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Alsheghri AA, Abdalla AN, Mokahhal B, Cortes ARG, Garcia-Denche JT, Celemin A, Cascos R, Song J, Tamimi F. Development of a peak insertion torque prediction model for parallel-walled dental implants. Med Eng Phys 2025; 138:104318. [PMID: 40180531 DOI: 10.1016/j.medengphy.2025.104318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Revised: 01/19/2025] [Accepted: 02/25/2025] [Indexed: 04/05/2025]
Abstract
Implant peak insertion torque is a commonly used indication of primary stability that dentists rely on to make clinical decisions. The aim of this manuscript is to model the peak torque required for dental implant insertion based on clinical data such as bone properties, implant properties, and drilling procedure. A total of 116 parallel-walled Sweden and Martina dental implants were included in this study. Parameters such as age, sex, bone quality (derived from radiographs), applied peak insertion torque, implant location, implant length, final drill diameter, and implant diameter were recorded. Six data-driven regression models were trained and tested using different combinations of the clinical data to predict the peak torque. A physics-based model was also derived for the peak torque and compared with the data-driven models. The neural network model with early stopping achieved the best accuracy in predicting the clinically measured torque (R2 = 0.7692, MSE = 0.08815). Within the limitations of this study, the results suggest that it is possible to predict the peak torque required for implant placement based on the patient's radiographs, implant's properties, and drill diameter. The findings of this study can serve as a reference for dentists in choosing drilling parameters for dental implant surgeries.
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Affiliation(s)
- Ammar A Alsheghri
- Department of Mechanical Engineering, King Fahd University of Petroleum and Minerals (KFUPM), Dhahran, Kingdom of Saudi Arabia; Interdisciplinary Research Center for Biosystems and Machines, King Fahd University of Petroleum and Minerals (KFUPM), Dhahran, Kingdom of Saudi Arabia.
| | - Ali N Abdalla
- Department of Mechanical Engineering, King Fahd University of Petroleum and Minerals (KFUPM), Dhahran, Kingdom of Saudi Arabia.
| | - Basel Mokahhal
- Department of Mining and Materials Engineering, McGill University, Montreal, QC, Canada.
| | | | | | - Alicia Celemin
- Department of Conservative Dentistry and Prosthetics, Complutense University, Madrid, Spain.
| | - Rocio Cascos
- Clinical Dentistry Department, European University of Madrid, Madrid, Spain.
| | - Jun Song
- Department of Mining and Materials Engineering, McGill University, Montreal, QC, Canada.
| | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.
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Probst M, Probst F, Tröltzsch M, Bruckbauer M, Marka AW, Andreisek G, Frauenfelder T, Burian E. Retrospective Analysis of Dental Implant Stability in Relation to Mandibular Bone Density and Cortical Thickness in Osteopenic and Osteoporotic Patients. J Clin Med 2025; 14:1339. [PMID: 40004869 PMCID: PMC11856041 DOI: 10.3390/jcm14041339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2025] [Revised: 02/04/2025] [Accepted: 02/10/2025] [Indexed: 02/27/2025] Open
Abstract
Background/Objectives: The aim of this study is to examine the relationship between cervical spine and jaw bone mineral density (BMD) and assess how cortical thickness and BMD influence primary implant stability (PIS) across different bone health conditions. Methods: The study included 29 patients (mean age: 63.7 ± 13.7 years; 13 women) and 15 healthy controls (mean age: 25.3 ± 3.0 years; seven women). Cervical spine (C2-C4) and mandibular BMD were evaluated using asynchronous calibration and manual segmentation. Cortical thickness was measured, and primary implant stability was assessed via insertion torque in Newton centimeters (Ncm). Results: Cervical spine BMD was significantly lower in the patient group compared to controls (203.0 ± 51.0 vs. 252.0 ± 21.7 mg/dL, p < 0.0001). No significant correlation was found between mandibular BMD and cervical spine BMD in both groups (patients: ρ = 0.1287; p = 0.506, controls r = -0.1214; p = 0.667). Linear regression analysis revealed that cortical thickness alone, not implant site BMD, significantly influenced PIS (F(2.74) = 5.597, p = 0.005). Conclusions: Asynchronous calibration accurately quantifies cervical and mandibular BMD. Cortical thickness rather than overall bone density emerges as a critical factor in determining implant stability. These findings suggest that clinicians should prioritize cortical thickness assessment when planning dental implant procedures, potentially improving outcomes across diverse patient bone health profiles.
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Affiliation(s)
- Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 80636 Munich, Germany;
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University of Munich, 80636 Munich, Germany; (F.P.); (M.T.)
| | - Matthias Tröltzsch
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University of Munich, 80636 Munich, Germany; (F.P.); (M.T.)
| | - Matthias Bruckbauer
- Department of Oral and Maxillofacial Surgery, University of Salzburg, 5020 Salzburg, Austria;
| | - Alexander W. Marka
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 80636 Munich, Germany;
| | - Gustav Andreisek
- Department of Diagnostic and Interventional Radiology, Cantonal Hospital Frauenfeld, 8500 Frauenfeld, Switzerland;
- Faculty of Medicine, University of Zurich, 8057 Zurich, Switzerland;
| | - Thomas Frauenfelder
- Faculty of Medicine, University of Zurich, 8057 Zurich, Switzerland;
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8057 Zurich, Switzerland
| | - Egon Burian
- Faculty of Medicine, University of Zurich, 8057 Zurich, Switzerland;
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8057 Zurich, Switzerland
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Rezallah NNF, Luke AM. Evaluating Micro-computed Tomography in Dental Implant Osseointegration: A Systematic Review and Meta-analysis. Acad Radiol 2025; 32:1086-1099. [PMID: 39368915 DOI: 10.1016/j.acra.2024.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 09/01/2024] [Accepted: 09/02/2024] [Indexed: 10/07/2024]
Abstract
RATIONALE AND OBJECTIVES The success of dental implants is heavily dependent on the implant's efficient integration with the surrounding bone, a process known as osseointegration. This integration is influenced by a range of individual characteristics of each patient, as well as the accuracy of diagnostic imaging techniques. Micro-computed tomography (micro-CT) is capable of capturing detailed three-dimensional images with high resolution. It may offer superior capabilities for assessing the connections between bones and implants compared to older techniques such as cone-beam computed tomography (CBCT) and intraoral radiography. This systematic review will discuss the uses of micro-CT in dental implant osseointegration, compare it to other radiography methods, and discuss it's effect on patients, especially those with previous history of periodontal disease. MATERIALS AND METHODS This research performed an extensive search across multiple databases, choosing papers based on specific criteria for inclusion and exclusion. The study focus was on using micro-CT to evaluate bone osseointegration. Meta-analyses were conducted to measure the impact of micro-CT on bone loss and the success rates of implants, while comparing various surgical procedures and depths of implantation. This systematic review is registered in PROSPERO with the registration number CRD42023482747. RESULTS The result of this study comprised 28 papers, incorporating a meta-analysis of 8. It emphasized the exceptional spatial resolution of micro-CT, which enables accurate assessments of bone volume and density, crucial factors for implant success. Micro-CT, when compared to CBCT and intraoral radiography, provides more comprehensive information, but it faces limitations due to its elevated expenses and radiation exposure. The analysis also indicated that micro-CT could be particularly advantageous in tailored therapy planning, particularly for patients with impaired conditions. Systemic factors like diabetes or periodontal disease can cause bone conditions. CONCLUSION Micro-CT is a highly advanced imaging technique that offers extensive information about dental implants, which is essential for evaluating osseointegration. Although micro-CT has several limitations, it has the capacity to improve clinical outcomes by providing more accurate diagnoses and tailored implant techniques. Subsequent investigations should focus on assessing its cost-effectiveness and establishing protocols to mitigate radiation exposure.
