Periotest Research Articles

An In Vitro Evaluation of Periotest Implant Stability Measurements Taken on Implant Retained Crowns and Healing Abutments.

To assess the reliability of implant stability measurements recorded with the Periotest device and to investigate the differences in values when these measurements were taken on implant retained crowns and healing abutments. Fifty-six implants in eight synthetic bone blocks were used to carry out implant stability measurements using the Periotest device by two different operators. Each block constituted an example of bone of density D1, D2, D3, or D4, and two blocks of each density were used. The healing abutments placed were of a height to allow approximately 6 mm of the implant-abutment complex to be supracrestal and temporary crowns were made to match the dimensions of an average central incisor. Descriptive statistics were used to describe the perio test values (PTVs) at each of the different heights on the implant abutments and implant crowns. Means for each site were calculated and distribution of data assessed using the Kruskal Wallis test. The interclass correlation coefficient (ICC) was used to determine the relationship between the PTVs recorded on the implant abutments and implant crowns. The mean PTV (±standard devidation) recorded across all sites was 5.57 ± 11.643 on the implant abutments, and 12.27 ± 11.735 on the temporary crowns. Excellent/good inter-operator ICCs were recorded for the mid-abutment site in all bone blocks D1-D4 (ICC = 0.814, p < 0.001, ICC = 0.922, p < 0.001, ICC = 0.938, p < 0.001, ICC = 776, p < 0.001). For mid crown sites, ICC between operators was excellent/good only for recordings in D2 bone (ICC = 0.897, p < 0.001). Periotest device seems to be able to reliably measure implant stability across all types of bones when the implant stability is assessed at approximately 3 mm coronal to the implant platform for abutments and 4.5 mm for implant supported single crowns.

The Effect of Melatonin and Its Agonist on Bone Metabolism

Objectives : To assess the effects of melatonin and its agonist on bone tissue through a scoping review of the literature. Materials and Methods: The keywords were searched on Scopus, Web of Science, and PubMed. Title and abstracts were reviewed to exclude the duplicates and irrelevant articles. The full-text articles were then screened in accordance with the inclusion criteria. Results: Of the 5,383 identified articles [PubMed=5,508, Web of Science=122, Scopus=53], only 3 studies qualified to be included in the scoping review based on the inclusion criteria. The first study assessed effects of the oral melatonin on bone integrity and mass in postmenopausal osteopenic women through dual X-ray absorptiometry, quantitative computed tomography (QCT), high-resolution peripheral QCT (HR-pQCT), determined calciotropic hormones and bone markers. The other two studies evaluated radiographic and clinical outcomes such as Perio test, Angulated Bleeding test, Pink Esthetic Score (PES), Gingival index (GI), Peri-implant sulcus depth (PD), Wound healing index (WHI), Linear measurements of bone loss around implant and Densitometric analysis of dental implants with the local application of melatonin. All studies showed an improved outcome parameters in comparison with the control group. Conclusion: Based on the findings of the included studies, it was found that melatonin improved bone mineral density, increased marginal bone level and minimized root resorption aiding in implant stability. The findings were suggestive that melatonin has osteoinductive properties and inhibitory effect on osteoclastic activity.

The Effects of Smoking Cigarettes on Immediate Dental Implant Stability—A Prospective Case Series Study

