Comparison of Implant Stability between Regenerated and Non-Regenerated Bone. A Prospective Cohort Study

Implant stability is one of the main indicators of successful osseointegration. Although it has been measured in numerous studies, there has been little research on implant stability in regenerated bone. The study compares primary and secondary stability between implants placed in regenerated versus native bone and evaluates the influence of bone quality on the results. Sixty implants were placed in 31 patients: 30 implants inserted in native bone (non-regenerated) after a healing period of at least 6 months post-exodontia and 30 inserted in regenerated bone at 6 months after grafting with xenograft. Resonance frequency analysis (RFA) was used to obtain implant stability quotient (ISQ) values at baseline (implant placement), 8 weeks, and 12 weeks. Statistically significant differences were found between implants placed in regenerated bone and those placed in native bone at all measurement time points (p < 0.05). ISQ values were significantly influenced by bone quality at baseline (p < 0.05) but not at 8 or 12 weeks. Greater stability was obtained in implants placed in native bone; however, those placed in regenerated bone showed adequate primary and secondary stability for prosthetic loading. Bone quality influences the primary but not secondary stability of the implants in both native and regenerated bone.

Relation Between Insertion Torque and Implant Stability Quotient: A Clinical Study

Objectives This study aimed to assess the relation between the insertion torque and implant stability quotient (ISQ recorded immediately and 6 months after implant placement). Materials and Methods Twenty-five patients over the age of 18 years were selected for this study. One implant was placed per patient after tooth extraction. The implant site needed 15 mm in height and 8 mm in width. All implants had the same size (11.5 × 3.75 mm) and brand (Hexagonal Morse cone, DSP Biomedical). The insertion torque (Ncm) and resonance frequency analysis (ISQ value) (Osstell Mentor) were used to assess the primary stability (on the day of surgery). After 6 months, ISQ value was used to assess the secondary stability of each implant. Statistical Analysis The insertion torque data were correlated with ISQ measurements by using Pearson’s correlation. The significance level was 5%. Results There was a positive correlation between insertion torque and initial ISQ (correlation: 0.457; p = 0.022); however, no correlation was found between insertion torque and final ISQ (p = 0.308). Conclusion The present study demonstrated that there is a positive correlation between the insertion torque and the initial ISQ. Therefore, the higher the insertion torque, the higher the initial ISQ (or vice versa).

Does the Osseodensification Technique Allow for the use of a Healing Chamber with Primary Stability in Low-Density Bone? An in Vivo Study

This study aimed to investigate in vivo the hypothesis that the osseodensification technique, through a wider osteotomy, produce healing chambers at the implant-bone interface with no impact on primary stability osseointegration in low-density bone. Twenty implants (3.5 x 10 mm) presenting nanohydroxyapatite (nHA) surface were inserted in the ilium of ten sheep, after preparation of a 2.7-mm wide implant bed with conventional subtractive drilling (SCD) or a 3.8-mm wide implant bed with an osseodensification bur system (OBS) (n = 5/group/period). The final insertion torque (IT) and implant stability quotient (ISQ) evaluated the primary implant stability. After 14 and 28 days, the bone samples containing the implants were processed for histological and histomorphometric evaluation of bone implant contact (BIC) and bone area fraction occupancy (BAFO). No significant differences occurred between the implant bed preparations regarding IT and ISQ (P > 0.05). Histological analysis showed bone remodeling, and bone growth in all samples with no inflammatory infiltrate. BIC values were higher for SCD after 14 and 28 days (p < 0.05), however BAFO values were similar on both groups (p > 0.05). It was possible to conclude that the osseodensification technique allowed a wider implant bed preparation with no prejudice on primary stability and bone remodeling.

Reliability and Agreement of Three Devices for Measuring Implant Stability Quotient in the Animal Ex Vivo Model

Resonance frequency analysis (RFA) is the most extended method for measuring implant stability. The implant stability quotient (ISQ) is the measure obtained by different RFA devices; however, inter- and intra-rater reliability and agreement of these instruments remain unknown. Thirty implants were placed in three different pig mandibles. ISQ was measured parallel and perpendicular (lingual) to the peg axis with Osstell® Beacon, Penguin® and MegaISQ® by two different investigators and furthermore, one performed a test-retest. Intraclass correlation coefficient was calculated to assess the intra- and inter-rater reliability. Pearson correlation coefficient was used to assess the agreement. Intraclass correlation coefficients ranged from 0.20 to 0.65 for the Osstell® Beacon; 0.57 to 0.86 for the Penguin®; and −0.01 to 0.60 for the MegaISQ®. The highest ISQ values were obtained using Penguin® (66.3) in a parallel measurement; the lowest, using the MegaISQ® (60.1) in a parallel measurement. The highest correlation values with the other devices were obtained by MegaISQ® in a parallel measurement. Osstell® Beacon and MegaISQ® showed lower reliability than Penguin®. Osstell® had good agreement for measuring ISQ both in parallel and perpendicular, and MegaISQ® had the best agreement for measuring ISQ in parallel.