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Affiliation(s)
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE; Center for Medical and Bio-Allied Health Sciences Research (CMBHSR), Ajman University, Ajman, UAE.
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Al-Juboori H, Petronis Z, Razukevicius D. The Interrelation between Cortical Bone Thickness and Primary and Secondary Dental Implant Stability: a Systematic Review. J Oral Maxillofac Res 2024; 15:e2. [PMID: 40017687 PMCID: PMC11863651 DOI: 10.5037/jomr.2024.15402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Accepted: 12/30/2024] [Indexed: 03/01/2025]
Abstract
Objectives Dental implants have emerged as a reliable and long-lasting solution for missing teeth, offering advantages over traditional prosthetic options. The aim of this systematic review was to thoroughly explore the correlation between cortical bone thickness of the jaws and bone-level dental implant primary and secondary stability. Material and Methods A comprehensive literature search was conducted in MEDLINE (PubMed), ClinicalKey and the Cochrane Library from 1 January, 2019 to 21 June, 2024. This review focused on patients undergoing dental implant placement with varying cortical bone thicknesses and implant stability levels. Quality and risk-of-bias assessment evaluated by Cochrane risk of bias tool. Results Out of 160 screened articles, 28 were reviewed in full, and 6 met the inclusion criteria, involving 209 patients and 418 implants. Implant stability quotient (ISQ) values showed no significant correlations during baseline and secondary assessments (P > 0.05). Correlations were noted between implant stability, bone density, alveolar ridge width, and implant size (P < 0.01). ISQ and insertion torque value (ITV) were strongly correlated at insertion (P < 0.001) but not at follow-ups (P = 0.059 at 2 months, P = 0.817 at 6 months, P = 0.029 at 12 months). ISQ values increased over time (P < 0.001). Implants in native bone showed higher ISQ values at baseline (P = 0.011), 8 weeks (P = 0.013), and 12 weeks (P < 0.001). Regions with thicker cortical bone demonstrated superior primary stability. Conclusions Thicker cortical bone enhances primary implant stability, as indicated by higher insertion torque and implant stability quotient values.
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Affiliation(s)
- Halah Al-Juboori
- Department of Maxillofacial surgery, Lithuanian University Of Health Sciences Medical Academy, KaunasLithuania.
| | - Zygimantas Petronis
- Department of Maxillofacial surgery, Lithuanian University Of Health Sciences Medical Academy, KaunasLithuania.
| | - Dainius Razukevicius
- Department of Maxillofacial surgery, Lithuanian University Of Health Sciences Medical Academy, KaunasLithuania.
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Iram J, Ajaz S, Hussain SS, Irshad A, Shahid H, Jahangir I. Immediate dental implant placement with and without Platelet-Rich Fibrin (PRF) in esthetic zone: A comparative study. Natl J Maxillofac Surg 2024; 15:467-473. [PMID: 39830456 PMCID: PMC11737578 DOI: 10.4103/njms.njms_42_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/22/2023] [Accepted: 06/26/2023] [Indexed: 01/22/2025] Open
Abstract
Context Biomaterials such as platelet-rich fibrin (PRF) have shown to improve healing and osseointegration. Aims The aim of this study was to clinically and radiographically evaluate and compare immediate implants placed with and without PRF. Settings and Design This prospective and comparative study was conducted among 30 patients in the Department of Oral and Maxillofacial Surgery, Govt. Dental College and Hospital, Srinagar. Materials and Methods Thirty subjects were randomly divided into two groups: group A or PRF group and group B or non-PRF group with fifteen patients in each group. Clinical parameters such as implant mobility and bleeding on probing were recorded. The radiographic parameters such as bone density in Hounsfield units (HU) and marginal bone loss (mm) were measured using cone-beam computed tomography (CBCT). Statistical Analysis Used For intergroup analysis of data, Student's independent t-test and Chi-square test were employed. The paired t-test and McNemar test were applied for intragroup analysis of data. Results No significant difference in the mean marginal bone level scores between PRF group and non-PRF group (intergroup) at baseline and at 3 months was observed. A Statistically significant difference was observed in the mean bone density (HU) in the PRF group (intragroup) between baseline and 3 months and also in bleeding on probing between baseline and 6 months in the PRF group (intragroup). Conclusions The results highlighted the promising but transitory effects of (PRF) membrane in immediate implants and showed an improvement in peri-implant bone density, which improves implant stability and subsequent long implant survival and prognosis.
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Affiliation(s)
- Jan Iram
- Department of Oral and Maxillofacial Surgery, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Karnataka, India
| | - Shah Ajaz
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India
| | - Sheikh Shujah Hussain
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India
| | - Ahmed Irshad
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India
| | - Hassan Shahid
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India
| | - Irfan Jahangir
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Bernabeu-Mira JC, Peñarrocha-Diago M, Canullo L, Camacho-Alonso F, Cortes ARG, Peñarrocha-Oltra D. Autologous bone harvested during implant bed preparation: A randomized clinical trial comparing high-speed drilling with irrigation versus low-speed drilling without irrigation. Clin Implant Dent Relat Res 2024; 26:724-733. [PMID: 38802889 DOI: 10.1111/cid.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/06/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE To compare collected bone weight and the frequency of autologous bone harvesting from the flutes of surgical drills used for implant bed preparation using two different drilling techniques. A comparative evaluation of radiographic bone density and bone quality was also made. MATERIALS AND METHODS A randomized clinical trial was made of 66 dental implants in patients with a single posterior edentulous site. The compared drilling techniques were high-speed drilling with irrigation (control group) and low-speed drilling without irrigation (test group). The bone collected in both groups was dried and weighed with a precise electronic balance. The frequency of harvesting was calculated. The median radiographic bone density of each implant site was measured using cone-beam computed tomography (CBCT) pixel values. Patient sex, age, implant position and dimensions, as well as the last drill diameter were analyzed as independent variables. The level of significance was 5%. RESULTS The harvesting of bone chips from drill flutes proved possible in 51.5% of the procedures in the control group and in 100% in the test group (p < 0.001). There were also statistically significant differences in bone weight between the control group (6.7 ± 10.6 mg) and the test group (41.9 ± 30.3 mg) (p < 0.001). The CBCT pixel values were directly correlated with the collected bone weight in both groups. The median radiographic bone density, arch and last drill diameter were significantly associated with harvesting bone frequency and collected bone weight (p < 0.05). CONCLUSIONS Our findings suggest that the frequency and weight of autologous bone harvested from drills are greater with low-speed drilling without irrigation than with high-speed drilling with irrigation. Radiographic bone density, arch and last drill diameter also significantly influenced the harvesting outcomes.
