Resonance Frequency Analysis Measurements Research Articles

ISQ as a Diagnostic Tool in Implants Affected with Bone Loss: In Vitro Experimental Study.

to determine the relationship between bone loss that occurs during the peri-implantitis process and variations in implant stability using resonance frequency analysis measurement methods. 40 self- tapping implants were placed in cow ribs. For each group of 10 implants, a bone loss of 0 mm, 4 mm (simulating 1/3 of bone loss) and 8 mm (simulating 2/3 of bone loss) was established. Osteotomy measurements were made with a periodontal probe. For each implant, RFA was measured using the OSSTELL BEACON system by the same operator. The initial ISQ value of the 40 implants placed exceeded values of 70, reflecting an average of 73 in the VL direction and 74.8 in the MD direction. ISQ measurements in the 10 implants in which bone dehiscence was performed on the vestibular aspect reflected a decrease in ISQ values as bone loss deepens. When generating bone loss in two opposite faces (V and L), a greater decrease in ISQ values was observed when 2/3 of the implant were affected. The average value of the measurements in the VL direction was less than 70 when the loss is 2/3. when bone loss occurs on only one side of the implant, the ISQ values decrease,but the implant maintains good stability. The same occurs when two opposite sides of the implant are affected, the unaffected side has the least decrease in ISQ value.

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

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

Influence of diameter and length on primary stability in various implant site densities-An in vitro study in polyurethane blocks.

The influence of dental implant length and diameter on primary stability in various bone densities is not well understood. To in vitro study the effect of length and diameter on resonance frequency analysis (RFA), insertion torque (IT) and displacement (DP) measurements of dental implants in different implant site densities. Dental implants of four different diameters (Ø 3.5, 4.0, 4.5 and 5.0 mm) and three different lengths (7, 11 and 15 mm) (Neoss Ltd, Harrogate, UK) were placed in polyurethane blocks of three different densities (Sawbones Europe AB, Malmö, Sweden). The primary stability was assessed by RFA (ISQ) (Osstell, Osstell AB, Gothenburg, Sweden) and insertion torque measurements (ITmax in N cm) (iChiropo™, Bien-Air Dental SA, Bienne, Switzerland). In addition, the blocks were mounted in a rig and a lateral force of 25 N cm was applied to the implants and the DP was measured in μm with a micrometer gauge placed on the opposite side of the load transducer. Statistical analyses using linear and quadratic models were applied. Implant length, diameter and block density were found to be significant independent predictors of RFA, ITmax, and DP measurements. Implant length had a strong effect, while the effect of diameter in general was subtle, particularly in the softest block. Implant length affects primary stability more than implant diameter in polyurethane blocks of uniform density along the whole length of the tested implants.

An in vitro study evaluating the efficacy of a novel mount with torque control designed to tighten Osstell® transducers.

To evaluate the efficacy of a novel mount with torque control for tightening of Osstell® transducers and to determine the reliability of recorded ISQ measurements from implants placed in various bone densities. MATERIALAND METHODS: Fifty-six implants, comprising seven different implant types, were placed in eightpolyurethane blocks representing D1, D2, D3, and D4 bone densities. Resonance frequency analysis (RFA) transducers were attached to each implant in four different ways: (a) hand tightening, (b) hand tightening with a SmartPeg Mount™, (c) hand tightening using the novel mount with torque control (SafeMount) and (d) tightening to 6 Ncm with a calibrated torque device. ISQ measurements were taken and a second operator repeated the measurements. Intraclass correlation coefficient (ICC) was calculated to assess the reliability of the measurements and linear mixed effects regression was employed to determine the effect explanatory variables had on ISQ values. There was a statistically significant difference in ISQ values obtained by hand tightening transducers compared to the calibrated torque device p < .001, 95%(-2.89, -1.21) but not between any other tightening methods. There was excellent agreement between the two RFA devices (ICC 0.986) and between buccal and mesial measurements (ICC 0.977). For all transducer tightening methods there was excellent inter-operator agreement in D1 and D2 (ICC > 0.8) but very poor agreement in D4 (ICC < 0.24). Bone density accounted for 36% of the variation in ISQ values, the implant for 11% and the operator for 6%. SafeMount, did not significantly improve the reliability of the RFA measurements when compared to the standard mount, but calibrated torque devices seem to have benefits when compared to tightening the transducers by hand. Results also indicate that the ISQ values should be interpreted with caution when measuring implant stability in poor quality bone regardless of the implant geometry.

