ISQ Values Research Articles

The effect of hydrothermal spark discharge anodization in the early integration of implants in sheep sinuses.

Spark discharge anodic oxidation forms a porous oxide film on titanium implant surfaces, which may increase surface roughness and enhance early osseointegration. This study aimed to clinically and histomorphometric compare commercially-available sandblasted (RBM) implants, treated with hydrothermal anodization and placed into an animal maxillary sinus model. Thirty 3.75 mm×8.5mm threaded titanium implants were placed into the maxillary sinuses of 10 sheep via an external approach, with three test groups and 10 implants per group: right side, Control=CP-titanium with RBM surface, Test group 1=CP-titanium with RBM+anodized surface; left side, Test group 2=Ti-6Al-7Nb with RBM+anodized surface. Schneiderian membranes were elevated but not bone grafted. Resonant frequency analysis (RFA) was measured at surgery. Animals were sacrificed after 1month unloaded healing. Resin-embedded undemineralized ground-sections were digitised, and mean bone-implant contact (% BIC) was measured bilaterally for the best-three consecutive threads. Seven of 30 implants showed signs of failure. RFA was low at placement but did not differ between the groups (group mean ISQ values ranged from 23 to 35; χ(2) =0.37). RFA was not repeated at sacrifice due to implant instability. Histomorphometric analysis showed % BIC was highest for control (34.8±15.7), followed by Test 1 (29.6±18.1) and Test 2 implants (23.3±22.7), but this difference was not statistically significant (χ(2) =0.3). Early integration of RBM implants placed into thin maxillary sinus walls was not enhanced by hydrothermal anodization of implant surfaces. This may be related to the initial low stability of the implants and the relatively short healing period. However, non-anodized RBM surfaces showed promising results, with % BIC values comparable to the best estimates of other studies using sinus grafting. Whether the modification of the implant surfaces through anodization with simultaneous sinus grafting would promote enhanced early osseointegration, is a subject of future research.

Effect of implant macro-design on primary stability: A prospective clinical study.

BackgroundImplant restorations have become a high predictable treatment option. Several caracteristics such as surgical technique and implant design can influence the treatment outcomes. The aim of the present study was to evaluate the influence of implant macro-design on primary stability measured with resonance frequency analysis (RFA) and insertion torque (IT).Material and MethodsA total of 47 implants divided in two groups: Test group (TI): 22 Tapered MIS® Seven implants; Control group (CI): 25 cylindrical Astra® Osseospeed implants. All implants were inserted following the manufacturers’ standard protocols. Implant primary stability was measured at the moment of implant placement by registering insertion torque values (ITv) and ISQ values by means of Osstell™ Mentor (ISQv) (Integration Diagnostic Ltd., Goteborg, Sweden).ResultsIn the mandible, mean ISQv for tapered implants (TI) was 71.67±5.16 and for cylindrical implants (CI) 57.15±4.83 (p=0.01). Mean insertion torque was 46.67±6.85 Ncm for TI and 35.77±6.72 Ncm for CI (p=0.01). In the maxilla, mean ISQ was 67.2±4.42 for tapered implants and 49.17±15.30 for cylindrical implants (p=0.01). Mean insertion torque for TI was 41.5±6.26 Ncm and for CI 39.17±6.34 Ncm (p>0.05). For tapered implants, no correlation could be found between implant diameter and primary stability. But for cylindrical implants there was a statistically significant correlation between implant diameter and primary stability: ITv (p=0.03); ISQv (p=0.04).ConclusionsWithin the limits of the present study, tapered shaped implants achieve higher primary stability measured through ISQ and insertion torque values. Moreover, for cylindrical implants positive correlation has been established between implant diameter and primary stability. Key words:Primary stability, tapered, cylindrical, conical, implant macro-design.

Biomechanical evaluation of oversized drilling technique on primary implant stability measured by insertion torque and resonance frequency analysis.