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Affiliation(s)
- Juan Carlos Bernabeu-Mira
- Oral Surgery Unit, Faculty of Medicine and Dentistry, Department of Stomatology, University of Valencia, Valencia, Spain
| | - Miguel Peñarrocha-Diago
- Oral Surgery Unit, Faculty of Medicine and Dentistry, Department of Stomatology, University of Valencia, Valencia, Spain
| | | | | | | | - David Peñarrocha-Oltra
- Oral Surgery Unit, Faculty of Medicine and Dentistry, Department of Stomatology, University of Valencia, Valencia, Spain
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Ghasemzadeh F, Mortazavi N, Mallahi M, Gharib MH, Behnampour N, Badeleh MT, Asgari N. Association between psychological stress and mandibular condyle structure: an analytical cross-sectional study. BMC Musculoskelet Disord 2024; 25:563. [PMID: 39030530 PMCID: PMC11264819 DOI: 10.1186/s12891-024-07692-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 07/15/2024] [Indexed: 07/21/2024] Open
Abstract
OBJECTIVE The potential influence of psychological factors on temporomandibular joint disorders has been clinically documented. To date, all research examining the impact of psychological stress on the temporomandibular joint has been conducted on animals. This study aims to explore the relationship between psychological stress and the structure of the human mandibular condyle. METHODS This cross-sectional study was performed on individuals, who were referred to the radiology division of 5th Azar Hospital for head and neck Computed Tomography (CT) scans. All participants completed a perceived stress questionnaire to determine their level of stress. Bone density and cortical bone thickness were measured as indicators of mandibular condyle structure. Based on multi-slice CT scan data, bone density was calculated in the anterior, middle, and posterior mandibular condyle. The cortical bone thickness was also measured at the anterior and posterior mandibular condyle. Statistical analysis was performed in R 4.0.2 software. RESULTS Seventy individuals, aged 18-59 years, participated in this study. The CT scans revealed a decrease in Hounsfield units (HU) and bone mineral density (BMD) in both the anterior and posterior regions. However, in the high-stress group, there was no significant difference in cortical bone thickness in the anterior and posterior regions of the condyle, nor in HU and BMD in the middle region of the condyle. An inverse correlation was observed between BMD and perceived stress in the anterior, middle, and posterior regions of both condyles. CONCLUSION The current findings indicate that recent psychological stress is associated with changes in the structure of the condyle.
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Affiliation(s)
- Fatemeh Ghasemzadeh
- Dental Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nazanin Mortazavi
- Dental Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Mysa Mallahi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Hadi Gharib
- Department of Radiology, School of Medicine, 5th Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Naser Behnampour
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Taghi Badeleh
- Department of Psychology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Negar Asgari
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
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Wang SH, Fuh LJ, Chen MYC, Tsai MT, Huang HL, Peng SL, Hsu JT. Preoperative assessment of bone density for dental implantation: a comparative study of three different ROI methods. Head Face Med 2024; 20:33. [PMID: 38760840 PMCID: PMC11100211 DOI: 10.1186/s13005-024-00434-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images. METHODS Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods. RESULTS The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001). CONCLUSIONS The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results. TRIAL REGISTRATION This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study.
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Affiliation(s)
- Shiuan-Hui Wang
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
| | - Michael Y C Chen
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, 433, Taiwan
| | - Heng-Li Huang
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
- Department of Biomedical Engineering, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
| | - Jui-Ting Hsu
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan.
- Department of Biomedical Engineering, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
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Palomino-Zorrilla JJ, Córdova-Limaylla NE, Rosas-Díaz JC, Cayo-Rojas CF, Cervantes-Ganoza LA, Guerrero ME. Jawbone quality classification in dental implant planning and placement studies. A scoping review. J Int Soc Prev Community Dent 2024; 14:89-97. [PMID: 38827351 PMCID: PMC11141890 DOI: 10.4103/jispcd.jispcd_4_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 06/04/2024] Open
Abstract
Aim Cone beam computed tomography has become an attractive method for implant planning. However, in most cases, not all the information is taken advantage of and often the radiographic evaluation of bone quality is based on subjective assessment by the individual clinician. Therefore, the aim of this study was to examine classifications of bone tissue characteristics and methods for assessing them in dental implant planning and placement studies. Materials and Methods Three databases (Pubmed, Scopus, Web of Science) were searched using specific index terms: "Bone quality, bone quantity, bone density, cone-beam CT and cone-beam computed tomography". Three reviewers selected titles and analyzed abstracts according to inclusion and exclusion criteria. Some descriptions of bone tissue characteristics (bone quality, density, and quantity) used before or during dental implant placement were selected and categorized. Results The search yielded 442 titles. A total of 32 articles were selected and read in full text. Seventeen articles were considered relevant. Different classification systems were found to evaluate bone tissue characteristics as well as different examination protocols. Thirteen publications included in this review reported on bone quality and quantity using the Lekholm and Zarb classification. However, only four studies implemented and/or proposed modifications of the Lekholm and Zarb system. Four other publications described bone quality according to different classification systems such as Misch, University of California Los Angeles (UCLA), or Trisi and Rao. The assessment methods were often briefly described (or not described at all in one publication). Of the articles analyzed, five presented observer performance, whereas three presented diagnostic accuracy of the assessment method. Conclusion Currently, there are different classification systems applied to dental implant planning and placement, particularly regarding whether bone quality or quantity affects treatment outcomes. However, most authors have not validated the diagnostic accuracy and reproducibility of the classification used. Therefore, it is necessary to develop a classification system consistent with characteristics of bone tissue, taking into consideration an adequate description of bone tissue assessment methods, their diagnostic accuracy, and observer performance.
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Affiliation(s)
| | | | - José C Rosas-Díaz
- School of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru
| | - César F Cayo-Rojas
- School of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru
| | | | - Maria E Guerrero
- Faculty of Dentistry, Department of Medico Surgical Stomatology, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Rosa C, Bento V, Duarte N, Sayeg J, Santos T, Pellizzer E. Do dental implants installed in different types of bone (I, II, III, IV) have different success rates? A systematic review and meta-analysis. Saudi Dent J 2024; 36:428-442. [PMID: 38525185 PMCID: PMC10960139 DOI: 10.1016/j.sdentj.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 11/11/2023] [Accepted: 12/18/2023] [Indexed: 03/26/2024] Open
Abstract
Purpose The objective of this systematic review and meta-analysis was to evaluate the survival rate of implants installed in bone type IV (Lekholm and Zarb, 1995) compared to that of implants installed in bone types I, II, and III. Material and methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and was registered in the PROSPERO International Database of Systematic Reviews (CRD42021229775). The PubMed/MEDLINE, Scopus, and Cochrane databases were searched through July 2021. The PICO question was: "Dental implants installed in type IV bone have a lower success rate when compared to implants installed in type I bone, II and III?". The established inclusion criteria were: 1) controlled and randomized clinical trials (RCT), 2) prospective and retrospective studies with at least 10 participants with dental implants, and 3) patients with dental implants installed in bone tissue types I, II, III, and IV (Lekholm and Zarb, 1985). The minimum followup duration was 1 year. Results After searching the identified databases, 117 articles were selected for full reading and 68 were excluded. Thus, 49 studies were included for qualitative and quantitative analyses. The total number of participants included was 12,056, with a mean age of 41.56 years and 29,905 implants installed. Bone types I, II, and III exhibit a lower implant failure rate when compared to bone type IV. Conclusion Dental implants installed in bone types I, II, and III showed significantly higher survival rates than those installed in type IV. The bone type I success rate was not significantly different than that of type II; however, the success rate of bone type I and II was higher than that of type III.