Background: Smoking tobacco significantly affects the biology of periodontal tissues and contributes to the increased risk of peri-implant diseases. The aim of the study was to investigate whether smoking cigarettes affects the primary and secondary stability of maxillary dental implants, inserted into fresh sockets immediately after extraction. Methods: The study was conducted on 164 patients between the ages of 27–71 years old. 67 individuals smoked more than 20 cigarettes daily and 97 were non-smokers. 190 immediate implants were inserted in the maxilla. Immediate implantations were performed with simultaneous augmentation of the socket with xenogenic bone grafting material. In the posterior region, implants were inserted into the palatal alveolus. The stability of the implants was measured using Insertion Torque Value (ITV) and two types of devices: Periotest (PT) and Osstell (ISQ). Marginal bone loss was evaluated on cone beam computed tomography scans. Results: In an aesthetic area, the PT values at 6 months post-implantation were higher for smokers than non-smokers (p &lt; 0.05), respectively. The ISQ values were significantly lower in smokers compared to non-smokers at 6 months post-implantation (p = 0.0226), respectively. In the posterior region PT values were higher in smokers both on the day of implantation (p = 0.0179), 6 months after surgery (p = 0.0003) as well as 24 months after surgery (p &lt; 0.0001), as compared to non-smokers, respectively. Smokers revealed lower ISQ values than non-smokers (p = 0.0047) on the day of implantation, as well as 6 months after implantation (p = 0.0002), respectively. There were no significant differences in marginal bone loss after 18 months of loading between smokers and non-smokers in the aesthetic, as well as posterior regions (p &gt; 0.05). ITV measurements were lower in smokers than non-smokers in the aesthetic (16.3 vs. 17.5 Ncm) and posterior area (16.8 vs. 17.9 Ncm). Conclusions: This study indicate that smoking cigarettes has a negative effect on the stability of immediate implants in the maxilla. Primary stability of immediate implants may be lower in the posterior area of the maxilla in smokers when compared to non-smokers, which may eliminate smokers from immediate implants in this region. Secondary stability of immediate implants may be lower in both the aesthetic and posterior areas in smokers compared to non-smokers, which may encourage the postponement of final crowns delivery at 6 months post op and the extension of the occlusaly temporary crowns use in some smoker cases.

Six-implant-supported immediate fixed rehabilitation of atrophic edentulous maxillae with tilted distal implants

BackgroundThe aim of this retrospective study was to evaluate the treatment outcome of six Bredent blueSky™ implants (Bredent GmbH, Senden, Germany) immediately loaded with a fixed full-arch prosthesis (two tilted posterior and four axial frontal and premolar implants).MethodsAll 10 patients with atrophic edentulous maxillae being treated with a standardized procedure from 09/2009 to 01/2013, who had a follow-up of at least 3 years, were included. Sixty implants were placed to support 10 screwed prostheses. Twenty-one of them were inserted in fresh extraction sockets. Lab-side-prepared provisional fixed prostheses were placed at the day of implantation. Periotest (PT) values and implant stability quotient (ISQ) were measured after implant surgery and after 3 months of healing in all patients.ResultsThe analyzed implants were in function in mean 64 ± 13 months (range 42 to 84 months). One axial and two tilted implants failed in three patients. The mean PT values decreased, and ISQ increased significantly after the first 3 months at the osseointegrated tilted and axial implants. With an area under the curve of 0.503 and 0.506 in the receiver operating characteristic, the PT values and the ISQ were unspecific parameters and unsuitable as a predictor for the risk of non-osseointegration.ConclusionsWithin the limits of this small group (n = 10 patients/60 implants), the failure rate of the analyzed implant system (n = 3 respective 5% implant loss) seems to be comparable with other immediate-loading protocols. The failure rate of tilted implants in the atrophic upper jaw was quite high, but the aimed treatment concept could be achieved in every patient. The rehabilitation of the posterior region in edentulous maxilla remains a challenge.

Sensitivity and Specificity of Stability Criteria for Immediately Loaded Splinted Maxillary Implants.

