Secondary Stability Of Implants Research Articles

Experimental evaluation of the effectiveness of Russian dental implants with modified surface

In an experiment on animals, the effectiveness of osseointegration of DIF Dental Implants Classic Heavy implants (manufactured in the Russian Federation) was evaluated. The assessment was carried out at 30 and 60 days after the implantation of standard structures into the proximal condyle of the right tibia of rabbits with an assessment of implant stability and morphological changes in the process of osseointegration. It has been established that modification of the implant surface with calcium hydroxyapatite with characteristics close to the phase composition of bone matrix hydroxyapatite increases the efficiency of osseointegration, which is manifested both in higher indicators of secondary stability of implants and more intensive processes of bone tissue regeneration in the periimplantation zone.

Effect of Low-Level Laser Therapy on the Osseointegration of Immediately Loaded Implants with a Connective Tissue Graft: A Randomized Clinical Trial.

Introduction: This study assessed the effect of low-level laser therapy (LLLT) on the osseointegration of immediately loaded implants with a connective tissue graft (CTG). Methods: This clinical trial was conducted on patients with buccal bone dehiscence requiring dental implants. A CTG was harvested from the palate and placed in the labial side by considering the 2 mm distance between the implant thread and bone. Autogenous bone was harvested from the tuberosity, mixed with the allograft, and implanted at the site. After sufficient torquing of the implant, a customized abutment was fabricated and placed. The patients were randomly assigned to two groups (n=5) of intervention and control. The patients in the intervention group received LLLT with a 940 nm gallium-aluminum-arsenide laser while those in the control group received placebo irradiation. The primary implant stability was measured before the delivery of customized abutment while the secondary implant stability was measured after 12 weeks by Osstell® and reported as the implant stability quotient (ISQ). Results: No significant difference was found in secondary ISQ between the laser and control groups (P>0.05). In the intervention group, a significant difference was found between the primary and secondary ISQ in the buccolingual dimension (P<0.05) but not in the mesiodistal dimension (P>0.05). The two groups had no significant difference in gingival thickness or vertical bone gain (P>0.05). All implants were successful with no complications. Conclusion: LLLT had a significant positive efficacy for the enhancement of secondary stability of implants in the buccolingual dimension. CTG showed optimal efficacy for the treatment of buccal bone dehiscence.

Primary and Secondary Stability of Implants with Hydrophilic Surfaces in the Posterior Maxilla: A Split-Mouth Randomized Controlled Clinical Trial.

The aim of this split-mouth randomized clinical trial was to evaluate the primary and secondary stability of implants with hydrophilic surfaces in comparison to implants with conventional surfaces in the posterior region of the maxilla. Twenty patients with a bilateral edentulous ridge in the posterior area of the maxilla randomly received implants with two types of surfaces: (1) implants with the surface modified by double acid-etching and sandblasting (DAS, n = 20); and (2) implants with the surface modified by double acid-etching and sandblasting, stored in 0.9% saline solution to confer highly hydrophilic properties (DAS-H, n = 20) on the surface. The implants presented the same macrostructure with a hybrid design. The resonance frequency analysis was performed in order to obtain the implant stability quotient (ISQ) using Osstell. The ISQ analyses were performed just after placement of the implant (primary stability) and at 28, 40, and 90 days after the surgical procedure (secondary stability). There were no differences between the DAS and DAS-H surfaces in the primary stability or during the conversion of the primary to the secondary stability; however, there was a reduction in the stability of the implants at 28 days, which increased significantly at 40 and 90 days in both surfaces. It can be concluded that the surface wettability of implants with a hybrid macrostructure did not increase the primary and secondary implant stability in the posterior region of the maxilla.

Effect of 808 nm Semiconductor Laser on the Stability of Orthodontic Micro-Implants: A Split-Mouth Study.

