 94.11% for the EL group.

Insertion Torque and Resonance Frequency Analysis in Tapered and Parallel Dental Implants.

Primary implant stability (PIS) is known to vary with recipient bone mass and density, dental implant design and surgical technique. The objective of this preliminary study was to compare rotational and lateral PIS of same-coronal-diameter conical and parallel implants, using insertion torque recorded with a dental implant motor set and implant stability quotient obtained from resonance frequency analysis (performed with both Osstell and Penguin systems) as measures of rotational and lateral stability, respectively. Additionally, the relationship between PIS and alveolar ridge width (ARW) was explored in both implant types. Sixty dental implants (30 tapered and 30 parallel) were randomly placed with a split-mouth design in 17 patients. Bone density and ARW were estimated from cone beam computed tomography images taken with radiological-surgical templates. Density and width values were similar in the 2 groups (P > .05). Implant coronal diameters were 3.75 mm in all cases, while consistent with the manufacturer's recommendations, final drill bit diameters used were 3.25 and 3.4 mm for parallel and tapered implants, respectively. Insertion torque was higher (P < .05) with parallel implants, but between-group differences in implant stability quotient were not significant (P > .05). In tapered implants, insertion torque was inversely correlated with ARW (P < .001). Notably, significant differences were observed between resonance frequency analysis values from Osstell and Penguin systems (P < .001). In conclusion, future studies should explore how PIS may be influenced by final drill bit size regardless of implant design and potential limits on the effectiveness of tapered implants to achieve good stability in thick low-density bone.

Maxillary sinus membrane elevation and coagulum compared with maxillary sinus floor augmentation and a composite graft: A 1-year single-blinded randomized controlled trial.

The aim was to evaluate the 1-year implant outcome and patient-related outcome measures (PROMs) after maxillary sinus membrane elevation and coagulum (test) compared with maxillary sinus floor augmentation and a 1:1 ratio of autogenous bone graft from the buccal antrostomy and deproteinised porcine bone mineral (DPBM) (control). Forty patients (30 female, 10 male) with a mean age of 50 years (range 25-71 years) and an alveolar ridge height between 4 and 7 mm were randomly allocated to test or control. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of the peri-implant tissue, peri-implant marginal bone loss, frequency of complications and PROMs using Oral Health Impact Profile-14 combined with questionnaires assessing patient's perception of the peri-implant soft tissue, implant crown, function of the implant, and total implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was 0.05. All suprastructures and implants were well-functioning after 1-year of functional implant loading. No significant difference in any of the applied outcome measures was observed between test and control. Both treatments revealed high patient satisfaction scores and significant improvement in oral health-related quality of life. There were no significant differences in implant outcome and PROMs between test and control, after 1-year of functional implant loading. Neither of the treatments can therefore be considered better than the other. Thus, long-term randomized controlled trials are needed before definitive conclusions can be provided about the two treatment modalities.

A Comparison of Conical and Cylindrical Implants Inserted in an In Vitro Post-Extraction Model Using Low-Density Polyurethane Foam Blocks.

Combining tooth extraction and implant placement reduces the number of surgical procedures that a patient must undergo. Thus, the present study aimed to compare the stability of two types of conical implants (TAC and INTRALOCK) and another cylindrical one (CYROTH), inserted with a range of angulation of 15-20 degrees in low-density polyurethane blocks (10 and 20 pounds per cubic foot, PCF) with or without a cortical lamina (30 PCF), which potentially mimicked the post-extraction in vivo condition. For this purpose, a total of 120 polyurethane sites were prepared (10 for each implant and condition) and the Insertion Torque (IT), Removal Torque (RT), and Resonance Frequency Analysis (RFA) were measured, following a Three-Way analysis of variance followed by Tukey's post hoc test for the statistical analysis of data. The IT and RT values registered for all implant types were directly proportional to the polyurethane density. The highest IT was registered by INTRALOCK implants in the highest-density block (32.44 ± 3.28 Ncm). In contrast, the highest RFA, a well-known index of Implant Stability Quotient (ISQ), was shown by TAC implants in all clinical situations (up to 63 ISQ in the 20 PCF block without the cortical sheet), especially in lower-density blocks. Although more pre-clinical and clinical studies are required, these results show a better primary stability of TAC conical implants in all tested densities of this post-extraction model, with a higher ISQ, despite their IT.