Mean Implant Stability Quotient Research Articles

Implant Stability after Graftless Motor-Driven Crestal Sinus Elevation: A Cohort Study.

Graftless motor-driven crestal sinus elevation may be a preferable alternative to conventional methods due to the reduction of post-surgical complications and lower cost. This prospective cohort study evaluated the stability of implants installed using this technique. Twenty-nine Straumann BLT implants in 29 different patients were included in the sample. Average implant stability quotients (ISQ) were measured immediately after surgery (Mean 73.5 ± 9.2) and after a period of healing (Mean 77.1 ± 4.5) using resonance frequency analysis (RFA). There was a significant increase in implant stability after healing (p = .035). The healing duration did not significantly influence how implant stability increased (p =.373). The mean ISQ after healing was significantly higher than the clinically acceptable stability value of 65 ISQ (p <.001). Implant length and width were not significantly correlated with ISQ increase (p =.764 and p =.085, respectively). In addition, there were no significant differences in average ISQ values measured immediately post-surgery (at baseline) or after healing between implants with and without registered perforations during surgery (p =.118 and p =.366, respectively). The post-healing stability of four implants that did not achieve primary stability was not significantly less stable after the healing period than those that had achieved primary stability (p =.086). Moreover, the level of insertion torque significantly impacted implant stability immediately post-surgery (p < .001), but the ISQ values measured after healing were not significantly different based on the initial insertion torque values (p = .131). This study suggests that implants installed using graftless motor-driven crestal sinus elevation may achieve clinically acceptable stability as measured by RFA.

Nano-superhydrophilic and bioactive surface in poor bone environment. Part 1: transition from primary to secondary stability. A controlled clinical trial

ObjectivesBioactive surfaces were designed to increase the interaction between the surface and the cells. This may speed up the biological stability and loading protocols.Materials and methods36 patients with D3-D4 bone density were recruited and allocated into two groups. 30 bioactive (test group) and 30 traditional (control group) surfaced implants were placed. Insertion torque value (Ncm), insertion torque curve integral (cumulative torque, Ncm), torque density (Ncm/sec), implant stability quotient (ISQ) measured at three timepoints (baseline (T0), 30 (T30) and 45 (T45) days after surgery), and marginal bone loss (MBL) at 6 months of loading were assessed.ResultsThe mean ISQ and standard deviation at T0, T30, T45 were respectively 74.57 ± 7.85, 74.78 ± 7.31, 74.97 ± 6.34 in test group, and 77.12 ± 5.83, 73.33 ± 6.13, 73.44 ± 7.89 in control group, respectively. Data analysis showed significant differences between groups in ΔISQ at T0-T30 (p = 0.005) and T30-T45 (p = 0.012). Control group showed a significant decrease in ISQ at T30 (p = 0.01) and T45 (p = 0.03) compared to baseline, while no significant change was observed in test group. Due to the stability of the ISQ value ≥ 70, 26 test group and 23 control group implants were functionally loaded after 45 days. Conversely, due to the ISQ < 70 at T45, four test group implants and one control group implant were loaded after 90 days, and 6 control group implants were loaded after 180 days. Neither insertion torque nor ISQ at baseline were correlated with bone density (in Hounsfield units). There was no significant correlation between cumulative torque and ISQ at baseline. There was a significant positive slope in the correlation between torque density and ISQ at baseline, more accentuated in D3 than D4. This correlation remained significant for the test group in D3 bone at day 30 and 45 (p < 0.01 in both time frames), but not in D4 bone, and it was not significant in CG.ConclusionsThe bioactive surface showed better behavior in terms of implant stability in D3-D4 bone quality in the early stages of bone healing. Clinical relevance This study demonstrated that the transition from primary to secondary stability is improved using bioactive surface, especially in cases of poor bone environment (D3/D4 bone).

Primary stability and osseointegration comparing a novel tapered design tissue-level implant with a parallel design tissue-level implant. An experimental invivo study.