Influence of implant design, length, diameter, and anatomic region on implant stability: a randomized clinical trial

Objectives: To evaluate the influence of implant geometry and anatomical region on implant stability. Methods: A randomized controlled clinical trial was conducted on 45 patients, in whom a total of 79 implants were placed: 40 MIS C1 Implants and 39 MIS Seven Implants. The implant stability quotient was measured using resonance frequency analysis immediately after implant placement and 8 weeks later with an Osstell Mentor device. Results: 76 implants were analyzed. The implant stability quotient was statistically significantly higher for secondary stability than primary stability (68.7±8,6 vs. 65.2±10.3, respectively, p=0.023). Considering primary stability, no statistical differences were found between the implant lengths 8.0 mm, 10.0 mm, 11.0 mm, and 11.5 mm (67.9±7.6, 63.9±10, 57.2±11.1, and 66.4±11.3, respectively, p=0.312). The same was observed for secondary stability (68.4±9.4, 67.9±9.3, 74.7±1.5, and 69.2±7.9, respectively, p=0.504). Also, there were no statistically significant differences between the implant diameters 3.75 mm and 4.20 mm concerning primary stability (64.3±8.7 and 66.1±11.7 respectively, p=0.445) or secondary stability (68.8±8.2 and 68.7±9.1 respectively, p=0.930). Regarding implant design, a statistically significant difference was found only for secondary stability, favoring MIS Seven implants (p=0.048). The intraoral location was statistically significant for both primary and secondary stability, as these were higher on the anterior maxilla than the posterior maxilla and mandible (p<0.05). Conclusions: The diameter and length of the implants studied did not influence their stability. Implant design may influence secondary stability, whereas intraoral location has a relevant effect on primary and secondary stability.

Long-Term Outcomes of the Minimally Invasive Ponto Surgery vs. Linear Incision Technique With Soft Tissue Preservation for Installation of Percutaneous Bone Conduction Devices

Objective: Comparing the surgical outcomes of the Minimally Invasive Ponto Surgery (MIPS) technique with the linear incision technique with soft tissue preservation (LITT-P) for bone conduction devices after a follow-up of 22 months.Methods: In this multicenter randomized controlled trial, there was the inclusion of 64 adult patients eligible for unilateral surgery. There was 1:1 randomization to the MIPS (test) or the LITT-P (control) group. The primary outcome was an (adverse) soft tissue reaction. Secondary outcomes were pain, loss of sensibility, soft tissue height/overgrowth, skin sagging, implant loss, Implant Stability Quotient measurements, cosmetic scores, and quality of life questionnaires.Results: Sixty-three subjects were analyzed in the intention-to-treat population. No differences were found in the presence of (adverse) soft tissue reactions during complete follow-up. Also, there were no differences in pain, wound dehiscence, skin level, soft tissue overgrowth, and overall quality of life. Loss of sensibility (until 3-month post-surgery), cosmetic scores, and skin sagging outcomes were better in the MIPS group. The Implant Stability Quotient was higher after the LITT-P for different abutment lengths at various points of follow-up. Implant extrusion was nonsignificantly higher after the MIPS (15.2%) compared with LITT-P (3.3%).Conclusion: The long-term results show favorable outcomes for both techniques. The MIPS is a promising technique with some benefits over the LITT-P. Concerns regarding nonsignificantly higher implant loss may be overcome with future developments and research.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02438618.

Influence of implant design, length, diameter, and anatomic region on implant stability: a randomized clinical trial

Objectives: To evaluate the influence of implant geometry and anatomical region on implant stability. Methods: A randomized controlled clinical trial was conducted on 45 patients, in whom a total of 79 implants were placed: 40 MIS C1 Implants and 39 MIS Seven Implants. The implant stability quotient was measured using resonance frequency analysis immediately after implant placement and 8 weeks later with an Osstell Mentor device. Results: 76 implants were analyzed. The implant stability quotient was statistically significantly higher for secondary stability than primary stability (68.7±8,6 vs. 65.2±10.3, respectively, p=0.023). Considering primary stability, no statistical differences were found between the implant lengths 8.0 mm, 10.0 mm, 11.0 mm, and 11.5 mm (67.9±7.6, 63.9±10, 57.2±11.1, and 66.4±11.3, respectively, p=0.312). The same was observed for secondary stability (68.4±9.4, 67.9±9.3, 74.7±1.5, and 69.2±7.9, respectively, p=0.504). Also, there were no statistically significant differences between the implant diameters 3.75 mm and 4.20 mm concerning primary stability (64.3±8.7 and 66.1±11.7 respectively, p=0.445) or secondary stability (68.8±8.2 and 68.7±9.1 respectively, p=0.930). Regarding implant design, a statistically significant difference was found only for secondary stability, favoring MIS Seven implants (p=0.048). The intraoral location was statistically significant for both primary and secondary stability, as these were higher on the anterior maxilla than the posterior maxilla and mandible (p<0.05). Conclusions: The diameter and length of the implants studied did not influence their stability. Implant design may influence secondary stability, whereas intraoral location has a relevant effect on primary and secondary stability.