To assess the suitability of dental implants for immediate loading, primary stability is usually evaluated intraoperatively. This retrospective study aimed to assess the suitability of three stability parameters - namely, insertion torque (IT), implant stability quotient (ISQ; measured by resonance frequency analysis), and Periotest (PT) values - as potential predictors for the risk of nonosseointegration of immediately loaded splinted implants. The stability parameters were routinely collected under immediate loading. Nineteen patients with 11 edentulous and 8 partially edentulous maxillae were treated with 105 dental implants, which were immediately loaded using temporary fixed dentures. The IT results, PT values, and ISQ results were recorded. Receiver operating characteristic analysis was performed to assess the quality of each parameter as a diagnostic test. After a 3-month observation period, 11 implants in four patients were not osseointegrated. The IT and ISQ (IT 25.0 ± 12.5 Ncm and 8.4 ± 2.3 Ncm; PT -1.5 ± 3.0 and +2.7 ± 3.0; and ISQ 62.6 ± 6.7 and 54.7 ± 6.2) differed significantly between the osseointegrated and failed implants (p < .005). The IT showed the greatest specificity at a sensitivity of 1 and the greatest area under the curve (AUC; 0.929), followed by the PT value (AUC = 0.836) and ISQ (AUC = 0.811). Among the intraoperative parameters analyzed, IT showed the highest specificity at a high sensitivity of 1. Therefore, the IT can be considered the most valid prognostic factor for osseointegration of immediately loaded splinted dental implants.

Multistepped Drill Design for Single-Stage Implant Site Preparation: Experimental Study in Type 2 Bone.

To evaluate an experimental multistepped drill for single-stage implant site preparation by means of real-time analysis of thermal variations during and postdrilling, and by implant stability evaluation. Temperature and time were recorded in real time by paired microprobe thermocouples during simulated osteotomy in type 2 bone similes at the cortical and cancellous zones. Three different drilling groups with a new multistepped drill design were compared: Control (2-mm diameter pilot drill + 3.3-mm three-stepped drill + 4.1-mm three-stepped drill); Test A (3.3-mm three-stepped drill); and Test B (4.1-mm three-stepped drill). Implants were inserted, and implant stability was evaluated with the Perio Test Value (PTV). Two-way anova was used to test the independent effects of osteotomy and implant diameter on temperature and stability. All the drills induced thermal changes without significant differences between groups (p > .05). Drilling in cortical bone produced significant increase of the temperatures in a range of 1.8 ± 0.9°C compared with drilling in cancellous bone (p < .05). ΔT temperatures were significantly higher for test groups in cortical and cancellous bone (p < .05); ΔT10 for all groups showed a reduction of the temperature in a range of 1.7 ± 0.3°C without significant differences between groups (p > .05); the mean time to accomplish drilling was significantly longer in the control group (p < .05); test groups took 10 ± 0.3 seconds less to reach the required drilling depth. PTV values were higher in test groups compared with controls (p < .05). The multistepped drills used for single-stage implant site preparation Increase temperature as in comparison with a conventional incremental protocol; Induce the temperature increment in cortical bone compared with the cancellous bone; Reduce drilling time when a multistepped drill is used alone; and Increase implant stability twofold compared with a conventional incremental protocol.

Comparative study of two different designs of partial over denture supported with distal implant for the treatment of mandibular Kennedy class II cases

The objective of the present study was to compare between two mandibular implant overdentures of class II Kennedy classification. Material and methods: Fourteen male patients (30–45 years) were selected and divided into two equal groups. Group I received a mandibular removable partial over denture retained with implant abutment at the first molar region and with extra coronal attachment to the first premolar. Cross arch stabilization was made by using double Aker clasp on the first and second molars of the opposite side. Group II received a unilateral mandibular removable partial over denture retained with implant abutment at the first molar region and with extra coronal attachment to a splinted first premolar and canine. Patient satisfaction, clinical and radiographic evaluations were carried out at regular recall appointments up to one year from implant loading. Results: There was insignificant increase in the pocket depth and gingival recession and insignificant decrease in the perio test values and plaque index around implants and abutments. There was insignificant increase in the marginal bone loss around implants and abutments in both groups. All patients strongly disagreed the high cost of the treatment. Group II patients were more satisfied regarding aspects of the patients' comfort and phonetics. Conclusion: It is concluded that unilateral removable partial denture was more comfortable and better with speech. The use of dental implant as a distal abutment in class II Kennedy classification reduces all the movements of denture base and results in better healthy condition for the gingival and periodontium of the abutment tooth than when using conventional partial denture.