The aim of the present study was to compare a novel tapered, double-threaded self-tapping tissue-Level design implant (TLC) to a well-established parallel walled tissue-level (TL) implant in terms of primary and secondary stability over time. Test TLC (n = 10/per timepoint) and control TL (n = 10/per timepoint) implants were placed in the mandible of minipigs and left for submerged healing for 3, 6, and 12 weeks. Maximum insertion torque and implant stability quotient (ISQ) were measured for each implant at placement. Osseointegration and cortical bone maintenance were histologically evaluated by measuring total bone-to-implant contact (BIC) and first bone-to-implant contact (fBIC). A significantly higher maximum insertion torque was measured for the test implant TLC compared to the control TL implant (57.83 ± 24.73 Ncm and 22.62 ± 23.16 Ncm, respectively; p < .001). The mean ISQ values were comparable between the two implant types (75.00 ± 6.70 for TL compared to 75.40 ± 3.20 for TLC, p = .988). BIC was comparable between both implant types at each of the evaluated time points. The fBIC was found to be significantly more coronal at 12 weeks for the TLC implant compared to the TL implant (0.31 ± 0.83 mm for TLC compared to -0.22 ± 0.85 for TL, p = .027). The novel tapered tissue level design implant showed improved primary stability and an overall improved crestal bone height maintenance compared to the parallel walled design at 12 weeks.

Implant stability and clinical outcome between implant placement using internal sinus floor elevation with alloplastic bone material grafting and without grafting: A 1-year randomized clinical trial.

To compare implant stability and clinical outcome in implant placement between osteotome sinus floor elevation (OSFE) with biphasic calcium phosphate (BCP) which consisted of 30% of hydroxyapatite (HA) and 70% of beta-tricalcium phosphate (β -TCP) grafting material and OSFE without using bone grafting material. The research questions is whether the BCP provides any benefit in OSFE or not. Thirty patients (30 implants) with a single edentulous area of upper premolar or molar were randomly separated into OSFE with BCP (n = 15) and OSFE without grafting (n = 15). The patients were reevaluated 3, 6, 9, and 12months after implant loading. The clinical assessments (implant stability quotient (ISQ), implant survival-failure rate, and surgical complication) were analyzed. Together with radiographic assessments in 2D (endo-sinus bone gain (ESBG), mean marginal bone change (MMBC)) and 3D (endo-sinus bone gain in CBCT (ESBG-CT)) were evaluated, with a mean follow-up time of at least 12months of functional loading and prosthetic complication. 20 remaining implants (OSFE with BCP, n = 10; OSFE without grafting, n = 10) were analyzed. Mean ISQ was 79.18 3.43 in 1-year follow-up (ISQ; OSFE with BCP = 78.72 3.46, OSFE without grafting = 79.65 3.52). ISQ in both groups increased steadily without significant differences in each follow-up. (p = 0.56). In radiographic evaluation, at 6-, 9-, and 12-month, OSFE without grafting group showed statistically significant lower MMBC (p < 0.05). The 1-year clinical results showed that 2 implants failed in OSFE with BCP, and 1 implant failed in OSFE without grafting. Graft material "BCP" (HA30:TCP70) coupled with OSFE presents no extraordinary benefit in implant stability, clinical and radiographic outcome in 1-year follow-up. Clinically, OSFE with grafting materials provides no additional benefit. TCTR20210517008 (date of registration: May 17, 2021).

First-in-Human Pilot Study to Assess Methodology for Using a Mineral-Organic Bone Adhesive for Optimization of Primary Stability and Implant Success for Implants Glued into Immediate Extraction Sockets and Immediately Temporized: Pilot Study.