Novel approach for underpreparation protocol in dental implant with low bone quality depending on hounsfield unit presurgically

Objective: The purpose of this research was to adapt a normal or undersized implant preparation protocol for different bone densities depending on the density measure (Implant stability quotient ISQ, Newton centimeter NCM) and from Cone Beam Computed Tomography reading pre-surgically. To eliminate the need for practice and experience in inserting implants in poor bone quality areas to enhance implant primary stability and survival rate. Material and methods: Fifty-nine patients were selected for inclusion in the study. A total of fifty-nine implants were placed. Insertion torque data were recorded, resonance frequency analysis measurements were taken at first stage surgery, and Hounsfield Unit HU was assessed before surgery and kept hidden to prevent bias. The implant preparation protocol divided the patients into two groups whether standard or undersized, which was determined according to the tactile sensation of the operator. Depending on primary stability measures (ISQ, NCM) samples were divided into 4 subgroups. Finally, HU measurements were taken from subgroups with high stability measures to assess whether to do a standard or underprepared surgical preparation. Result: the result showed a positive and strong correlation with a high significance between ISQ, HU, and insertion torque.

Intra- and inter-operator concordance of the resonance frequency analysis. A cross-sectional and prospective clinical study.

Resonance frequency analysis (RFA) provides an evaluation of implant stability over time. This analysis is a non-invasive, precise, and objective method. Several studies compare the RFA system with other devices. However, few investigations analyze repeatability and reproducibility between different operators. The aim of this study was to evaluate the intra- and inter-operator concordance of the Osstell® ISQ. RFA measurements were performed with Osstell® ISQ in a total of 37 implants placed in 21 patients. At the time of implant placement, 6 measurements per implant were taken by three different experienced operators. Three measurements were carried out consecutively and three by removing and placing the SmartPeg-Osstell® to assess intra-operator and inter-operator agreement. Intra-operator concordance according to the intraclass correlation coefficient (ICC) showed high concordance. The ICC values were higher than 0.9 (p < 0.0001) for consecutive measures and alternative measures, being almost perfect of Landis & Koch classification. For inter-operator concordance The ICC was 0.709 (p < 0.0001) and 0.670 (p < 0.0001) for consecutive and alternative measures, respectively, both estimates being in the substantial category. In torque and ISQ values, no statistically significant differences were observed when operators and measurements were compared. Osstell® ISQ system was stable both in intra-operator and inter-operator measurements. This device has excellent repeatability and reproducibility, demonstrating reliability to measure the stability of dental implants. Resonance frequency analysis (RFA) is a non-invasive, objective, and reliable diagnostic method to determine the ideal moment to load the implant, as well as to predict possible failures.

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.

Peri-İmplant Kemik Defekti Tipinin Yerleştirme Torku ve Rezonans Frekans Analizi Üzerine Etkisi: İn Vitro Çalışma