Background: To evaluate the effect of photobiomodulation (PBM) on orthodontic micro-implants (n = 44; 14 women, 8 men). Methods: PBM with 808 nm diode laser was applied immediately, 3, 6, 9, 12, 15, and 30 days post the implantation. Results were assessed within same time frames and additionally after 60 days to check for implants stability using the Periotest device. Patients pain experiences following the first day post-treatment and potential loss of micro-implants after 60 days were recorded. The procedure involved insertion of mini-implants in the maxilla for the laser group (L, n = 22) and negative control group (C, n = 22). Irradiation was carried buccally and palatally with respect to the maxillary ridge (2 points). The energy per point was 4 J (8 J/cm2), total dose was 56 J. Results: Patients did not report significant differences in terms of pain experiences comparing the L and C groups (p = 0.499). At 30 days post-treatment, higher secondary stability of implants was observed in the laser group (Periotest Test Value, PTV 6.32 ± 3.62), in contrast to the controls (PTV 11.34 ± 5.76) (p = 0.004). At 60 days post-treatment, significantly higher stability was recorded in the laser group (PTV 6.55 ± 4.66) compared with the controls, PTV (10.95 ± 4.77) (p = 0.009). Conclusions: Application of the 808 nm diode laser increased secondary micro-implant stability.

Evaluation of Bone Quality and Primary and Secondary Stability of Implants Installed in Alveolar Regeneration Area by Three Different Techniques

Evaluation of Bone Quality and Primary and Secondary Stability of Implants Installed in Alveolar Regeneration Area by Three Different Techniques

Influence of Implant Dimensions and Position on Implant Stability: A Prospective Clinical Study in Maxilla Using Resonance Frequency Analysis

Implant stability is relevant for the correct osseointegration and long-term success of dental implant treatments. The aim of this study has been to evaluate the influence of implant dimensions and position on primary and secondary stability of implants placed in maxilla using resonance frequency analysis. Thirty-one healthy patients who underwent dental implant placement were enrolled for the study. A total of 70 OsseoSpeed TX (Astra Tech Implant System—Dentsply Implants; Mölndal, Sweden) implants were placed. All implants have been placed according to a conventional two-stage surgical procedure according to the manufacturer instructions. Bone quality and implant stability quotient were recorded. Mean implant stability quotient (ISQ) at baseline (ISQ1) was statistically significant lower compared to 3-months post-implant placement (ISQ2) (p &lt; 0.05). Initial implant stability was significantly higher with 4 mm diameter implants with respect to 3.5 mm. No differences were observed within maxilla regions. Implant length, diameter and maxillary regions have an influence on primary stability.

Primary and Secondary Stability of Implants in Postextraction and Healed Sites: A Randomized Controlled Clinical Trial.

This randomized clinical trial aimed to investigate the relationships between insertion torque, implant stability quotient (ISQ), and crestal bone loss (CBL) of implants placed in fresh or 12-week healed extraction sites. Forty patients were randomly assigned to one of two groups and had one implant placed immediately (test group, n = 20) or 12 weeks after extraction (control group, n = 20) at premolar or molar sites. For all implants, insertion torque and ISQ scores at insertion and loading were recorded. Patients were followed for up to 12 months. Implant success was 100% in both groups. No differences were observed concerning both ISQ at insertion and ISQ at loading. A stronger correlation was detected between ISQ at insertion and insertion torque in the postextractive group (R = 0.83), than in the delayed group (R = 0.39), while ISQ at loading and insertion torque showed no correlation. CBL at 12 months was significantly different between test (0.68 ± 0.43 mm) and control (0.40 ± 0.26 mm, P = .02) groups. Implant placement timing (immediate or delayed) may affect correlation between insertion torque and ISQ at insertion with ISQ at loading. While insertion torque influences ISQ at insertion, it does not affect ISQ at loading because of successful osseointegration. Postextraction and delayed implants seem to have similar ISQ at insertion and at loading, but different CBL after 12 months of follow-up because of postextraction bone remodeling.

The analysis of primary and secondary stability of implants with modified surfaces based on Osstell Mentor and Periotest S comparison: An animal study

The analysis of primary and secondary stability of implants with modified surfaces based on Osstell Mentor and Periotest S comparison: An animal study

The physicochemical/biological properties of porous tantalum and the potential surface modification techniques to improve its clinical application in dental implantology.