To assess the handling properties and clinical function of a new class of material, a so-called mineral-organic bone adhesive (Tetranite; TN), which as yet has no precedent in orthopedic or oral and maxillofacial surgery, for clinically unstable implants placed in immediate extraction sockets and immediately temporized in the anterior maxilla. A cohort of up to 15 patients requiring between one and four immediate dental implants placed into maxillary extraction sockets from canine to canine were eligible for inclusion. Implants had to be unstable with an insertion torque of < 15 Ncm. Implants were then stabilized using TN, which was allowed to set before reassessing stability using both torque and resonance frequency measurements. Implant stability quotients (ISQs) taken after TN setting were compared to ISQs taken prior to its application, and the implants had to demonstrate resistance to a forward torque of 20 Ncm to be considered stable. ISQs were monitored at 1 week and 1, 3, 7, and 12 months postplacement. In addition, peri-implant tissue health was monitored, adverse events were recorded, and implant success was determined at 1 year postplacement. Eleven patients received a total of 14 implants. Three out of the first six implants failed within 1 month (50%), and thus a protocol amendment was made to remove steps considered potentially destructive to the bonding process. As a result of these amendments, only one further failure was experienced for the next eight implants placed (12.5%). Mean ISQ data averaged for buccolingual and mesiodistal measurements demonstrated a baseline value before TN application of 59.1 Ncm (SD: ± 9.7; range: 40.5 to 73.0). After final setting of the TN, mean ISQ measured 71.9 Ncm (± 6.5; 56.0 to 80.0). At 3 months, just prior to restoration placement, mean ISQ measured 71.0 Ncm (± 6.6; 57.0 to 78.0). Thereafter, the mean ISQ continued to increase at both the 7- and 12-month follow-ups with scores of 78.9 (± 4.6; 72.0 to 84.5) and 80.3 (± 3.8; 74.5 to 85.0), respectively. The surviving 10 implants went on to be fully restored and remained in function beyond the end of the study period to yield a final success rate of 71.4%. The purpose of a first-in-human study is to demonstrate an extrapolation of preclinical data into the controlled human clinical arena. It is an opportunity to learn what does and does not translate well from experimental data. In that regard, the current pilot study can be deemed a complete success. The implant survival rate of 71.4%, while disappointing, should be considered in light of the protocol amendments identified, the user handling experience learned, and the opportunity to modify the material to better perform in the human patient, as all represent important lessons learned. The notable increase in ISQ sheds light on the nature by which the glue was substituted for bone to yield a stable implant by the end of the study period.

Management of Advanced Peri-Implantitis by Guided Bone Regeneration in Combination with Trabecular Metal Fixtures, Two Months after Removal of the Failed Implants: Two-Year Results of a Single-Cohort Clinical Study

Background: Implant replacement is among the treatment options for severe peri-implantitis. The aim of this single-cohort study was to evaluate the feasibility of replacing compromised implants affected by advanced peri-implantitis with new implants with a porous trabecular metal (TM) structure. Materials and Methods: Patients with one or more implants in the posterior region showing a defect depth &gt;50% of implant length, measured from the residual crest, were consecutively included. Two months after implant removal, patients received a TM implant combined with a xenograft and a resorbable membrane. The implant stability quotient (ISQ) was measured at placement and re-assessed five months later (at uncovering), then after 6, 12, and 24 months of function. Marginal bone loss was radiographically evaluated. Results: Twenty consecutive cases were included. One patient dropped out due to COVID-19 infection, and nineteen cases were evaluated up to 24 months. At placement, the mean ISQ was 53.08 ± 13.65 (standard deviation), which increased significantly to 69.74 ± 9.01 after five months of healing (p &lt; 0.001) and to 78.00 ± 7.29 after six months of loading (p &lt; 0.001). Thereafter, the ISQ remained stable for up to 24 months (80.55 ± 4.73). All implants successfully osseointegrated and were restored as planned. After two years, the average marginal bone level change was −0.41 ± 0.38 mm (95% confidence interval −0.60, −0.21), which was limited yet significantly different from the baseline (p &lt; 0.05). Conclusions: The treatment of advanced peri-implant defects using TM implants inserted two months after explantation in combination with guided bone regeneration may achieve successful outcomes up to two years follow-up, even in the presence of low primary stability.

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.

Resonance Frequency Analysis to Assess the Stability of Immediate Implants: A Retrospective Clinical Trial.

Adequate implant primary stability is a key factor to obtain osseointegration and can be measured at insertion by insertion torque (IT) and at different timepoints with resonance frequency analysis (RFA), expressed as an implant stability quotient (ISQ). This retrospective study investigated the correlation between ISQ and IT at implant insertion. All patients who were eligible for this single-cohort retrospective clinical trial were treated with an immediate implant. IT parameters were recorded at implant insertion, and ISQ values were recorded at insertion and at 2-, 4-, and 12-month follow-ups. The study comprised 23 patients who received 32 implants. The mean IT value was 46.87 ± 9.66 Ncm (range: 25 to 65 Ncm), and the mean ISQ value at implant insertion was 71.45 ± 4.24 (range: 63 to 78); these values showed a statistically significant correlation (P < .0001). According to the present data and considering the implant design used in this trial, there is a statistically significant and positive correlation between IT and ISQ values. Thus, ISQ can be used as a reliable method to measure implant stability over time.