Objective: The aim of the present study is to investigate the effects of different peri-implant bone defects on primary stability and the correlation between insertion torque (IT) and resonance frequency analysis (RFA) measurements. Material and Methods: Fourty implant beds were prepared in artificial bone blocks using the 3D surgical guide. Implant osteotomies were divided into 5 groups (n=8) according to defect type: i) no peri-implant bone defect (control), ii) a dehiscence defect, iii) a fenestration defect on the middle part, iv) a fenestration defect on the apical part and v) a circumferential defect. Implants were inserted by using a surgical drilling unit with torque control and RFA measurement were done. Results: IT values for the control group were significantly higher than the other groups (p<0.001). The results of IT measurements for dehiscence defect group were significantly greater when compared to fenestration and circular defect groups (p<0.01). Implant stability quotient (ISQ) values for the control group were significantly higher than other groups (p<0.05). In addition, the ISQ values for the dehiscence defect group were significantly lower when compared to fenestration defect groups (p<0.001), and ISQ values for the circular defect group were significantly lower than any other groups (p<0.001). IT values and, ISQ values are moderately correlated (p=0.013, r=0.388). Conclusion: The location of peri-implant bone defect affects RFA measurements more than IT. However, IT seems to be correlated with bone implant contact. Therefore, in the case of peri-implant bone defect, IT measurement may be preferred for evaluation of primary stability.

Evaluation of the primary stability in dental implants placed in low density bone with a new drilling technique, Osseodensification: an in vitro study.

Background Primary stability is an important key determinant of implant osseointegration. We investigated approaches to improve primary implant stability using a new drilling technique termed osseodensification (OD), which was compared with the conventional under-drilling (UD) method utilized for low-density bones. Material and Methods We placed 55 conical internal connection implants in each group, in 30 low-density sections of pig tibia. The implants were placed using twist drill bits in both groups; groups Under Drilling (UD) and Osseodensification (OD) included bone sections subjected to conventional UD and OD drilling, respectively. Before placing the implants, we randomized the bone sections that were to receive these implants to avoid sample bias. We evaluated various primary stability parameters, such as implant insertion torque and resonance frequency analysis (RFA) measurements. Results The results showed that compared with implants placed using the UD technique, those placed using the OD technique were associated with significantly higher primary stability. The mean insertion torque of the implants was 8.87±6.17 Ncm in group 1 (UD) and 21.72±17.14 Ncm in group 2 (OD). The mean RFA was 65.16±7.45 ISQ in group 1 (UD) and 69.75±6.79 ISQ in group 2 (OD). Conclusions The implant insertion torque and RFA values were significantly higher in OD group than in UD. Therefore, compared with UD, OD improves primary stability in low-density bones (based on torque and RFA measurements). Key words:Osseodensification, primary stability, low density bone, RFA.

Does Biphasic Calcium Phosphate-Coated Surface Increase the Secondary Stability in Dental Implants? A Split-Mouth Study.

This study aimed to evaluate biphasic calcium phosphate coating (BCPC) on the secondary stability of dental implants compared to sand-blasted and acid-etched (SLA) implants. This is a split-mouth study. Thirty subjects (20 males and ten females) underwent a dental implant procedure to replace mandibular first or second molars bilaterally. The subjects were randomly assigned to BCPC or SLA groups. The resonance frequency analysis measurements were performed two, four, six, and eight weeks after the implant placement. Sixty implants were placed in the two groups (30 implants per group). The mean ISQ was 52.26 ± 3.73 in group 1 and 50.21 ± 2.59 in group 2 on day 14 after the implant insertion, 63.20 ± 2.76 in group 1 and 58.80 ± 2.14 in group 2 on day 28, 72.30 ± 3.15 in group 1 and 64.53 ± 3.19 in group 2 on day 42, and 78.70 ± 1.56 in group 1 and 71.63 ± 3.22 in group 2 on day 56. The data analysis demonstrated significant differences between the two groups in terms of the mean ISQ at various evaluation times. Regarding ISQ measurements, the secondary stability in BCPC implants may be higher compared to SLA implants in two months after implant insertion.

Reliability of the Resonance Frequency Analysis Values in New Prototype Transepithelial Abutments: A Prospective Clinical Study.