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Affiliation(s)
- Cleber Rosa
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
| | - Victor Bento
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
| | - Nathália Duarte
- Department of Basic Sciences, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
| | - Joao Sayeg
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
| | - Thawan Santos
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
| | - Eduardo Pellizzer
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
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Aboelmahasen MMF, Othman SS, Dena ASA, Zhran M, Ma M, El-Destawy MT, Bilal AM. Histomorphometric and CBCT comparison of osseointegration around orthodontic titanium miniscrews coated with different nanoparticles: An in-vivo animal study. Int Orthod 2024; 22:100823. [PMID: 37992473 DOI: 10.1016/j.ortho.2023.100823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/16/2023] [Accepted: 10/22/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Temporarily installed titanium orthodontic miniscrews are usually used for many orthodontic applications, especially those cases that need high force, such as skeletally anchored orthodontic appliance cases. Surface modification of titanium miniscrews has proved success in preventing failure and overcoming their limitations. OBJECTIVE The present study aims at the assessment of the quality of osseointegration of surface modified titanium miniscrews installed in the maxilla of albino rabbits with cone-beam computed tomography (CBCT) imaging as well as histomorphometric investigations. MATERIAL AND METHODS The orthodontic titanium miniscrews (TMSs) were coated with silver/hydroxyapatite (Ag/HA) nanoparticles (NPs) or zinc oxide (ZnO) NPs via electrochemical deposition. The coating nanomaterials were then characterized with X-ray diffractometry (XRD) and scanning electron microscopy (SEM) imaging. Moreover, the antimicrobial activity of the coated titanium miniscrews were evaluated in the rabbits' oral cavity to investigate their ability to prevent biofilm formation. RESULTS It was found that the Ag/HA-coated TMSs demonstrated the highest antimicrobial activity and bone area fill, followed by the ZnO NPs-coated TMSs when compared to their uncoated counterparts. In the anterior area surrounding the installed TMSs, the highest osseointegration was demonstrated by ZnO NPs-coated TMSs. However, Ag/HA-coated TMSs showed the highest osseointegration values in the posterior peri-implant area. CONCLUSIONS Ag/HA- and ZnO NPs-coated TMSs may provide a promising solution to overcome the 30% probable failure in temporarily installed orthodontic miniscrews, as they can enhance the osseointegration process and prevent biofilm formation.
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Affiliation(s)
| | - Samer Salim Othman
- Department of Clinical Dental Sciences, College of Dentistry, Ibnsina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq
| | - Ahmed S Abo Dena
- Pharmaceutical Chemistry Department, National Organization for Drug Control and Research (NODCAR), Giza, Egypt; Faculty of Oral and Dental Medicine, Future University in Egypt (FUE), New Cairo, Egypt
| | - Monira Zhran
- Botany and Microbiology Department, Faculty of Science (Girls Branch), Al-Azhar University, Cairo, Egypt
| | - Mohamed Ma
- Oral pathology Department, Faculty of Dental Medicine (Cairo-Boys), Al-Azhar University, Cairo, Egypt
| | - Mahmoud Taha El-Destawy
- Oral medicine Department, Faculty of Dental Medicine (Cairo-Boys), Al-Azhar University, Cairo, Egypt
| | - Ahmed Mohamed Bilal
- Oral medicine Department, Faculty of Dental Medicine (Cairo-Boys), Al-Azhar University, Cairo, Egypt
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12
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Xiao Y, Lv L, Xu Z, Zhou L, Lin Y, Lin Y, Guo J, Chen J, Ou Y, Lin L, Wu D. Correlation between peri-implant bone mineral density and primary implant stability based on artificial intelligence classification. Sci Rep 2024; 14:3009. [PMID: 38321110 PMCID: PMC10847140 DOI: 10.1038/s41598-024-52930-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/25/2024] [Indexed: 02/08/2024] Open
Abstract
Currently, the classification of bone mineral density (BMD) in many research studies remains rather broad, often neglecting localized changes in BMD. This study aims to explore the correlation between peri-implant BMD and primary implant stability using a new artificial intelligence (AI)-based BMD grading system. 49 patients who received dental implant treatment at the Affiliated Hospital of Stomatology of Fujian Medical University were included. Recorded the implant stability quotient (ISQ) after implantation and the insertion torque value (ITV). A new AI-based BMD grading system was used to obtain the distribution of BMD in implant site, and the bone mineral density coefficients (BMDC) of the coronal, middle, apical, and total of the 1 mm site outside the implant were calculated by model overlap and image overlap technology. Our objective was to investigate the relationship between primary implant stability and BMDC values obtained from the new AI-based BMD grading system. There was a significant positive correlation between BMDC and ISQ value in the coronal, middle, and total of the implant (P < 0.05). However, there was no significant correlation between BMDC and ISQ values in the apical (P > 0.05). Furthermore, BMDC was notably higher at implant sites with greater ITV (P < 0.05). BMDC calculated from the new AI-based BMD grading system could more accurately present the BMD distribution in the intended implant site, thereby providing a dependable benchmark for predicting primary implant stability.
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Affiliation(s)
- Yanjun Xiao
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Lingfeng Lv
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, 350001, China
| | - Zonghe Xu
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Lin Zhou
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Yanjun Lin
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, 350001, China
| | - Yue Lin
- Newland Digital Technology Co., Ltd., Fuzhou, Fujian, China
| | - Jianbin Guo
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, 350001, China
| | - Jiang Chen
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Yanjing Ou
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Lin Lin
- Newland Digital Technology Co., Ltd., Fuzhou, Fujian, China
| | - Dong Wu
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, 350001, China.
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13
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Hassan GS, AbouZaid BH, Ghouraba RF, Ibrahim HF. Cemental and alveolar bone defects after chronic exposure to amoxicillin in rats (histopathologic and radiographic study). Arch Oral Biol 2024; 158:105870. [PMID: 38091768 DOI: 10.1016/j.archoralbio.2023.105870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/11/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES This study aimed to shed new light on the potential detrimental effects on cementum and adjacent alveolar bone after chronic exposure to amoxicillin. METHODS Six pregnant adult Albino rats were equally divided into two groups. Saline solution and amoxicillin (100 mg/Kg) were given to rats of control and amoxicillin group, respectively from the 13th to the 21st day of pregnancy. The same treatment was given to the pups till the 42nd day. The cementum of the first molar teeth and the surrounding alveolar bone were examined qualitatively by histopathological and scanning electron microscope, and quantitatively by energy dispersive X-ray spectroscopy and cone beam computed tomography. RESULTS Amoxicillin group depicted cemental and alveolar bone defects along with resorption lacunae. Statistically significant decreases in calcium and calcium/phosphorus ratio in cementum and in calcium only in alveolar bone were evident (p ≤ 0.05). Overall cementum and alveolar bone densities also showed statistically significant decreases (p ≤ 0.05). CONCLUSION Chronic amoxicillin administration displayed destructive effects on cementum and the surrounding alveolar bone which may disturb tooth attachment integrity. Therefore, it is recommended to minimize its haphazard usage during pregnancy and early childhood.
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Affiliation(s)
- Gihan S Hassan
- Assistant professor of Oral Biology, Faculty of Dentistry, Tanta University, Egypt.
| | - Basant H AbouZaid
- Lecturer of Oral Pathology, Faculty of Dentistry, Tanta University, Egypt.
| | - Rehab F Ghouraba
- Lecturer of Oral Medicine, Periodontology, Oral diagnosis and Radiology, Faculty of Dentistry, Tanta University, Egypt.
| | - H F Ibrahim
- Lecturer of Oral Biology, Faculty of Dentistry, Tanta University, Egypt.