Sinus floor augmentation using crestal approach in conjunction with hydroxyapatite/cross-linked collagen sponge: A pilot study.

Different biomaterials were suggested for sinus floor augmentation (SFA). Recently, new materials were launched showing true bone formation without remnants. The aim of this prospective study was to evaluate an hydroxyapatite-based, sugar cross-linked collagen sponge (OSSIX™ Bone) in transcrestal SFA (t-SFA). Twenty-four patients with edentulous posterior maxilla and residual bone height (RBH) >4 mm underwent t-SFA with OSSIX™ Bone as grafting material and simultaneous implant placement. The implant Stability Quotient (ISQ) was measured by resonance frequency analysis (RFA) directly after implant insertion and at 6 months. Differences in bone height (BH) and volume were determined in CBCT and x-rays at baseline versus 1 year of follow-up. Graft volume was evaluated by tridimensional reconstructions. Linear regression analysis was used to evaluate the effect of bucco-palatal sinus dimension, RBH, and length of the implant protruding (PIL) into the sinus, on the graft height (GH) changes up to 1 year, and on the graft volume at 1 year. Autocorrelation between time lag and augmented bone volume was evaluated through time series analysis correlograms. Health-related quality-of-life outcomes were captured. Twenty-two patients completed the study. The mean RBH measured at baseline was 5.81 ± 2.2 mm. The mean graft volume was 1085.8 ± 733.4 mm3 . The mean GH, measured in the immediate post-operative period, at 6 and 12 months respectively, was 7.24 mm ±1.94; 6.57 mm ± 2.30; 5.46 mm ± 2.04. The mean ISQ measured after the implant placement was 62.19 ± 8.09, and 6 months later was 76.91 ± 4.50. There was a significant correlation between buccolingual dimension and graft volume at 1 year. Neither buccolingual volume nor RBH had a significant effect on GH change, while the PIL showed a significant positive correlation (P = 0.02 and P = 0.03 at 6 and 12 months, respectively). The correlograms indicated no significant correlation, meaning that there is no tendency for graft volume to increase or decrease over time, therefore suggesting graft stability, at least up to one year of follow-up. 86% of patients had no chewing interference. Within the limitations of the study, OSSIX™ Bone could be considered a valid material for SFA due to its manageability and its positive results in promoting new bone formation with long-term stability. T-SFA is confirmed as a less invasive and less painful method.

Immediate vs. Delayed Placement of Immediately Provisionalized Self-Tapping Implants: A Non-Randomized Controlled Clinical Trial with 1 Year of Follow-Up.

This study aimed to examine the clinical and esthetic outcomes of immediately provisionalized self-tapping implants placed in extraction sockets or healed edentulous ridges one year after treatment. Sixty patients in need of a single implant-supported restoration were treated with self-tapping implants (Straumann BLX) and immediate provisionalization. The implant stability quotient (ISQ) and insertion torque were recorded intraoperatively. After one year in function, the implant and prosthesis survival rate, pink esthetic score (PES), white esthetic score (WES), and marginal bone levels (MBL) were assessed. Sixty patients received 60 self-tapping implants. A total of 37 implants were placed in extraction sockets and 23 in edentulous ridges, and then all implants were immediately provisionalized. All implants achieved a high implant stability with a mean insertion torque and ISQ value of 58.1 ± 14.1 Ncm and 73.6 ± 8.1 Ncm, respectively. No significant differences were found between healed vs. post-extractive sockets (p = 0.716 and p = 0.875), or between flap vs. flapless approaches (p = 0.862 and p = 0.228) with regards to the insertion torque and ISQ value. Nonetheless, higher insertion torque values and ISQs were recorded for mandibular implants (maxilla vs. mandible, insertion torque: 55.30 + 11.25 Ncm vs. 62.41 + 17.01 Ncm, p = 0.057; ISQ: 72.05 + 8.27 vs. 76.08 + 7.37, p = 0.058). One implant did not osseointegrate, resulting in an implant survival rate of 98.3%. All implants achieved PES and WES scores higher than 12 at the 1-year follow-up. The clinical use of newly designed self-tapping implants with immediate temporization was safe and predictable. The implants achieved a good primary stability, high implant survival rate, and favorable radiographic and esthetic outcomes, regardless of the immediate or delayed placement protocols.