More rapid restoration and more rigid functionality have been pursued for decades in the field of dental implantology. Under such motivation, porous tantalum has been recently introduced to design a novel type of dental implant. Porous tantalum bears interconnected porous structure with pore size ranging from 300 to 600μm and a porosity of 75-85%. Its elastic modulus (1.3-10GPa) more closely approximates that of natural cortical (12-18GPa) and cancellous bone (0.1-0.5GPa) in comparison with the most commonly used dental materials, such as titanium and titanium alloy (106-115GPa). Porous tantalum is highly corrosion-resistant and biocompatible. It can significantly enhance the proliferation and differentiation of primary osteoblasts derived from elderly people than titanium. Porous tantalum can allow bone ingrowth and establish not only osseointegration but also osseoincorporation, which will significantly enhance the secondary stability of implants in bone tissue. In this review, we summarize the physicochemical, mechanical and biological properties of porous tantalum. We further discuss the performance of current tantalum dental implants and present the methodologies of surface modifications in order to improve their biological performance.

A correlation between bone (B), insertion torque (IT), and implant stability (S): BITS score

Although criteria for assessing bone quality have been reported, an overall score that correlates bone quality with the primary stability and secondary stability of implants is not yet available. The purpose of this article was to propose a scoring index that will establish a correlation among the bone density values from computed tomography, maximum insertion torque values, and resonance frequency analysis in different phases of implant treatment. In this study, 60 implant sites were evaluated to assess bone density (Hounsfield units), insertion torque values (Ncm), and primary stability and secondary stability (implant stability quotient values obtained by using resonance frequency analysis). On the basis of computed tomography data, the bone was classified as D1 to D4. The insertion torque was noted and classified into 2 groups, A and B. The implant stability quotient values obtained from resonance frequency analysis depicting primary stability and secondary stability were classified into 5 groups. The primary score noted was a result of the values obtained for the 3 parameters at the time of implant placement. The secondary score was obtained by considering the values of the bone density and resonance frequency analysis recorded at different time intervals. Bone densities of D2, D3, and D4 were noted, dividing the bone type into 3 groups. The maximum torque noted in the study was 40 Ncm. The difference between various insertion torque values and bone types was found to be statistically nonsignificant. Higher mean implant stability quotient values were obtained for primary and secondary stability for the D2 bone than for D3 and D4 bone. When analyzed according to the time of insertion, the mean values increased at second stage surgery in all bone types. The difference in mean values among all bone types was found to be statistically significant (P<.001). A comparison of primary and secondary implant stability quotient values in all bone types did not find any statistical significance (P=.780). A score was recorded at the time of implant placement and at the time of second stage surgery, and the prosthetic treatment was planned accordingly. The score highlights the importance of considering the association of bone quality, insertion torque values, and stability as denoted by implant stability quotient throughout treatment. Based on the variation in the score noted at recall visits, alterations in the treatment plan can be made with respect to the healing period and prosthetic design.

Implant stability in posterior maxilla: bone-condensing versus bone-drilling: a clinical study

The aim of this clinical trial was to compare primary and secondary stability of implants placed by bone condensing versus the standard drilling technique in the posterior edentulous maxilla. Forty-eight SLA Straumann implants 4.1 × 10 mm (Institut Straumann AG, Waldenburg, Switzerland) were placed into edentulous maxillary posterior region in the same positions bilaterally, using the bone condensation technique for one and the standard technique for the other side. Implant stability measurements were performed immediately after implant placement, as well as every week for the next 6 weeks by use of resonance frequency analysis (RFA). Data were analyzed using Mann-Whitney U and Wilcoxon tests. After bone condensing, significantly higher implant stability was recorded immediately after surgery as well as during the whole observation period of 6 weeks compared with bone-drilling technique (Mann-Whitney U test, P = .000). The bone-condensing technique can be recommended as an alternate surgical approach for implant site preparation in reduced bone density to achieve greater implant stability in the posterior maxilla.

Comparison of clinical outcomes of sinus bone graft with simultaneous implant placement: 4-month and 6-month final prosthetic loading