Resonance frequency analysis (RFA) requires abutment disconnection to monitor implant stability. To overcome this limitation, an experimental transepithelial abutment was designed to allow a SmartPeg to be screwed onto it, in order to determine the prototype abutments repeatability and reproducibility using Osstell ISQ and to assess whether implant length and diameter have an influence on the reliability of these measurements. RFA was conducted with a SmartPeg screwed directly into the implant and onto experimental abutments of different heights of 2, 3.5 and 5 mm. A total of 32 patients (116 implants) were tested. RFA measurements were taken twice for each group from mesial, distal, buccal and palatal/lingual surfaces. Mean values and SD were calculated and Intraclass Correlation Coefficients (ICC) (p < 0.05, IC 95%). The implant stability quotient (ISQ) mean values were 72.581 measured directly to implant and 72.899 (2 mm), 72.391 (3.5 mm) and 71.458 (5 mm) measured from the prototypes. ICC between measurements made directly to implant and through 2-, 3.5- and 5-mm abutments were 0.908, 0.919 and 0.939, respectively. RFA values registered through the experimental transepithelial abutments achieved a high reliability. Neither the implant length nor the diameter had any influence on the measurements’ reliability.

A Simplified Prosthetic Implant Loading Protocol: 1-Year Clinical Follow-Up Study.

Purpose To retrospectively investigate the one-year clinical outcome following a standardized treatment protocol for immediate loading. The protocol mandates predefined requirements for implant stability. If fulfilled, immediate loading of the implants is performed with a simplified prosthetic protocol which includes one-time impression at the time of surgery and definitive restoration within eight weeks. Methods Twenty-five patients were treated with 48 Neoss ProActive Tapered implants. Minimum primary stability was established before subjecting the implants to immediate nonfunctional load. Definitive prostheses were delivered six to eight weeks from implant placement. Insertion torque (IT), resonance frequency analysis (RFA), intraoral radiographs, and impressions of implant positions were registered at implant placement. During clinical follow-up, RFA was measured at two, four, and six to eight weeks and six months from implant placement to monitor continued implant stability. Marginal bone level measurements were performed at implant placement, six-month, and one-year follow-up visits. Results IT was over 40 N·cm for 46 implants. Two implants with IT <30 N·cm were both splinted to another implant with IT >50 N·cm, tightening the retention screw with low forces. No implants were lost during the observation period. Mean RFA measurements remained stable without any decrease during the initial six-month healing phase. Mean marginal bone remodeling was −0.47 ± 0.38 mm from implant placement to 1 year. No significant difference was found for marginal bone remodeling between implants placed in the healed bone or fresh extraction sockets. Conclusion Within the limits of this study, it is concluded that using a simplified immediate loading protocol can be predictably applied to reduce the overall treatment time and the number of clinical sessions.

In Vitro Evaluation of the Primary Stability of Short Implants in Different Surgical Techniques.

This study was designed to evaluate the effects of four different surgical techniques on the primary stability of short implants in two sizes (4-mm and 6-mm length) through resonance frequency analysis and insertion torque measurement in vitro. Forty implant site preparations and implant insertions were performed in pig ribs. Guided surgery, bone condensing, conventional drilling, and undersized preparation surgical techniques were used five times in each bone block to prepare 4-mm/6-mm-length implant beds. The maximum insertion torque and implant stability quotient (ISQ) values were recorded for each implant. Both the ISQ and torque differed significantly for various surgical techniques (P = .009 and P < .001). The conventional technique had higher ISQ (79.00), whereas the condenser technique had higher torque (48.00 Ncm) than did the other techniques. The mean torque was significantly higher in all surgical techniques other than the guided surgery group regardless of implant length (P < .01 for all). Implant lengths were not significantly different in terms of ISQ and torque in all surgical techniques. There are significant correlations between the implant bed preparation technique and primary implant stability when using short implants. Conventional surgery and the bone condensing technique are favorable alternatives with higher primary stability and torque values in short implants.