BackgroundThis study evaluated the influence of implant site preparation depth on primary stability measured by insertion torque and resonance frequency analysis (RFA).Material and MethodsThirty-two implant sites were prepared in eight veal rib blocks. Sixteen sites were prepared using the conventional drilling sequence recommended by the manufacturer to a working depth of 10mm. The remaining 16 sites were prepared using an oversize drilling technique (overpreparation) to a working depth of 12mm. Bone density was determined using cone beam computerized tomography (CBCT). The implants were placed and primary stability was measured by two methods: insertion torque (Ncm), and RFA (implant stability quotient [ISQ]).ResultsThe highest torque values were achieved by the conventional drilling technique (10mm). The ANOVA test confirmed that there was a significant correlation between torque and drilling depth (p<0.05). However, no statistically significant differences were obtained between ISQ values at 10 or 12 mm drilling depths (p>0.05) at either measurement direction (cortical and medullar). No statistical relation between torque and ISQ values was identified, or between bone density and primary stability (p >0.05).ConclusionsVertical overpreparation of the implant bed will obtain lower insertion torque values, but does not produce statistically significant differences in ISQ values. Key words:Implant stability quotient, overdrilling, primary stability, resonance frequency analysis, torque.

IMPLANT STABILITY AND MARGINAL BONE LOSS IN MANDIBULAR IMPLANT RETAINED OVERDENTURE CASES: A COMPARATIVE STUDY USING TWO STUD ATTACHMENT SYSTEMS

The present study was designed to compare two stud attachment systems [Locator and Ball / O-Ring attachment] in mandibular overdenture cases retained by two implants in the inter-foraminal area. Twenty completely edentulous male patients received mandibular overdentures retained by two implants were randomly assigned into two groups; Group-I received Locator attachment while Group-II received Ball / O-Ring attachment. A comparison based on implant stability quotient [ISQ] was done using Resonance Frequency Analyzer [Osstell, ISQ] and another comparison was conducted based on the marginal bone loss using cone beam computed tomography [CBCT]. The patients were then scheduled for recall appointments up to two years follow up period starting from the loading time. The statistical analysis of the results reported no significant difference for the marginal bone loss & ISQ values between the two groups at all intervals except the third month implant stability results which showed a significant difference between the two groups with better stability results in the Locator attachment group (at p<0.05). Within the limits of the present study, it may be concluded that both studied attachment systems are successful and useful however the Locator attachment system shows superior initial stability results than the Ball attachments.

Early loading of titanium dental implants with an intra-operatively conditioned hydrophilic implant surface after 21days of healing.

The aim of the present observational medical device performance study was to test whether implants with an intra-operatively conditioned hydrophilic surface can be safely reconstructed when applying an early loading protocol after 21days in partially edentulous posterior mandibles. Partially edentulous patients with missing teeth in the posterior mandible were recruited. Immediately after implant placement, the implant position was indexed using a pickup impression technique. ISQ values were measured after 21days of healing. When ISQ values were ≥70, the implants were directly restored with provisional reconstructions in occlusal contact allowing an early loading protocol. ISQ values were repeated again at 1, 3, and 6months postloading. Clinical parameters (mPLI, mSBI, PPD, DIM, and CAL) were assessed. Standardized periapical radiographs were obtained after surgery, at implant loading and 3 and 6months later. Changes over time were analyzed for statistical significance using the nonparametric method by Brunner & Langer (SAS Proc Mixed). Fifteen partially edentulous patients with healed sites in the posterior mandible received 20 implants. All implants healed uneventfully. At 21days, all implants achieved an ISQ value of ≥70 (mean of 3 measurements) and were reconstructed at this time point with provisionals. ISQ values showed a gradual increase from baseline to 3 and 6months postloading. The assessment of clinical parameters revealed stable tissue integration. The evaluation of the radiographs showed that 3 and 6months after loading the median mesial and distal marginal bone levels had stabilized at the border between the rough surface and the 1-mm machined implant collar. Functional occlusal loading of implants with a hydrophilic, moderately rough endosseal surface 3weeks after placement appears to be a safe and predictable treatment option in healed sites in the posterior mandible without need of bone augmentation procedures.

Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone.

BackgroundJaw bone and iliac bone are the most frequently used autologous bone sources for dental implant placement in patients with atrophic alveolar ridges. However, the comparative long-term stability of these two autologous bone grafts have not yet been investigated. The aim of this study was to compare the stability of simultaneously placed dental implants with autologous bone grafts harvested from either the iliac crest or the intraoral jaw bone for severely atrophic alveolar ridges.MethodsIn total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed. We compared the residual increased bone height of the grafted bone, peri-implantitis incidence, radiological density in newly generated bones (HU values), and implant stability using resonance frequency analysis (ISQ values) between the two autologous bone graft groups.ResultsBoth autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates. However, the grafted iliac bone exhibited more prompt vertical loss than the jaw bone, in particular, the largest vertical bone reduction was observed within 6 months after the bone graft. In contrast, the jaw bone graft group exhibited a slower vertical bone resorption rate and a lower incidence of peri-implantitis during long-term follow-up than the iliac bone graft group.ConclusionsThese findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.