The aim of this study was to compare the survival rate and surrounding tissue condition of sinus bone grafts with simultaneous implant placement between 4-month and 6-month occlusal loading after implantation. Twenty-seven patients (61 implants) who were treated with sinus bone grafts (sinus lateral approach) and simultaneous Osstem GS II implant placement from July 2007 to June 2008 were included in this study. Of these patients, 14 (31 implants) were in the 4-month loading group, and 13 (30 implants) were in the 6-month loading group. We investigated the implantation type (submerged or nonsubmerged), sinus membrane perforation, type of prosthesis, opposed tooth type, primary and secondary stability of implants, and crestal bone loss around implant and surrounding tissue conditions. The amounts of crestal bone-loss at the final recall time (12.56 ± 5.95 mo after loading) of the 4-month and 6-month loading groups were 0.19 ± 0.33 mm and 0.39 ± 0.86 mm, respectively. However, the difference between groups was not statistically significant (P = .211). The width of keratinized mucosa, gingival index, plaque index, and pocket depth of the 4-month and 6-month loading groups were 2.50 ± 1.69 mm and 1.73 ± 1.40 mm (P = .081), 0.72 ± 0.83 and 0.59 ± 0.69 (P = .671), 1.11 ± 0.96 and 0.76 ± 0.79 (P = .226), 3.56 ± 0.98 mm and 3.65 ± 1.06 mm (P = .758), respectively. The primary stabilities of implants in the 4-month and 6-month loading groups were 61.96 ± 12.84 and 56.06 ± 15.55 (P = .120), and the secondary stabilities were 71.85 ± 6.80 and 66.51 ± 11.28 (P = .026), respectively. The secondary stability of the 4-month group was significantly higher than that of the 6-month group. There was no statistical difference (P > .05) between the 4-month and 6-month loading groups regarding the implantation type (submerged or nonsubmerged), sinus membrane perforation, type of prosthesis, or opposed tooth type. In the 4-month and 6-month groups, all of the implants survived until the final recall time. For the cases in which the residual bone was >3 mm and primary implant stability could be obtained, we conclude that loading is possible 4 months after the sinus bone graft and simultaneous implant placement.

Mechanical evaluation of the influence of low-level laser therapy in secondary stability of implants in mice shinbones

The present work evaluates mechanically the bone-implant attachment submitted or not to low-level laser therapy, with wavelength of 795 nm, in a continuous way, with power of 120 mW. The implant was placed in one of the shinbones of 24 mice, randomly distributed into two groups. The experimental group was submitted to six laser applications, divided into four points previously established, two lateral and two longitudinal, six times 8 J/cm2 with an interval of 2 days, totaling the dose of 48 J/cm2. The control group did not receive laser therapy. The interval between applications was 48 h and the irradiations began immediately after the end of the implant surgeries. The two groups were killed on the 14th day and a bone block of the area was removed where the implant was inserted. A torque machine was used to measure the torque needed for loosening the implants. A statistically significant difference was observed between the two groups. The experimental group presented larger difficulty for breaking up the implant interface with the bone block than the control group. It can be concluded that with the animal model and the protocol of irradiation present in this study, the laser therapy demonstrated capacity to increase the attachment bone implant.

Dental implants – pertinent papers 2002–2003: A personal view

T u c t s r o o a i i s when custom-made bridges and crowns fitted at the time of placement implants is the norm. This paper stresses the importance of careful planning and notes failures associated with bruxism; this harks back to similar warnings in earlier papers about implants. The benefits of accelerated care for patients are clear; we are, however, reminded that this is associated with a slightly higher risk of failure than the traditional approach.

Effect of the initial implant fitting on the predicted secondary stability of a cementless stem.

A numerical model able to investigate the influence of biomechanical factors on the long-term secondary stability of implants would be extremely useful for the design of new cementless prosthetic devices. A purely biomechanical model of osseo-integration has been developed, formulated as a rule-based adaptation scheme. Due to its complexity, the problem was divided into three steps: preliminary implementation of the model (proof of concept); implementation of the complete model and investigation of the model solution; and model validation. The paper describes the first of these three steps. The model was implemented as a discrete-states machine, and the few parameters required were derived from the literature. It was then applied to a real clinical case. The study was conducted using the frictional contact finite element model of a human femur implanted with a cementless anatomical stem. A stable solution was achieved after between three and 15 iterations for all initial positions considered. Similar initial conditions yielded similar final configurations. The model predicted all initial configurations, with the exception of a partial osseo-integration, ranging between 62% (distal fit) and 78% (proximal fit) of the viable interface. This is in good agreement with the values reported in the literature that never exceed 75%, even in the best conditions, and report better clinical results for proximal fit. For the varus configuration, which lacks cortical support, the algorithm predicted a completed loosening.