Objective Assessment of Implants Stability placed in Fresh Extraction Socket using Periotest Device

Objective: To present our experience of using periotest (PT) device for measuring implant stability in immediate implants placed in fresh extraction sockets.Materials and methods: We used a PT device to measure for 10 implants placed in 10 patients over a period of 18 months. All the implants were placed immediately after extraction. The minimum follow-up period was 6 months with PT readings taken at 4th, 5th and 6th months (stage I) and after restoration at 7th, 8th and 9th months.Results: Negative values are generally considered good. This means the implant is well osseointegrated and can be loaded. The PT values for the maxillary tooth were lower than those for the mandibular tooth. A stable mandibular implant presents PT value readings between �2 and +2. A stable maxillary implant presents PT value reading between �4 and �2.Conclusion: PT enables us to assess osseointegration noninvasively and objectively in any situation. PT helps us to optimize our decision whether or not an implant is ready for functional loading.

Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planing

The aim of the in vitro study was to examine the clinical efficacy of semiconductor laser periodontal pocket irradiation as an adjunct to conventional scaling and root planing. Twenty-two healthy patients with a need of periodontal treatment (15 women, 7 men, mean age 45.0 +/- 10.8 years) with at least four teeth in all quadrants, were included. All of them underwent a conventional periodontal treatment including scaling and root planing. Using a split mouth design, two randomly chosen quadrants (one upper and the corresponding lower one) were subsequently treated with an 809 nm GaAlAs laser operated at a power output of 1.0 Watt using a 0.6 mm optical fiber. The teeth in the control quadrants were rinsed with saline. The clinical outcome was evaluated by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), sulcus fluid flow rate (SFFR), Periotest (PT), probing pocket depth (PPD), and clinical attachment loss (CAL) at baseline and at 3 months after treatment. A total of 492 teeth in both groups were evaluated and differences between the laser and the control teeth were analyzed using the Wilcoxon test (P < 0.05). Teeth treated with the laser revealed a significantly higher reduction in tooth mobility, pocket depth, and clinical attachment loss. Twelve percent of the teeth in the laser group showed an attachment gain of 3 mm or more, compared to 7% in the control group. An attachment gain of 2-3 mm was found in 24% of the teeth in the laser group and 18% in the control group. No significant group differences, however, could be detected for the plaque index, gingival index, bleeding on probing, and the sulcus fluid flow rate. The higher reduction in tooth mobility and probing depths is probably not predominantly related to bacterial reduction in the periodontal pockets but to the de-epithelization of the periodontal pockets leading to an enhanced connective tissue attachment. The application of the diode laser in the treatment of inflammatory periodontitis at the irradiation parameters described above is a safe clinical procedure and can be recommended as an adjunct to conventional scaling and root planing.

Enhancement of primary stability of dental implants using cortical satellite implants.

This study aims to assess the effect of satellite implants on the primary stability of dental implants placed in fresh extraction sites in vitro. 34 titanium screw implants (3.75 mm x 10 mm; Bego, Bremen, Germany) were inserted in premolar- and molar-fresh extraction sites in domestic pig mandibles. Periotest (PT) values were assessed before and after insertion of one vestibular and one lingual 1.7-mm bone screw (Mondeal, Tuttlingen, Germany) as a satellite implant was connected to the implants with a 0.6-mm microplate welded to the implant abutment. The average PT values were 2.9 without satellite implants, -1.0 with one satellite implant, and -2.5 with two satellite implants during horizontal testing, and 3.0, 1.4, and 0.4, respectively, for vertical testing. Satellite implants increase the horizontal stability of implants in fresh extraction sites. Differences for horizontal PT assessment were significant on a 0.01 level of confidence. Implants in extraction sites may be loaded immediately, if vertical stabilization is provided by cortical bone and if horizontal PT values show sufficient stability after satellite implant insertion.