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14
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Wang SH, Hsu JT, Fuh LJ, Peng SL, Huang HL, Tsai MT. New classification for bone type at dental implant sites: a dental computed tomography study. BMC Oral Health 2023; 23:324. [PMID: 37231447 DOI: 10.1186/s12903-023-03039-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE This study proposed a new classification method of bone quantity and quality at the dental implant site using cone-beam computed tomography (CBCT) image analysis, classifying cortical and cancellous bones separately and using CBCT for quantitative analysis. METHODS Preoperative CBCT images were obtained from 128 implant patients (315 sites). First, measure the crestal cortical bone thickness (in mm) and the cancellous bone density [in grayscale values (GV) and bone mineral density (g/cm3)] at the implant sites. The new classification for bone quality at the implant site proposed in this study is a "nine-square division" bone classification system, where the cortical bone thickness is classified into A: > 1.1 mm, B:0.7-1.1 mm, and C: < 0.7 mm, and the cancellous bone density is classified into 1: > 600 GV (= 420 g/cm3), 2:300-600 GV (= 160 g/cm3-420 g/cm3), and 3: < 300 GV (= 160 g/cm3). RESULTS The results of the nine bone type proportions based on the new jawbone classification were as follows: A1 (8.57%,27/315), A2 (13.02%), A3 (4.13%), B1 (17.78%), B2 (20.63%), B3 (8.57%) C1 (4.44%), C2 (14.29%), and C3 (8.57%). CONCLUSIONS The proposed classification can complement the parts overlooked in previous bone classification methods (bone types A3 and C1). TRIAL REGISTRATION The retrospective registration of this study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH 108-REC2-181.
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Affiliation(s)
- Shiuan-Hui Wang
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung, 404, Taiwan.
- Department of Biomedical Engineering, China Medical University, Taichung, 404, Taiwan.
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University and Hospital, Taichung, 404, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, 404, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, 404, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, 433, Taiwan
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15
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Starch-Jensen T, Spin-Neto R, Veiss-Pedersen P, Dahlin C, Bruun NH, Fink T. Radiographic outcome after maxillary sinus floor augmentation with allogeneic adipose tissue-derived stem cells seeded on deproteinized bovine bone mineral. A randomized controlled experimental study. J Craniomaxillofac Surg 2023; 51:321-331. [PMID: 37355369 DOI: 10.1016/j.jcms.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/01/2023] [Accepted: 05/21/2023] [Indexed: 06/26/2023] Open
Abstract
The objective was to test the hypothesis of no difference in radiographic outcome after maxillary sinus floor augmentation (MSFA) with allogeneic adipose tissue-derived stem cells (ASCs) seeded on deproteinized bovine bone mineral (DBBM) (test) compared with excipient on DBBM (control). Eighteen minipigs were assigned into three groups of six animals and euthanised after one month (T1), two months (T2), and four months (T3), respectively. Each maxillary sinus was randomly allocated to either test or control with an equal volume of graft. Computed tomography scans (CTs) after MSFA (T0) were compared with CTs after euthanasia to evaluate graft volume (GV) changes and bone density (BD) using three-dimensional measurements and Hounsfield units. GV was larger in test compared with control at T1 (P = 0.046), whereas GV was larger in control compared with test at T3 (P = 0.01). BD increased from T0 to T1-T3 (P < 0.001) with both treatments. Higher BD was observed in control compared with test at T3 (P = 0.01), while no significant difference was observed at T1 and T2. Conclusively, the present study demonstrate that allogeneic ASCs seeded on DBBM in conjunction with MSFA seemed not to improve the radiographic outcome compared with excipient on DBBM. However, radiological outcomes need to be supplemented by bone histomorphometry before definitive conclusions can be provided about the beneficial use of allogeneic ASCs seeded on DBBM in conjunction with MSFA compared with DBBM alone.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital and Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section of Oral Radiology, Faculty of Health, Aarhus University, Aarhus, Denmark
| | | | - Christer Dahlin
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Science, The Sahlgrenska Academy, University of Gothenburg, and Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Gothenburg, Sweden
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Trine Fink
- Regenerative Medicine Group, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Fakih KA, Edreva MS, Stoichkov BB. Removal of a Horizontally Displaced Dental Implant below the Mandibular Canal. Case Rep Dent 2023; 2023:6663874. [PMID: 37006703 PMCID: PMC10065860 DOI: 10.1155/2023/6663874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/12/2023] [Accepted: 03/16/2023] [Indexed: 03/28/2023] Open
Abstract
A clinical case of a horizontally displaced dental implant, which moved below the level of the mandibular canal during surgery is presented together with a brief review of the comparable published cases. The bone mineral density and the morphology of the alveolar ridge were analyzed at the site of osteotomy, and the low bone density of
Hounsfield Units was found in the area. The factors related to implant displacement were: the anatomical features of bone structure, and the applied mechanical pressure during the implant insertion. The displacement of the dental implant below the level of the mandibular canal during implantation can be a severe complication. Its removal requires the safest surgical approach to avoid damaging the inferior alveolar nerve. The description of one clinical case does not provide grounds for drawing definite conclusions. To avoid similar incidents, detailed radiographic assessment before implantation is necessary; it is also important to follow the surgical protocols of implant placement into soft bone and to create conditions for a good visibility and sufficient control of bleeding during surgery.
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17
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Al-Haj Husain A, Stadlinger B, Özcan M, Schönegg D, Winklhofer S, Al-Haj Husain N, Piccirelli M, Valdec S. Buccal bone thickness assessment for immediate anterior dental implant planning: A pilot study comparing cone-beam computed tomography and 3D double-echo steady-state MRI. Clin Implant Dent Relat Res 2023; 25:35-45. [PMID: 36454235 DOI: 10.1111/cid.13160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE To evaluate image quality and diagnostic accuracy of buccal bone thickness assessment in maxillary and mandibular anterior region using cone-beam computed tomography (CBCT) and 3-dimensional double-echo steady-state (DESS) MRI for preoperative planning of immediate dental implants in healthy individuals. METHODS One hundred and twenty teeth in 10 volunteers were retrospectively evaluated for image quality and artifacts using Likert scale (4 = excellent to 0 = decreased). Buccal bone thickness was measured at three measurement points (M1 = 2 mm from the cementoenamel junction, M2 = middle of the root, and M3 = at the root apex) for each tooth in the maxillary (13-23) and the mandibular anterior region (33-43). Descriptive statistics and two-way ANOVA with Tukey's Post-hoc test were performed to evaluate the significant differences (α = 0.05) between both imaging modalities. RESULTS Image quality showed little to no artifacts and enabled confident diagnostic interpretation (CBCT (3.72 ± 0.46); MRI (3.65 ± 0.49)), with no significant differences between both imaging modalities (p > 0.05). Regarding the assessment of buccal bone thickness at M1-M3 for the teeth 13-23 and 33-43, no significant differences were noted (p > 0.05). MRI demonstrated slight, nonsignificant overestimation of thickness with the canines having mainly a thick buccal bone wall, where thin buccal wall was evident for the central incisors. CONCLUSION Black bone MRI sequences, such as 3D-DESS MRI, for immediate implant planning provided confidential diagnostic accuracy in bone thickness assessment without significant disadvantages compared to CBCT. Thus, the implementation of no-dose protocols for dental rehabilitation using an immediate loading approach seems promising and could further improve the treatment strategy for dental rehabilitation.
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Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daphne Schönegg
- Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Supachaiyakit P, Serichetaphongse P, Chengprapakorn W. 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. Clin Implant Dent Relat Res 2022; 24:444-454. [PMID: 35580961 DOI: 10.1111/cid.13100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/21/2022] [Accepted: 05/01/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION There are several factors that greatly influence implant stability with implant design being a paramount factor; however, few studies investigate its impact. AIM 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. MATERIALS AND METHODS 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. RESULTS 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. CONCLUSIONS 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. CLINICAL TRIAL REGISTRATION TCTR20211020005.