Comparison of Primary Stability of Two Different Implants DesignsA Prospective Clinical Study

Introduction: Any implant treatment must begin with successful implant integration. The effectiveness of implant osseointegration is determined by various factors, including implant design, implant diameter and density, and surgical technique. Osseointegration is dependent on implant design. Aim: To assess the primary stability of tapered and cylindrical implants by using Resonance Frequency Analysis (RFA) and Insertion Torque Values (ITV). Materials and Methods: This in-vivo, prospective clinical study was conducted in the Department of Prosthodontics at Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India in the month of November 2019. Twenty patients were selected for the study. Tapered Bioline implants (Bioline Dental GmbH &amp; Co. KGGermany) were spaced in 10 patients (group 1) and cylindrical Bioline implants (Bioline Dental GmbH &amp; Co. KG-Germany) in the other 10 patients (group 2). For both implant designs, primary stability was assessed immediately after implant placement using RFA by Osstell Mentor and ITV by a torque wrench. KolmogorovSmirnov test, Shapiro-Wilk test were used for checking normality. Mann Whitney U test, Independent t tests, Spearman correlation tests were done by using software Statistical Package for Social Sciences (SPSS) Version 23.0. Results: The mean ISQ (Implant Stability Quotient) for tapered implants was 76.6±2.3, and for cylindrical implants mean ISQ is 59.75±4.2 (p-value &lt;0.001). The mean ITV for tapered implants was 43.5±2.58 Ncm, and for cylindrical implants, the mean ITV was 33±4.21 Ncm (p-value &lt;0.001). The correlation between ITV and RFA was 0.928 which was highly significant (p&lt;0.001**). Conclusion: Within the scope of this investigation, tapered implants showed better primary stability than cylindrical-shaped implants as determined by ISQ and insertion torque values. ITV and ISQ values showed a positive correlation in determining the primary stability of implants.

The Effects of Injectable Platelet-Rich Fibrin on Implant Stability.

To investigate the effects of injectable platelet-rich fibrin (i-PRF) on implant stability. A total of 40 implants (BEGO Semados RS/RSX implants, BEGO Implant System) were surgically placed in 15 patients between the ages of 25 and 67 years who had mandibular edentulous areas. After the implant sockets were prepared with the appropriate protocol, i-PRF was applied to the implant surface and socket with the help of a 5-cc sterile syringe in the study group, and implants were placed without i-PRF in the control group. In the research process, the resonance frequency analysis (RFA) method was used to measure implant stability. The implant stability quotient (ISQ) values were determined during the time of the operation and at the first, second, and fourth weeks. The results obtained after the stability measurement periods showed that the decrease in the mean ISQ values in the control group was statistically significant in the first week. Evaluations made in the following weeks were not statistically significant. The study group showed an increase in ISQ values during the measurement periods, and the increases in the second and fourth weeks were statistically significant. I-PRF had positive effects on early implant stability, and i-PRF can be safely used in dental implant surgery and promotes bone healing around dental implants.

Resonance Frequency Analysis for Immediately Placed Dental Implants Replacing Periapically Infected Teeth

Aims: There is a controversy regarding the indication of implant insertion into the sockets of infected teeth. This study aimed to evaluate the outcome of immediate implants replacing periapically infected teeth utilizing Resonance Frequency Analysis (RFA) method. Materials and Methods: Preoperatively, clinical, and radiographic examination accomplished for the patients. After anesthetizing the surgical area, the accused tooth extracted, and the socket curetted by surgical curette to remove the periapical lesion then irrigated by normal saline solution. The implant inserted into its prepared site. Beta-tricalcium phosphate (β-TCP) (combined by collagen membrane) used to fill gaps ≥ 2 mm and to repair bone defects. Implant stability quotient (ISQ) values were measured for the implants during surgery and after 16 weeks. Postoperative clinical and radiographic evaluation were conducted for each patient. Results: Fourteen implants out of 41 immediate implants (34.1%) had been inserted in the extraction sockets of teeth have chronic periapical lesions (infected sites), T-test showed no significant difference in implant stability (ISQ value) between implant placed in infected and non-infected sites neither at baseline nor at 16-weeks. Paired t-test showed highly significant increase in implant stability (ISQ value) of implants placed in infected sites while in the other implants the mean ISQ value increased with no significant difference during the healing period. The success rate was 100% after 4 years of implantation. Conclusions: Presence of periapical lesion is not a contraindication to place immediate implant when properly managed and can provide similar survival rate to that of implants inserted into healthy sockets.