Treatment strategies in moderate atrophic posterior maxilla: short dental implants or sinus floor elevation?

The aim of present study is to evaluate the implant stability, operative time and patient satisfaction of short dental implants (6mm) alone, short dental implants (8mm) combined with OSFE and standard dental implants (10mm) combined with OSFE for treating atrophic posterior maxilla of partially edentulous. 33 patients with 33 implants (Group 1: 9, Group 2: 12, Group 3: 12) were included in the present study. Implant survival rate, RFA measurements, operative time and patient satisfactory were evaluated. Comparison will be made among the 3 groups using ANOVA. The implant survival rates were 100% in all three groups. At implant placement, the mean ISQ values were 66.56 in group 1, 69.22 in group 2 and 70.78 in group 3. At implant impression, the mean ISQ values were 72.15 group 1, 70.67 in group 2, and 71.78in group 3. The operative time in group 1 (mean: 529.3±27.6) was significantly shorter than those in group 2 (mean 781.3±43.5) and group 3 (mean 820.8±54.1) (P<0.01). No significant difference of the intraoperative discomfort and postoperative pain scores was found among three groups. High survival rates, enough primary and secondary implant stability and excellent patient satisfactory can be achieved in all three groups. Short-6-mm implants group showed significantly shorter operative time. Future studies with large sample size should explore the difference of patient satisfactory among the three treatment strategies.

Measurements of Implant Stability Following Sinus Lift: A Pilot Clinical Study.

The aim of this study was to evaluate the implant stability of Bredent Sky Blue implants of different diameters following one stage sinus lift procedure. This study included 9 male patients with an existing indication for unilateral or bilateral sinus lift procedure. As grafting materials, combination of allograft material MinerOss® cortical & cancellous and Ossceram nano were used. All implants were considered successful and ISQ levels were measured by Osstell ISQ device. The ISQ values were from 68 to 84. The mean values of stability of Bredent Sky Blue implants of different diameters following one stage sinus lift procedure were 77.73 ± 2.93 (MD) and 77.98 ± 2.72 (VO).

A study on simplified procedure of enhanced designed implant drill

Purpose : The objective of this research was to develop a more simplified drilling procedure with an enhanced implant drill. Materials and Methods : The drill enhanced design factors enabled implantation of Dia. 5.0mm fixture with only 2 times drilling which is more simplified drilling procedure. The enhanced drill was designed with 2 flutes, 2-phase or 3-phase formed drill tip and 25 degrees of helix angle. The proposed drilling procedure (2 times) was compared with a general drilling process (4 times) in terms of temperature changes, cutting time and ISQ value. Results : The simplified drilling procedure indicated less heat than a conventional drilling procedure (p&lt;0.05). The enhanced drill showed significantly shorter drilling time than a conventional drill (p&lt;0.05). On the other hand, higher insertion torque and ISQ value were observed on the the suggested drilling procedure than the conventional drilling procedure (p&lt;0.05). Conclusion : A simplified drilling procedure with the newly designed drill could provide higher effectiveness and safety of dental implant operations under properly controlled external conditions, such as irrigation and RPM of drilling.

The effect of drill design on stability and efficacy of dental implants

Purpose : The objective of this research was to investigate an optimization of drill design factors for implant stability and efficacy through comparative evaluation by the cutting time, heat generation and initial stability. Materials and Methods : Three design factors were considered for the purpose of drill design optimization; the number of flute(2 flute, 3 flute), helix angle(15&amp;deg;, 25&amp;deg;) and drill tip shape(straight, 2-phase). Design factors were selected through comparative evaluation by temperature change, cutting time and ISQ value. Results : Heat generation and cutting time are influenced by all design factors(p&lt;0.05). Drill tip shape was the only factors which influenced to the largest initial stability(p&lt;0.05). Conclusion : Drills with 2 flutes, 2-phase formed drill tip, and 25 degrees of helix angle exhibit a better performance than other design.