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Affiliation(s)
- Pinmuk Supachaiyakit
- Esthetic Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pravej Serichetaphongse
- Esthetic Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Vasovic M, Jovanovic L, Djordjevic A. Bone Quality Assessment of Dental Implant Recipient Sites. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.1515/sjecr-2015-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The term bone quality is not clearly defined and depends on many factors, such as bone density, bone vascularity, bone metabolism and other factors that may affect implant outcome. The assessment of bone volume and bone density is most common in planning the treatment of dental implants. Bone quality is an important predictor of primary implant stability, which influences the future implant osseointegration. Numerous classifications have been described for the evaluation of bone density. The most commonly used has been the one proposed by Lekholmu and Zarb. For the objective evaluation of bone density, conventional computed tomography (CT) or Cone Beam Computed tomography (CBCT), have been proposed. Both methods are reliable for the measurement of bone density, but preference is given to CBCT, due to the lower radiation doses, greater comfort for the patient and the lower prices. Pre-operatively defined bone density is a good indicator of the future success of implant therapy. In addition to the bone density, vascularity of the jawbone is an important factor of the quality of the bone for the osseointegration of dental implants. Laser Doppler is a simple method that can determine the vascularity of bone during implant insertion. The development of modern diagnostic methods for assessing the quantity and quality of the jawbone has enabled easier implant planning and has provided a secure outcome.
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Affiliation(s)
| | - Lena Jovanovic
- Faculty of Medical Sciences , University of Kragujevac , Serbia
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20
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The Assessment of the Usefulness of Platelet-Rich Fibrin in the Healing Process Bone Resorption. COATINGS 2022. [DOI: 10.3390/coatings12020247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The main subject of this research was the use of PRF in dental surgery aimed at preventing changes in alveolar height and width after tooth extraction. Due to the large growth factor content, it seems to be particularly useful in bone loss management starting from the simplest loss occurring after tooth extraction through loss resulting from tooth resection ending with loss caused by large bone cysts. The study was performed on 50 patients. The extraction of two maxillary or mandibular homonymous teeth was carried out in each patient, where PRF was placed in one alveolus while the other alveolus was left empty. Then, the alveoli were surgically managed with a split flap technique. On the extraction day, after 10 days, and after 6 months, the alveolar process was measured, soft tissues healing was assessed, and imaging examinations were analyzed. It was proved that the healing of soft tissues in the PRF group was better. In the PRF group after 6 months from surgery, the newly formed bone had higher grayscale values in volumetric tomography (CBCT). Moreover, the reduced atrophy of the alveolar process at the site of the extracted tooth was proved in this study.
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21
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The Effect of Bone Density Measured by Cone Beam Computed Tomography and Implant Dimensions on the Stability of Dental Implants. J Craniofac Surg 2021; 33:e553-e557. [PMID: 34930876 DOI: 10.1097/scs.0000000000008429] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/26/2021] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The aim of this study was to evaluate the effect of bone density value in Hounsfield unit derived from cone beam computed tomography (CBCT), and implant dimensions in relation to implant stability parameters namely the resonance frequency analysis and the insertion torque (IT) value. It included 24 patients who received 42 dental implants (DI). The bone density of the planned implant site was preoperatively measured using cone beam computed tomography. The implant stability was measured using Osstell implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. The IT value was categorized as 35 N/cm or > 35 N/cm. The mean (standard deviation) primary stability was 79.58 (5.27) ISQ, which was significantly higher than the secondary stability 74.31 (6.34) ISQ (P < 0.0001). There was a significant moderate positive correlation of bone density with primary stability (r = 0.4, P = 0.0099) and no correlation with secondary stability (r = 0.003, P = 0.9867). The bone density of DI with 35 N/cm IT was significantly lower than with > 35 N/cm IT (P = 0.0390). Better stability was recorded with wider implants. Whereas the length of the DI showed a nonsignificant correlation with primary and secondary stability (P = 0.7633 and 0.4670, respectively). The DI dimensions showed a nonsignificant correlation with the IT. Cone beam computed tomography may be considered as a reliable method to assess bone density and predict the implant stability. The diameter of DI affected the implant stability favorably, whereas DI length showed no effect.
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22
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Di Stefano DA, Arosio P, Capparè P, Barbon S, Gherlone EF. Stability of Dental Implants and Thickness of Cortical Bone: Clinical Research and Future Perspectives. A Systematic Review. MATERIALS 2021; 14:ma14237183. [PMID: 34885335 PMCID: PMC8658728 DOI: 10.3390/ma14237183] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 12/30/2022]
Abstract
Dental surgery implantation has become increasingly important among procedures that aim to rehabilitate edentulous patients to restore esthetics and the mastication ability. The optimal stability of dental implants is correlated primarily to the quality and quantity of bone. This systematic literature review describes clinical research focusing on the correlation between cortical bone thickness and primary/secondary stability of dental fixtures. To predict successful outcome of prosthetic treatment, quantification of bone density at the osteotomy site is, in general, taken into account, with little attention being paid to assessment of the thickness of cortical bone. Nevertheless, local variations in bone structure (including cortical thickness) could explain differences in clinical practice with regard to implantation success, marginal bone resorption or anchorage loss. Current knowledge is preliminarily detailed, while tentatively identifying which inconclusive or unexplored aspects merit further investigation.
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Affiliation(s)
- Danilo Alessio Di Stefano
- Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy; (D.A.D.S.); (E.F.G.)
- Private Practitioner, 20132 Milan, Italy
| | | | - Paolo Capparè
- Department of Dentistry, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-0226433619
| | - Silvia Barbon
- Section of Human Anatomy, Department of Neurosciences, Padua University, 35121 Padua, Italy;
| | - Enrico Felice Gherlone
- Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy; (D.A.D.S.); (E.F.G.)
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Tian T, Liu HH, Zhang ZH, Han Q, Chen J, Lv J. Correlation between bone volume fraction in posterior implant area and initial implant stability. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:396-401. [PMID: 34556457 DOI: 10.1016/j.oooo.2021.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/13/2021] [Accepted: 08/11/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Bone volume fraction (BV/TV) was used as a quantitative indicator of bone mineral density (BMD) in the posterior dental implant area, and the relationship between it and the initial stability of the implant was analyzed. METHODS 53 patients with posterior dental implantation were selected. Remove the bone fragments from the planting area and put them in the formalin solution. Then, the implant was placed after the operator prepared the hole step by step. Peak Insertion torque value (ITV) and Implant stability quotient (ISQ) were recorded. The BV/TV of the bone fragments was measured by Image pro Plus6.0. The correlation between it and ITV and ISQ was analyzed. RESULTS BV/TV was correlated with ITV and ISQ in the posterior dental planting area (r=0.862, r=0.832, P < 0.05). The correlation of the parameters in the posterior part of maxilla was higher than that in the mandible. There were significant differences in BV/TV, ITV, and ISQ between the mandible and maxilla, and the implant area of the mandible was higher than that of the maxilla. CONCLUSION BV/TV can provide an objective index for BMD in the implant area, which has an important influence on the evaluation of the initial stability of the implant.