Effect of Sinus Floor Augmentation with Platelet-Rich Fibrin Versus Allogeneic Bone Graft on Stability of One-Stage Dental Implants: A Split-Mouth Randomized Clinical Trial.

Rehabilitation of an edentulous posterior maxilla with dental implants is challenging, and sinus floor augmentation could be considered as an important surgical procedure for bone augmentation in this region before implant placement. Platelet-rich fibrin (PRF) is a new-generation platelet concentrate with simplified processing: its application in sinus floor augmentation has been widely investigated in literature. However, the biological properties and actual efficacy of this product remain controversial. This study assessed the effect of sinus floor augmentation with PRF versus freeze-dried bone allograft (FDBA) on stability of one-stage dental implants. This split-mouth randomized clinical trial evaluated 10 patients who required bilateral sinus floor augmentation. PRF and L-PRF membrane were used in one quadrant while FDBA and collagen membrane were used in the other quadrant. Implant stability was assessed by resonance frequency analysis (RFA) immediately, and 2, 4, and 6 months after implant placement. The implant stability quotient (ISQ) was compared over time and between the two groups using repeated measures ANOVA and independent sample t-test. The mean ISQ significantly increased over time in both groups (p < 0.001). The increase was greater in the PRF group (p < 0.05). Within the limitations of this study, PRF yielded superior results compared with FDBA regarding the stability of one-stage dental implants.

Comparative clinical study of conventional dental implant and mini dental implant-retained mandibular overdenture: A 5- to 8-Year prospective clinical outcomes in a previous randomized clinical trial.

To compare the long-term prospective clinical outcomes in a previous randomized controlled clinical trial (RCT) of 2 Mini Dental Implant (2MDI), 4 Mini Dental Implant (4MDI), and 2 Conventional Dental Implant (2CDI)-retained mandibular overdenture with follow-up between 5 to 8 years. Thirty-seven patients formerly participated in the Comparative Clinical Study of CDI and MDI for Mandibular Overdenture were requested for examination of clinical outcomes. A total of 104 implants were placed with mean follow-up periods 6.64 ± 0.60 years. In Group 1 (2MDI) and Group 2 (4MDI), implants were placed and immediately loaded with Equator® attachments to retained mandibular overdenture. In Group 3 (2CDI), implants were placed and delayed 3months for denture loading with ball attachment. The success rate, survival rate, clinical implant performance scale (CIP scale), peri-implant tissue status, prosthetic complication, implant stability quotient (ISQ), marginal bone level change (MBLC), and patient satisfactions were analyzed. After 5 to 8 years follow-up, the success rate in Groups 1, 2, and 3 were 90.91%, 93.33%, and 54.55%, respectively. The success rate in Group 3 was significantly lesser than Group 1 (p=0.016) and Group 2 (p < 0.001). The survival rate in Groups 1, 2, and 3 was 100%, 96.67%, and 90.91%, respectively, and showed no significant differences. Mean ISQ reported no significant differences between groups. Mean MBLC were 0.57 ± 1.19 mm, 0.68 ± 0.90 mm, and 1.55 ± 1.60 mm in Groups 1, 2, and 3, respectively. Group 3 reported significantly greater mean MBLC than Group 1 (p=0.016) and Group 2 (p=0.011), but Groups 1 and 2 were not significantly differences. The overall patient satisfactions were reported as not significant differences between groups. Two MDI-retained mandibular overdentures with immediate loaded protocol performed had favorable clinical outcomes, cost effectiveness, and overall patient satisfactions after 5 to 8 years follow-up.

Does Caffeine Affect Dental Implant Stability? A Prospective Cohort Study.