Retracted: Histological and histomorphometric analyses of narrow implants, crestal and subcrestally placed in severe alveolar atrophy: a study in foxhound dogs

Narrow-diameter implants provide an alternative to the horizontal augmentation techniques situations severe bone atrophy. Lack of bone width and interdental space has been regarded as an encumbrance in the case selection for prosthetic rehabilitation using dental implants. The aim of the study was to evaluate bone-to-implant contact and marginal bone loss of two different narrow implants in resorbed ridges at different crestal positions. 48 Bredent Narrow(®) implants (24 MiniSky(®) and NarowSky(®) ) were placed at crestal and subcrestal levels in healing bone of atrophic alveolar ridge of 6 American foxhounds. Histological and histomorphometric analyses of osseointegration were carried out at 4 and 8 weeks. Modeling in the marginal defect region was accompanied by marked decreases in the dimensions of both the buccal and the more lingual bone walls. Relative to BIC, significant differences were found in favor of subcrestal group, for both Narrow Sky and MiniSky. Linear measurements showed to be slightly high in the crestal group. With significant differences for PM-IS (peri-implant mucosa to implant shoulder) and IS-BC (implant shoulder to buccal bone crest). Within the limitations of animal study, it can be stated that the NarrowSky(test group) crestal and subcrestal implants showed less crestal bone resorption, higher ISQ values and most BIC at 4 and 8 weeks of evaluation compared with MiniSky implants (control group). The design of the implants plays an important role in peri-implant mucosa and crestal bone maintenance at 8-week follow-up period.

Survival of Chemically Modified Titanium Surfaced Implants in Irradiated Jaws of Oral Cancer Patients

Objective: To investigate the clinical performance of implants with chemically modified surfaces in irradiated bone in a period of five-years. Patients & Methods: 15 (6 females, 9 males, 50.2 years with a range of 38 - 60 years) patients who had been operated for oral tumors and had undergone radiotherapy were enrolled and 40 SLActive surface implants were placed (24 in the maxilla, 16 in the mandible). Implants were allowed to integrate for a period of 90 days and the stability of the implants was measured with Resonance Frequency Analyzer/Osstell? Mentor (Integration Diagnostics, Savedalen, Sweden) at implant placement, 30 days later and at the end of the 90th day. Patients follow up periods after the implant placement varied from 20 months to 60 months (mean: 45 months). Results: Two implants were lost in maxilla in healing period as a result of osseointegration failure. The survival rate was 95%. During the observation period, totally 4 implants were lost. The overall success rate was 90%. 3 of the lost implants were in maxilla and one was in mandible. The initial ISQ values of the implants differed from 20 - 71; the second values were between 24 - 71 and the last values were between 30 - 89. The implants which were lost could not show a value greater than 35. Conclusion: There was no any complication on the SLActive surface implant placed bones due to irradiation. Within the limitations of this study, it may be concluded that osseointegrated implants can be placed in irradiated bones, unless a careful patient selection and treatment planning is performed.

Prospective analysis of stability testing for bone-anchored hearing implants in children after osseointegrating surgery without skin thinning

ObjectivesTo report normative values for osseointegration in 10 children with bone-anchored hearing implants who were consecutively operated on using a tissue preserving technique with individualized abutments and prospectively followed with stability testing 1 year after surgery. Methods and materialChildren were implanted with bone-anchored hearing devices using a non-skin thinning implantation technique and followed during the course of a year. Mean age was 5.1 years. Stability testing with Osstell's resonance frequency analysis (RFA) measurement was used at each visit, providing values between 0 and 100 (representing a range of low to high stability, respectively). Clinical signs and symptoms were also noted at each visit. Three of the children were operated on using a two-step procedure, while the remaining seven children were operated on using a one-step procedure. ResultsEight of the children showed skin-related problems during the 1-year control period that were easily treated. Two children experienced an abutment loss early following surgery (1 two-step and 1 one-step) and showed low resonance measurements of 30 or less within the first 3–4 weeks. Two children experienced a traumatic abutment loss and two required a change in abutment length. ConclusionsDuring the 1-year follow-up, nine children demonstrated signs of peri-implant infections, only two of which were recurrent. Stability was measured to be higher in eight children with longer abutments. Two children experienced low stability (<30) and abutment loss without peri-implant infection, while two additional children experienced abutment loss due to trauma. After the 1-year study period, 10 out of the 10 children used their hearing aid and mean ISQ values were 56.2 and 47.5 for 6mm and 9mm abutments, respectively.

Assessment of the correlation between implant stability and bone density by computed tomography and resonance frequency analysis in fresh cadavers.