部分床義歯装着後のこう歯動揺度の短期的な変化

The purpose of this study was to clarify the change of abutment teeth mobility by insertion of partial dentures for a short period.Twenty patients who received partial dentures at the Dental Clinic of Niigata University School of Dentistry, between August and November 1994, were selected.To evaluate changes in tooth mobility, the Periotest (PT) value of 49 abutment teeth within 3 months after initial insertion were measured and the following factors were analyzed.1. change in PT value of all abutment teeth2. change in PT value of upper abutment teeth3. change in PT value of lower abutment teeth4. the relationship between the type of edentulous space, the type of clasp and the amount of PT value changeThe results were as follows:1. PT value of all abutment teeth decreased after insertion of the dentures.2. PT value of upper abutment teeth showed no significant change within 3 months after initial insertion of the dentures.3. PT value of lower abutment teeth decreased from 2 weeks after insertion, and these decreases were clearly detected in free-end dentures.4. PT value of lower abutment teeth of free-end dentures decreased irrespective of the type of the clasp.

Implant stability related to insertion torque force and bone density: An in vitro study

Seventy-five implants were installed in 12 fresh ethanol-treated bovine ribs by use of a torque gauge manometer to measure the force needed to screw the implants fully into the bone. Digital radiographs were taken and a density histogram of the bone at the implant/bone interface was obtained. The damping characteristics of the implant/bone interface were assessed by tapping the abutment with the Periotest (PT) device. Abutments of several lengths screwed at 20 N/cm were used to conduct PT measurements and the PT values (PTVs) were related to the insertion torque force, the bone density, and implant and abutment length. The results indicated that high correlations exist between PTVs and insertion torque force (R value -0.74579), and PTVs and bone density (R value -0.83031). There was also a significant difference (p 0.001) among the PTVs of the different abutment lengths used. Implant length did not demonstrate influence on PTVs (p 0.3847).

Determination of the tooth mobility change during the orthodontic tooth movement studied by means of PERIOTEST and MIMD (the mechanical impedance measuring device for the periodontal tissue)

Two mechanical devices were selected to attempt to assess any changes in tooth mobility when orthodontic force was applied. A Periotest (PT) for assessing mobility and a mechanical impedance measuring device (MIMD) were the instruments chosen to diagnose the changes in the periodontal condition. The relative mobility of four canines after orthodontic tooth movement manipulation was assessed over a 4-week period. Both devices were able to detect very small changes in tooth mobility and could follow the changes during tooth movement. According to the Periotest unit, the tooth mobility changes were not within the clinically abnormal range, despite the initial retraction load from a sectional arch, applied in a horizontal direction with about 150 gm for each tooth. In all instances, the contiguous maxillary first premolar had been removed 1 to 2 months before force application. The tooth mobility observed in this investigation could be different from that caused by periodontal disease or traumatic injury. Just after orthodontic tooth movement manipulation, the Periotest values (PTV), as measured on the Periotest, of tooth mobility decreased and the resistance as measured by the mechanical impedance measuring device (MIMDM) was increased. Thus, initially, there is a greater resistance to movement with decreased mobility. After the experimental period of 4 weeks, there was an increase in the mobility, as measured by the Periotest and the mechanical resistance decrements were observed. However, the Periotest units showed some different changes occasionally that did not seem to reflect the state of tooth movement. This needs to be investigated further over a longer period of time. On the basis of the results obtained, it does appear that it is feasible to use these devices to determine mobility changes in patients at various stages of orthodontic treatment.

A Case Report about Mobility of Implants by PERIO TEST&#xAE;

A Case Report about Mobility of Implants by PERIO TEST^&#xAE;

A Case Report about Mobility of Implants by PERIO TEST

A Case Report about Mobility of Implants by PERIO TEST