RFA measurements of survival midpalatal orthodontic mini-implants in comparison to initial healing period

BackgroundIn dental implantology, the development of stability over time is a well-investigated topic. In case of orthodontic mini-implants, quantitative data for long-term stability is not available yet. This study aims to clinically investigate the long-term stability of mini-implants inserted in the midsagittal suture of the anterior palate. Moreover, the influence of the length of implants was elucidated. The stability of 2 × 9 and 2 × 11 mm mini-implants after orthodontic treatment (9 mm, 2.84 years ± 1.25 years; 11 mm, 3.17 years ± 0.96 years) was assessed by resonance frequency analysis (RFA). The obtained long-term pieces of data were compared with each other (9 mm vs 11 mm), as well as with the data from the matched early stability groups, to assess the initial and early secondary stability after the insertion from previous clinical trials.ResultsFor both lengths, the long-term stability (2 × 9 mm, 25.12 ± 7.11, n = 21; 2 × 11 mm, 24.39 ± 5.82, n = 18) was significantly lower than primary stability (2 × 9 mm, 36.14 ± 6.08, n = 19; 2 × 11 mm, 33.35 ± 3.53, n = 20). The differences within the groups disappeared over the initial healing period: after 4 weeks for the 2 × 9 mm implants and after 2 weeks for the 2 × 11 mm implants. Also, the 2 × 9 mm and 2 × 11 mm implants showed comparable long-term stability values.ConclusionThe stability of midpalatal mini-implants does not change in the long term after the initial healing period. Moreover, 2 × 9 mm mini-implants seem to be appropriate for orthodontic anchorage, as the stability of 2 × 11 mm implants is not higher. Therefore, owing to lower invasiveness, 2 × 9 mm implants should be preferred.

Influence of Resonance Frequency Analysis (RFA) Measurements for Successful Osseointegration of Dental Implants During the Healing Period and Its Impact on Implant Assessed by Osstell Mentor Device.

AIM:This study aimed to investigate and assess primary and secondary dental implant stability during the osseointegration period.METHODS:A total of 77 implants were placed in 42 patients with 26 males and 16 females. The study was conducted by comparing the resonance frequency analysis (RFA) values of the implants inserted in the lower jaw. RFA was done immediately after implant insertion and after 12 weeks. Results were statistically evaluated using SPSS Statistics for Windows, Version 7.1. Level of significance was set at P < 0.05.RESULTS:Significant differences were detected between the primary and secondary stability values, respectively. Maximum RFA value of 88 and the minimum value of 52 were observed. Stability values increased during the following three months, and all implants were successfully integrated without complication.CONCLUSION:Our results indicate and suggest that there is a strong linear correlation between implant stability and ISQ values that can be directly estimated by the RFA, especially in the posterior edentulous mandible. Osstell implant device could represent a useful tool which can be used to identify the risk for implant failure.

Effect of implant neck design on primary and secondary implant stability in the posterior maxilla: A prospective randomized controlled study.

To compare the early changes in implant stability of implants with different neck design duringthe first 3months of healing in the posterior maxilla. Patients were randomized toreceive triangular neck implant (test), or round neck implant (control). Resonance frequency analysis (ISQ) measurements were obtained at surgery and at 2, 4, 7, 14, 21, 28, 45, 60, and 90days followingimplant placement. Non-parametric statistic was used for data analysis. Thirty-two patients were included (17 test and 15 controls). Initial ISQ values of the test implants were high (mean: 68.4, SD=8.4) and increased over time (mean: 74.4, SD=6.0). Control implants presented a statistically significant higher initial ISQ value at implant placement (mean: 76.9, SD=8.7), which was maintained over the healing period (mean: 77.6, SD=3.6) with no significant changes between time intervals. After 6weeks of healing, both implants displayed comparable ISQ values with no differences between the groups. All implants exhibited a decrease in stabilityon days 2 and 21 post-placement. All roundneck implants used, and 82% of the triangularneck implants showed initial ISQ values above the suggested threshold for immediate loading (>60). Implant neck design plays a role in implant primary stability in the posterior maxilla. Both implants show high primary stability, with significantly higher values for the round neck. However, these differences disappeared after 6weeks of healing. While primary implant stability is partially governed by implant neck design, the role of this resultis negligible for the achievement of secondary stability.