Because of the immediate loading implant process, clinicians must consider implant primary stability issues before initiating surgery. The aim of this study was to assess the correlation between the bone density assessed by computed tomography (CT) images and the primary stability of two implant designs, as determined by resonance frequency analysis (RFA). Sixty implants (30 NobelActive, 30 NobelSpeedy [Nobel Biocare]) were placed in five totally edentulous fresh cadaver maxillae. Before surgery, CT images were analyzed and bone densities measured. Implant primary stabilities (measured in implant stability quotient [ISQ] units) were determined along the buccolingual and mesiodistal axes by RFA. Correlations were assessed using the Pearson correlation test. Bone densities were similar near NobelActive and NobelSpeedy implants: 434.67 (± 220.53) versus 479.87 (± 209.05) Hounsfield Units (HU). Bone densities and NobelActive primary stabilities were highly correlated with ρ = 0.74 (P = .000) and ρ = 0.78 (P = .000) for the buccolingual and mesiodistal axes, respectively. An association was found between the 350 HU and 50 ISQ values, confirming good primary stabilities. For NobelSpeedy implants, no correlation was found regardless of the axis, with ρ = -0.07 (P = .72) (buccolingual) and ρ = -0.10 (P = .59) (mesiodistal). However, poor and good stabilities were observed in the anterior and posterior areas, respectively. This study revealed variations in primary stabilities depending on the implant design. The primary stability of conical implants with a double-lead thread design (NobelActive) seemed bone density-dependent regardless of the area of the maxilla, whereas the primary stability of nearly parallel-wall implants with a classical thread design (NobelSpeedy) seemed dependent on anatomical morphology. These results raise questions about the specific roles of the implant shape and thread design depending on the bone density and alveolar morphology.

Clinical study on survival rate of short implants placed in the posterior mandibular region: resonance frequency analysis.

Short implants are increasingly used, but there is doubt about their performance being similar to that of regular implants. The aim of this study was to compare the mechanical stability of short implants vs. regular implants placed in the edentulous posterior mandible. Twenty-three patients received a total of 48 short implants (5×5.5mm and 5×7mm) and 42 regular implants (4×10mm and 4×11.5mm) in the posterior mandible. Patients who received short implants had <10mm of bone height measured from the bone crest to the outer wall of the mandibular canal. Resonance frequency analysis (RFA) was performed at time intervals T0 (immediately after implant placement), T1 (after 15days), T2 (after 30days), T3 (after 60days), and T4 (after 90days). The survival rate after 90days was 87.5% for the short implants and 100% for regular implants (P<0.05). There was no significant difference between the implants in time intervals T1, T2, T3, and T4. In T0, the RFA values of 5×5.5 implants were higher than values of 5×7 and 4×11.5 implants (P<0.05). A total of six short implants that were placed in four patients were lost (three of 5×5.5mm and three of 5×7mm). Three lost implants started with high ISQ values, which progressively decreased. The other three lost implants started with a slightly lower ISQ value, which rose and then began to fall. Survival rate of short implants after 90days was lower than that of regular implants. However, short implants may be considered a reasonable alternative for rehabilitation of severely resorbed mandibles with reduced height, to avoid performing bone reconstruction before implant placement. Patients need to be aware of the reduced survival rate compared with regular implants before implant placement to avoid disappointments.

Comparative study of immediate functional loading and immediate non-functional loading of monocortical implants

BackgroundAttempts to shorten the overall length of treatment have focused on immediate loading, subsequent to implant placement. Prosthetic rehabilitation immediately after implant placement can be either functional or non-functional in nature. There is paucity of literature on the comparative evaluation of immediate functional and immediate non-functional loading of implants. This in-vivo study was undertaken to comparatively evaluate Immediate Functional Loading and Immediate Non-Functional Loading of monocortical implants with a follow-up period of 18 months. Methods50 partially edentulous cases were selected for the study. The cases were divided into two groups. In first group (Group-1), 25 implants were subjected to immediate functional loading. In second group (Group-2), 25 implants were subjected to immediate non-functional loading. The crestal bone loss, clinical stability and degree of osseointegration of these two groups were comparatively evaluated. ResultsThe crestal bone loss in both groups was within acceptable limits. The implant stability, which is a reflection of the status of bone-to-implant interface, was comparable in both the groups at different time intervals. Although, the ISQ values in Group-2 were slightly higher than those in Group-1, the results were not statistically significant. Radiodensity indicating degree of osseointegration at different time intervals in both groups was also comparable. ConclusionBoth the IFL and INFL protocols can be undertaken satisfactorily in rehabilitation using endosseous implants; however, the main factors for success in IFL and INFL are case selection, meticulous treatment planning and the precision of technique.