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Affiliation(s)
- Tian Tian
- Graduate Student, First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Hong-Hong Liu
- Deputy Chief Physician, First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Zhi-Hong Zhang
- Chief Physician, First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
| | - Qian Han
- Attending Physician, First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jia Chen
- Attending Physician, First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jing Lv
- Resident Doctor, First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Effect of Implant Surface Modification on Bone Mineral Density and Survival Rate in the Maxilla After a Short Period Using Cone Beam Computed Tomography. J Craniofac Surg 2021; 33:e49-e52. [PMID: 34292234 DOI: 10.1097/scs.0000000000007908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT This study was aimed to objectively measure the changes in bone density amount obtained through cone-beam computed tomography around dental implants after a short period of time in the maxilla. Thirty-two SLActive Straumann implants were inserted into 12 healthy patients. Changes in bone density were measured at the surgery time (Bone mineral density (BMD)0) and 60 days after investment (Bone mineral density (BMD)60). Statistically, significant differences were observed between traumatic and sinus zones at the time of surgery and after 60 days respectively (P ≤ 0.05). For each group, a significant decrease in density was observed with the following variables (male, age of 18-40 years, sinus zone, and implant diameter of 4.1 mm). The survival rate was 83.8% after 60 days. Implant surface modification has no significant effect on bone mineral density after a short period of time in the sinus zone. Early loading of the prosthesis can be performed in the traumatic zone only.
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Ko SY, Hong JY, Lee W, Chang YY, Park KB, Yun JH. Osteoconductivity of Porous Titanium Structure on Implants in Osteoporosis. J Dent Res 2021; 100:1178-1185. [PMID: 34235985 DOI: 10.1177/00220345211023724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In compromised bone conditions such as osteoporosis, developments of the implant surface are necessary to secure the stability of implants. This study investigated the effect of the surface porous titanium structure (PS) on the osseointegration of implants in osteoporotic bone. Bilateral ovariectomy (OVX) was performed in 4 female beagle dogs to induce osteoporosis for 32 wk. Success of induction was based on the evaluation of bone mineral density by Hounsfield units (HU) in computed tomography images. Posterior teeth in both mandibles were extracted 1 wk after OVX, and a total of 30 implants (15 implants in each group) were placed after 32 wk of osteoporosis induction. The control group implant underwent resorbable blast media (RBM) surface treatment, whereas the test group underwent RBM surface treatment in the coronal two-thirds and a PS added to the apical 3-mm portion. HU values in the mandibular trabecular bone, lumbar, and femoral head significantly decreased 32 wk after OVX, confirming osteoporotic condition after induction. Resonance frequency analysis and removal torque test showed comparable values between the 2 groups at 4 wk after implant placement. The surface topography of the implant after removal showed hard tissue integration at the PS in the test group. Bone-to-implant contact length was greater in the apical portion of the test group, although statistical significance was not found between the groups. Interthread bone area in the apical portion of the test group showed a significant increase compared to the control group (control: 0.059 ± 0.041 mm2, test: 0.121 ± 0.060 mm2, P = 0.028) with the histological feature of bone ingrowth at the PS. The findings of the study demonstrated that the surface PS could improve osteoconductivity in the osteoporotic trabecular bone by bone ingrowth at the pore space, thereby enhancing the osseointegration and stability of the implants.
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Affiliation(s)
- S Y Ko
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea
| | - J Y Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - W Lee
- Advanced Process and Materials R&D Group, Korea Institute of Industrial Technology, Incheon, Republic of Korea
| | - Y Y Chang
- Department of Dentistry, Inha International Medical Center, Incheon, Republic of Korea
| | - K B Park
- MIR Dental Hospital and MegaGen, Daegu, Republic of Korea
| | - J H Yun
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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26
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Can the Bone Density Estimated by CBCT Predict the Primary Stability of Dental Implants? A New Measurement Protocol. J Craniofac Surg 2021; 32:e171-e174. [PMID: 33705063 DOI: 10.1097/scs.0000000000006991] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The use of dental implants to restore edentulous parts of the jaws is a common and well-documented treatment method. Effective dental implant treatment is known to be affected by both the quality and the quantity of bone required for implant placement, bone quality is a critical factor to consider when predicting stability of implants. Thus, stability of the initial implant and the possibility of early loading could be predicated using cone-beam computed tomography (CBCT) scans and primary stability parameters before implant placement. OBJECTIVES The aim of this study was to objectively assess bone density obtained by CBCT and the correlations with primary stability of dental implants using implant stability meter IST device. METHODS A total of 40 implants were placed in 16 patients (9 males and 7 females with a range of 22 to 61 years (mean age 40.44 ± 12.3 years). The bone densities of implant recipient sites were preoperatively recorded using CBCT. The maximum insertion torque value of each implant was measured by engine during implant placement and compared to the primary stability for every implant using implant stability meter device (IST). RESULTS A statistically significant correlation was found between bone density value from CBCT with the primary implant stability and insertion torque. CONCLUSION Although the small samples size, the study shown bone density assessment using CBCT is an efficient method and significantly correlated with primary stability using implant stability meter device IST and insertion torque.
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27
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Khalid T, Yunus N, Ibrahim N, Saleh NBM, Goode D, Masood M. Assessment of masticatory function of mandibular implant-supported overdenture wearers: A 3-year prospective study. J Prosthet Dent 2020; 124:674-681. [DOI: 10.1016/j.prosdent.2019.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 07/24/2019] [Accepted: 08/15/2019] [Indexed: 11/17/2022]
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Schnutenhaus S, Götz W, Dreyhaupt J, Rudolph H, Luthardt RG, Edelmann C. Associations among Primary Stability, Histomorphometric Findings, and Bone Density: A Prospective Randomized Study after Alveolar Ridge Preservation with a Collagen Cone. Dent J (Basel) 2020; 8:E112. [PMID: 33023224 PMCID: PMC7712570 DOI: 10.3390/dj8040112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/22/2020] [Accepted: 09/27/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The objective of this investigation was to examine whether determination of bone density (BD) with a cone beam computed tomography (CBCT) scan could help predict the primary stability (PS) of the implants and to investigate whether associations between the histomorphometric findings and the CBCT scan could be observed. MATERIALS AND METHODS In this randomized clinical study, the efficacy of alveolar ridge preservation (ARP) with a combination of a collagen cone and a collagen membrane procedure after tooth extraction was investigated. CBCT scans were obtained after a healing period of 8 (±1) weeks. Subsequently, the CBCT scans were evaluated in terms of BD at different heights of the former socket. Eleven (±1) weeks after tooth extraction, implant placement was performed and PS was measured with resonance frequency analysis. Potential associations among the radiologically measured BD, the histomorphometric results, and the PS were analyzed. RESULTS No direct association was observed between the radiologically determined BD and the histomorphometric findings. No significant associations could be found between the BD and the PS. CONCLUSION No significant associations were observed among the BD determined by the CBCT, the histomorphometric findings, and the PS.
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Affiliation(s)
- Sigmar Schnutenhaus
- Center of Dentistry, Dr. Schnutenhaus MVZ GmbH, 78247 Hilzingen, Germany
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, 89081 Ulm, Germany; (H.R.); (R.G.L.); (C.E.)
| | - Werner Götz
- Oral Biology Laboratory, Department of Orthodontics, University of Bonn, 53113 Bonn, Germany;
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, Germany;
| | - Heike Rudolph
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, 89081 Ulm, Germany; (H.R.); (R.G.L.); (C.E.)
| | - Ralph G. Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, 89081 Ulm, Germany; (H.R.); (R.G.L.); (C.E.)
| | - Cornelia Edelmann
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, 89081 Ulm, Germany; (H.R.); (R.G.L.); (C.E.)