Statement of the Problem: Caffeine intake affects bone metabolism through inhibition of osteoblast proliferation.Purpose: This study aims to assess the effect of caffeine consumption on implant stability in the healing period of patients.Materials and Method: A prospective cohort study is designed to assess implant stability in the posterior of the maxilla. Patients were divided into two groups based on daily caffeine intake as group 1 with consumption of 400 mg/daily caffeine or more, and group 2 with consumption of 100 mg/daily caffeine or less. The implant stability was measured by resonance frequency analysis (RFA). The mean implant stability quotients (ISQs) were calculated. RFA measurements were made at 4, 6 and 8 weeks after implant placement.Results: A total of 102 patients were studied (51 in each group). The mean of ISQ was 43.49± 2.32 in the group 1 and 42.78±2.34 in the group 2 at four weeks after insertion. The mean of ISQ was 50.86±3.06 in group 1 and 51.37±2.44 in the group at six weeks after implant placement. At eight weeks after implant surgery, the mean of ISQ was 56.78±3.77 in the group 1 and 57.84±1.82 in the group 2. The mean of ISQ between the two groups at 4, 6 and 8 weeks after implant placement was not statistically different. (p= 0.13, p= 0.36 and p= 0.08 respectively) The repeated measure test indicated a similar increase in ISQ in various study times in the two studied groups (p=0.47, df=1, F=0.52).Conclusion: Acquired data suggest that caffeine intake may not have a negative effect on implant stability in the healing period at the posterior of the maxilla.

The influence of implant design on implant stability in low-density bone under guided surgical template in inexperienced surgeons: A pilot randomized controlled clinical trial using resonance frequency analysis.

There are several factors that greatly influence implant stability with implant design being a paramount factor; however, few studies investigate its impact. To investigate the implant stability in relation to two different implant designs, a cylindrical shaped single-threaded design (CS/ST) and a tapered shaped double-threaded design (TS/DT) using resonance frequency analysis over the first 8 weeks after implantation. Twenty-eight implants were randomly allocated using computer-generated random numbers into two groups and were placed as single tooth implant in the posterior arch in human jaw as specimens. iCAT™ CBCT scan (Hatfield, PA) was used to determine the bone density according to Misch's Bone classification. The osseotomy sites were prepared and implants were placed with guided surgical template by inexperienced surgeons which were prepared with the same implant planning software (3shape® implant studio). The implant stability was measured using the resonance frequency analysis Osstell® ISQ (Osstell AB, Sweden) on the implant level over the first 8 weeks at three different time intervals. A mean implant stability quotient (ISQ) value was recorded at each measurement time points. The first ISQ of each implant recorded at the time of implant placement were considered as baseline and were the so-called primary stability. All 28 dental implants were analyzed. A similar pattern of implant stability changes was observed in both implant designs. A significant decreased was found at the first 4 weeks after implantation (p <0.05) before ascending to maximum cumulative stability by the eighth week (p <0.05). Between the two groups, TS/DT group had a higher mean ISQ values than that of the CS/ST group at all three observation periods but did not reach statistical significance (p=0.69). Regarding different types of bone, TS/DT showed a significant difference in mean ISQ values in D4 bone. To date, all 28 implants are in function with no failure/and or complications. The difference in implant design did not significantly influence the implant stability. TS/DT shows superiority over CS/ST when placed in D4 bone and offer a significant advantage due to their positive bounce back of the ISQ values by the eighth week after implant installation. TCTR20211020005.

The primary stability of two dental implant systems in low-density bone

Primary stability in low-density bone is crucial for the long-term success of implants. Tapered implants have shown particularly favourable properties under such conditions. The aim of this study was to compare the primary stability of tapered titanium and novel cylindrical zirconia dental implant systems in low-density bone. Fifty implants (25 tapered, 25 cylindrical) were placed in the anterior maxillary bone of cadavers meeting the criteria of low-density bone. The maximum insertion (ITV) and removal (RTV) torque values were recorded, and the implant stability quotients (ISQ) determined. To establish the isolated influence of cancellous bone on primary stability, the implantation procedure was performed in standardized low-density polyurethane foam bone blocks (cancellous bone model) using the same procedure. The primary stability parameters of both implant types showed significant positive correlations with bone density (Hounsfield units) and cortical thickness. In the cadaver, the cylindrical zirconia implants showed a significantly higher mean ISQ when compared to the tapered titanium implants (50.58 vs 37.26; P < 0.001). Pearson analysis showed significant positive correlations between ITV and ISQ (P = 0.016) and between RTV and ISQ (P = 0.035) for the cylindrical zirconia implants; no such correlations were observed for the tapered titanium implants. Within the limitations of this study, the results indicate that cylindrical zirconia implants represent a comparable viable treatment option to tapered titanium implants in terms of primary implant stability in low-density human bone.