One‐year clinical study evaluating the fast loading protocol – Immediate provisionalization and delivery of definitive prosthesis within 8 weeks

Background One requirement for the predictability of implant treatment with immediate loading protocols is high primary stability. Resonance frequency analysis (RFA) and insertion torque (IT) has been proposed to assess this stability with a quantitative method. Aim/Hypothesis To investigate the clinical outcome, marginal bone maintenance and implant survival for implant treatment using the fast loading protocol which include immediate provisionalization and early delivery of the definitive prosthesis. Material and Methods Of 25 patients were treated with 48 Neoss ProActive Tapered implants placed in both maxilla and mandible in healed bone as well as in fresh extraction sockets. Minimum primary stability, (IT > 35 ncm and RFA > 60), for all single implants was established before subjected to immediate (within 48 hours), non-functional, load using screw-retained temporary restorations (single or maximum 2 splinted implants with 2–3 teeth units). Definitive prostheses were delivered within 6–8 weeks from implant placement, based on RFA measurements during early healing phase. IT, RFA, intraoral radiographs, and impressions of implant positions were registered at implant placement. During clinical follow-up RFA was measured at 2, 4, 6 weeks and 6 months from implant placement. Marginal bone level measurements were performed from intraoral radiographs taken at implant placement, 6-, and 12-month follow-up visits. Results 48 implants were subjected to the fast loading protocol. IT was over 40 Ncm for 46 implants. Two implants with IT < 35 Ncm were both splinted to another implant with IT > 50 Ncm, tightening the retention screw with low forces. No implants were lost during the observation period, giving an implant survival rate of 100%. Mean RFA measurements remained stable without any decrease during the initial healing phase, 78.3 ± 4.0 in the mesiodistal direction and 77.6 ± 4.4 in the buccolingual direction at placement and 81.3 ± 3.7 and 80.8 ± 3.6 respectively at 6 months. Radiographic readings showed that at placement the implant platform was at bone level (+0.13 mm). Mean marginal bone remodeling was −0.47 ± 0.38 mm from implant placement to 1 year, −0.49 ± 0.38 mm from implant placement to 6 months, and only 0.01 ± 0.28 mm between 6 to 12 months follow-up. No significant differences could be found for marginal bone remodeling between implants placed in healed bone and those placed in fresh extraction sockets. Conclusion and Clinical Implications Achieving good primary stability (IT of 40 Ncm) with maintained implant stability during initial healing phase can guarantee predictable clinical outcome for patients subjected to a fast loading protocol. Fast loading showed no significant differences in marginal bone loss in the first year of follow-up as compared to other studies investigating the same implant type but followed different surgical and prosthetic protocols.

Short versus longer implants with osteotome sinus floor elevation for moderately atrophic posterior maxillae: A 1-year randomized clinical trial.

To compare the clinical, radiographic outcomes and patient satisfaction of short-6-mm implants and longer implants combined with osteotome sinus floor elevation (OSFE). Two hundred and twenty-five patients with 225 implants were included and randomly assigned into three groups (each group: 75 implants) using randomizing table method: group 6mm (6mm implants alone), group 8mm+O (8mm implants+OSFE) and group 10mm+O (10mm implants+OSFE). Outcomes measures were as follows: implant survival, complication, resonance frequency analysis measurement, surgical time, bleeding on probing (BOP), pocket probing depth (PPD), modified plaque index (mPI), marginal bone loss (MBL) and patient satisfaction. The dropout rate was 3.6% at 1year. Implant survival rates were 96%, 100% and 100% in group 6mm, group 8mm+O and group 10mm+O, respectively. In group 6mm, the survival rates of implants with diameter of 4.1mm were 90% (27/30), while the survival rates of implants with diameter of 4.8mm were 100% (42/42). The surgical time (min) in group 6mm was significantly shorter than those in group 8mm+O and group 10mm+O (13.6±2.2, 19.4±3.7 and 18.3±4.3, respectively, p=0.03). No significant differences in ISQ values, BOP, PPD, mPI and MBL were found among three groups. Significant higher value of intra-operative discomfort was found in group 6mm (p=0.02). All treatment options provided acceptable clinical and radiographic results up to 1year after loading. The current 1-year results must be confirmed by longer follow-ups of at least 5years.