The Evaluation of the Reliability of Periotest for Implant Stability Measurements: An In Vitro Study

Periotest (Medizintechnik Gulden, Modautal, Germany) is a widely accepted implant stability measurement method, although the reliability is not well known. The aim of this in vitro study was to investigate the reliability of the Periotest in implant stability measurements. Thirty implants were placed in 3 cow ribs. The stability of each implant was measured by insertion torque, resonance frequency analyses, and Periotest and then compared. The Periotest values (PTVs) were measured by 4 different examiners. The measurements were repeated twice in both the buccal and mesial directions, for each implant at 2-hour intervals and the intra- and interobserver reliability of Periotest was measured. Results showed that the intraobserver reliability of the Periotest was excellent for the buccal PTVs but fair to poor for the mesial PTVs. The interobserver reliability of the Periotest was excellent for the buccal PTVs but poor for the mesial PTVs. No significance was found between the PTVs and IT values (P = .803) and PTVs and ISQ values, whereas a 47.1% significant correlation was detected between the IT values and ISQ values (P = .009). The present study indicates that only Periotest measurements from buccal result in excellent intra- and interobserver reliability for the quantification of the implant stability.

Stability and survival of bone-anchored hearing aid implant systems in post-irradiated patients

Bone-anchored hearing aids (BAHAs) are based on the principle of osseointegration, which is fundamental to implant stability and survival. Previous exposure to ionising radiation may compromise this, as evidenced in relation to dental and craniofacial implants. There is a dearth of data, however, regarding BAHA implant systems in patients with previously irradiated implant sites. We sought, therefore, to investigate implant stability and survival in such patients. Patients were identified retrospectively from our electronic BAHA database. Hospital records were reviewed for demographics; operative technique; complications; and details regarding previous irradiation. Implant stability was assessed by resonance frequency analysis (RFA), generating a numerical value-implant stability quotient (ISQ). Extrapolating from dental studies, successfully loaded implants typically have ISQs of ≥60. Readings were, therefore, interpreted with respect to this. Seven patients were identified for inclusion. Mean time between irradiation and implant insertion was 33 months (range 16-72 months), and mean time from implant insertion to RFA measurement was 41 months (range 3-96 months). Operatively, all patients underwent single-stage procedures under local anaesthesia. One patient suffered a Holger's grade 2 skin reaction, while two suffered significant skin flap failure, requiring revision procedures. The implant survival rate was 100 %. All ISQ values were >60, with a mean of 66.9 (95 % confidence interval 63.1-70.6). Our data support sufficient osseointegration of BAHA implant systems in post-irradiated patients, but highlight issues with wound healing. Contemporary soft tissue preservation operative techniques will likely overcome this, facilitating safe and efficacious BAHA insertion in this ever-increasing group of patients.

Development of a Transducer for Dental Implant Stability Measurement

This study focuses on the development of transducers for Osstell® Mentor in measuring stability of various implant systems. Experiments are performed to verify the compatibility of a self-made transducer. An acoustic signal analysis system is introduced to analyze the acoustic signal emitted from the Osstell® Mentor probe, and the frequency with peak amplitude in the amplitude-frequency plot is identified. The resonance frequency obtained is found to be linearly dependent upon the ISQ value by Osstell® Mentor. This finding is helpful for developing compatible transducers for various implant systems.

Primary Stability Comparison Using Piezoelectric or Conventional Implant Site Preparation Systems in Cancellous Bone

This study compares implant primary stability achieved in cancellous bone after placement in piezoelectric prepared sites versus conventionally drilled sites. Four bovine ribs were randomly assigned and placed in a water bath at 36.5 °C. Five sites per rib (total n = 20 sites) were prepared using piezoelectric system (test) or conventional drills (control) with twenty 10 × 3.6-mm Implantium implants placed. Using Osstell Mentor quantitative analysis, 5 resonance frequency analysis [implant stability quotient {ISQ}] values per implant were recorded at 5 locations for a total of 100 measurements. Independent t test analysis indicated significant difference in primary stabilities between groups: t (17) = 2.637, P = 0.17, with equal variance assumption satisfied (P = 0.196). Examination of means indicated a higher mean ISQ for piezoelectric than for conventional: 58.9 (+8.55) versus 49.2 (+7.33), respectively. Analysis of variance indicated a significant difference in mean ISQ value by rib. Tukey test indicated significantly higher ISQ values for rib A (test) than ribs B, C (control), and D (test). Implant site preparation using the piezoelectric system gives higher implant primary stability in cancellous bone. However, variations in quality across bones may have affected the results.