The stability of tetracalcium phosphate/titanium implants: A short-term follow-up study

Background/purposeBioceramic tetracalcium phosphate (TTCP) is used as a surface modifier on the implant surface and the clinical studies on this surface modification are still limited. The objective of this clinical study was to investigate short-term implant stability of titanium implant surfaces being modified through sandblasting and acid etching (SLA), followed by TTCP sintered bioceramic anchoring.Materials and methodsA total of 20 patients who had single tooth space were included in this study. Surface modification by SLA plus with TTCP on Ti implants with a diameter of 4.0 mm and lengths of 10 and 11.5 mm were placed. Implant stability quotient (ISQ) value was measured immediately (ISQ0) and one month (ISQ1), two months (ISQ2), three months (ISQ3), and four months (ISQ4) after implantation. Subgroup analysis was defined to location (maxilla, mandible) and bone density (soft or hard bone). Statistical analysis was performed using Friedman test and Mann–Whitney U test.ResultsThe mean ISQ values with standard deviation at the different time points of ISQ0 to ISQ4 were 60.03 ± 14.12, 53.48 ± 15.24, 58.91 ± 14.43, 63.14 ± 12.22, and 63.50 ± 13.61, respectively. The results showed significant differences between the ISQ1 and ISQ3 groups and between the ISQ1 and ISQ4 groups. On the other hand, there was no statistical differences between the maxilla and mandible as well as between soft and hard bone types in all implant groups.ConclusionTTCP/titanium implant showed favorable stability in short-term ISQ values over 4 months. The locations and bone types demonstrated no effect on implant stability.

Navigation guided socket-shield technique for implant and pontic sites in the esthetic zone: A proof-of-concept 1-year prospective study with immediate implant placement and loading.

To assess clinical, radiological performance of novel navigation guided socket-shield technique (NSS) with immediate implant placement and loading. Eighteen patients (12 females; age 52.54 ± 4.92; 33-72) treated between January 2018 and June 2019, were investigated, and followed for at least 1year after definitive prosthesis placement (mean 20.1months, 18-23). Primary outcomes: implant and prosthetic success rates, surgical, biologic, prosthetic complications. marginal bone loss (MBL), implant stability quotient (ISQ), pink esthetic score (PES), plaque and bleeding indexes. Sixty-nine navigation guided socket-shield procedures were performed (27 implant-sites and 42 pontic-sites) and 27 implants (NobelParallel, NobelBiocare AG) positioned and immediately loaded. Mean insertion torque and ISQ at implant positioning were 49 ± 5.34 Ncm (36-74), 73 ± 5.72 (68-81). No implant failure was experienced. Two root-shield exposures with mucositis, ulceration and bleeding were reported at two pontic-sites (2.9%) and successfully treated. No complications were experienced at implant-site leading to an overall NSS success-rate of 100%. No prosthetic complications occurred. Mean MBL was -0.72 ± 0.26 mm (-0.42 to -1.06 mm). PES final at the last follow-up 12.84 ± 0.92. The plaque and bleeding scores were 18.5 ± 6.12 and 3.15 ± 2.21. Within study limitations, dynamic navigation was effective to streamline execution of socket-shield technique at implant and pontic sites, shortening treatment time and reducing complications. Navigation guided socket-shield technique was reliable to achieve digitally planned shield-to-implant distance, facilitate immediate implant placement and loading and establish the mucosal dimension needed for underlying bone-to-implant protection and esthetic integration. The investigated NSS technique overcomes the difficulties related to root preparation at implant and pontic-sites, facilitating immediate implant placement and loading. Dynamic guided surgery contributed to make socket-shield technique less technical-sensitive, shortening time for execution, reducing complication rate.