Factors Influencing Resonance Frequency Analysis (RFA) Measurements and 5-Year Survival of Neoss Dental Implants.

Background Diagnostic instruments based on resonance frequency analysis (RFA) can be utilised to assess dental implant stability during treatment and follow-up. Aim The aim of the present study was to investigate the influence of patient- and implant-related factors on implant stability and the 5-year implant survival. In addition, the influence of stability (ISQ value) at placement and abutment connection on implant survival was evaluated. Materials and Methods RFA measurements from a total of 334 consecutive patients with 745 dental implants (Neoss Ltd., Harrogate, UK) were retrospectively analysed after at least 5 years in function. Statistics were used to evaluate the influence of the different variables on implant stability and implant survival. Odds ratio calculations were performed to compare the risk for implant failure using 60, 65, 70, and 75 ISQ as threshold levels at placement and loading. Results A total of 20 implant failures in 14 patients were noted during the 5 years of follow-up, giving an overall cumulative survival rate (CSR) of 97.3% at the implant level and 95.8% at the patient level. Gender, jaw, position, bone quality, and implant diameter had an influence on implant stability at placement. Jaw, bone quality, and implant diameter had an influence on stability after 3-4 months of healing. More failures were observed in full than in partial rehabilitations. Age, gender, jaw, position, bone quantity, bone quality, implant diameter, and implant length had no influence on implant survival. Implants with ISQ values below the threshold levels showed lower survival rates compared to implants with values above these levels. Conclusions The present study showed a significantly higher risk for implant failure, showing an ISQ value below 70 and 75 at placement or after 3-4 months of healing. The results indicate that RFA measurements can be used to identify implants with increased risk for failure.

Crestal Bone Loss Around Submerged and Non-Submerged Dental Implants in Individuals with Type-2 Diabetes Mellitus: A 7-Year Prospective Clinical Study

Objective: In establishing an evidence-based rationale for the optimal use of implant therapy in patients with type 2 diabetes mellitus (T2DM), it is essential to first understand the impact of glycemic control on early healing and the success of dental implants. The objective of this study was to evaluate crestal bone loss (CBL) and stability around submerged and non-submerged dental implants in Saudi patients with well- and poorly controlled T2DM. Subject and Methods: Thirty-five patients with well-controlled T2DM (24 males and 11 females) and 32 poorly controlled T2DM patients (19 males and 13 females) were included. CBL was measured on digital radiographs; resonance frequency analysis (RFA) measurements were made for each implant at the time of fixture placement and at 3 months in both the groups. A p value less than 0.05 was considered statistically significant. Results: A total of 124 dental implants were placed. Mean RFA values between baseline and 3 months in poorly controlled T2DM patients was statistically significant (p = 0.048). CBL at first year (p = 0.047), second year (p = 0.041), third year (p = 0.046), and seventh year (p = 0.035) was significantly worse in poorly controlled T2DM. CBL around non-submerged dental implants showed statistically significant differences at all time-intervals (p < 0.05). Conclusion: Poorly controlled T2DM patients present worse peri-implant bone outcomes as compared to patients with well-controlled T2DM. We suggest that the predictability of successful dental implant therapy outcomes depends on the maintenance of optimal haemoglobin A1c levels.