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Planinić D, Dubravica I, Šarac Z, Poljak-Guberina R, Celebic A, Bago I, Cabov T, Peric B. Comparison of different surgical procedures on the stability of dental implants in posterior maxilla: A randomized clinical study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:487-493. [PMID: 32828993 DOI: 10.1016/j.jormas.2020.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Stability of a dental implant is very important when planning immediate loading and design of a final restoration. The aim of this study was to compare the primary and the secondary stability of dental implants inserted by three different surgical techniques: conventional (standard) technique using a sequence of drills for implant bed preparation, osteotome technique using tapered hand instruments for creating implant sites by condensing the bone and guided flapless implant surgery with surgical templates. MATERIAL AND METHODS The study included 150 patients (80 males and 70 females), 46-71 years old, who required implant supported fixed partial dentures in the posterior maxilla of D3 or D4 bone density. Patients were randomly assigned into one of the three surgical insertion technique groups. All patients received tapered implants of the same manufacturer of the same length and two different widths (3.3 × 11.5 mm or 4.2 × 11.5 mm). Primary and secondary implant stability were measured by means of resonance frequency analysis (RFA) at the time of implant placement and 5 months after surgery using the Ostell ISQ device (Osstell AB, Sampgatan, Goteborg, Sweden). Statistical analysis included one-sample Kolmogorov Smirnov test, descriptive statistics, multivariate analysis (Bonferoni post-hoc tests) and paired t-tests. RESULTS Patients in the osteotome group exhibited higher primary stability (P < 0.01) than in the conventional and surgically guided flapless groups. There were no significant differences in the secondary stability (p > 0.05). Wider implants presented higher ISQ values (P<0.01). CONCLUSION The osteotome technique led to the highest implant primary stability, therefore it can be recommended when immediate loading is planned or for one-piece implant insertion.
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Affiliation(s)
- Davor Planinić
- Private Dental Office, Medjugorje, Bosnia and Hercegovina
| | | | - Zdenko Šarac
- Department of Head and Neck Diseases, School of Medicine, University of Mostar, Mostar, Bosnia and Hercegovina
| | - Renata Poljak-Guberina
- Department of Dental Prosthetics, School of Medicine, University of Split, Split, Croatia.
| | - Asja Celebic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Tomislav Cabov
- Department of Oral Surgery, School of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Berislav Peric
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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H H, G W, E H. The clinical significance of implant stability quotient (ISQ) measurements: A literature review. J Oral Biol Craniofac Res 2020; 10:629-638. [PMID: 32983857 DOI: 10.1016/j.jobcr.2020.07.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022] Open
Abstract
Implant stability quotients (ISQ values) are obtained in dental clinical practice on a non-invasive basis by resonance frequency measurement rapidly after surgical placement of implants. The ISQ-values are used as indicator for mechanical implant stability, and are believed to have predictive power for clinical outcome. It is the aim of this review to provide a synopsis of all factors described in the literature that influence ISQ measurements by performing an exhaustive literature review; moreover, this review aims at elucidating the key factors relevant for a rapid clinical predictive assessment. We searched systematically and exhaustively all major databases for publications relating to ISQ measurement methodology and for ISQ-influencing factor analyses. The reports identified were ordered in experimental (preclinical) studies and in clinical publications. We were able to identify 13 basic factors influencing ISQ-measurements. Among these, local bone quality, playing a key role in such measurements, was subdivided in four specific subfactors; thus a total of 17 individual factors was identified and reported to influence ISQ-measurements. A comprehensive list of these factors is provided in Table-form. A critical analysis points out that only 6 of these factors are of a sound predictive power useful for a rapid clinical assessment; and only two of these factors appear to have a well-documented scientific basis.
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Affiliation(s)
- Huang H
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Gustav Mahlerlaan, 3004, 1081LA Amsterdam, Nord-Holland, the Netherlands.,Department of Osteoporosis, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010, Bern, Switzerland
| | - Wu G
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Gustav Mahlerlaan, 3004, 1081LA Amsterdam, Nord-Holland, the Netherlands
| | - Hunziker E
- Department of Osteoporosis, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010, Bern, Switzerland.,Departments of Osteoporosis and Orthopaedic Surgery, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010, Bern, Switzerland
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31
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Demircan S. Prosthetically driven immediate implant placement at lower molar area; an anatomical study. Eur Oral Res 2020; 54:25-30. [PMID: 32518907 PMCID: PMC7252531 DOI: 10.26650/eor.20200059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/26/2019] [Accepted: 09/16/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To examine the effectiveness and safety of immediate implant placement (IIP), we evaluated the risk of lingual plate perforation (LPP) and mandibular canal perforation (MCP) associated with posterior mandible anatomy using cone beam computed tomography (CBCT) images. MATERIALS AND METHODS A morphological study of the molar sockets of 135 patients (age: 18-84 y) was done and its relationship to the mandibular canal was investigated. The risk of LPP and MCP was recorded as yes or no. Mandibular cross-sectional morphology was defined as one of three types (U-P-C) using the criteria of Chan et al. RESULTS The risk of LPP was significantly higher for second molars (p = 0.0001), and the risk increased with age (p = 0.039). There was a strong relationship between the risk of LPP and cross-section type U (p = 0.0001). The mean root to alveolar canal (RAC) distance (mm) of males was significantly higher than that of females. The mean RAC value was 5.02 mm for males and 3.49 mm for females. There was no statistically significant relationship between the risk of MCP and sex. There was a significant relationship between the risk of MCP and cross-section type U (p = 0.0001). Although the MCP risk was higher in second molars, there was no statistically meaningful relation between MCP and tooth type. CONCLUSION The results suggest that IIP in the mandibular molar area carries a high risk of MCP and LPP. Based on the elevated level of risk, a delayed implant protocol should be considered.
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Affiliation(s)
- Sabit Demircan
- Beykent University Vocational School Dental Services, Oral Health Program, Istanbul,Turkey
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Comparison of Pixel Values of Maxillary Sinus Grafts and Adjacent Native Bone With Cone-Beam Computed Tomography. IMPLANT DENT 2019; 27:667-671. [PMID: 30320616 DOI: 10.1097/id.0000000000000823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Pixel values from cone-beam computed tomography (CBCT) are proportional to bone density. This study aimed to correlate and compare pixel values of healed maxillary sinus grafts and adjacent native bone (NB). MATERIAL AND METHODS This study was conducted on CBCT scan patients referred for maxillary sinus floor augmentation with biphasic calcium phosphate (n = 31). Graft height and width measurements were performed. In addition, mean pixel values were calculated in 3 different regions: NB, sinus graft close to NB (CNB), and sinus graft far from NB (FNB). Micro-CT and histological analyses of bone specimens of a representative case were also performed. RESULTS Significant correlations were found between CNB and graft height (r = 0.41; P < 0.021); and FNB and graft width (r = 0.519, P < 0.003). In addition, pixel values from both graft groups (CNB and FNB) differed significantly (P < 0.001). Finally, histological sections revealed smaller areas with newly formed bone in the FNB area. CONCLUSIONS Within the limitations of this study, the present findings suggest that pixel values of sinus grafted areas are directly correlated with the extension of the grafted area.
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Juboori MJA, Attas MAA, Gomes RZ, Alanbari BF. Using Resonance Frequency Analysis to Compare Delayed and Immediate Progressive Loading for Implants Placed in the Posterior Maxilla: A Pilot Study. Open Dent J 2018; 12:801-810. [PMID: 30450138 PMCID: PMC6198410 DOI: 10.2174/1745017901814010801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/05/2018] [Accepted: 09/25/2018] [Indexed: 11/24/2022] Open
Abstract
Objective: Implants placed in the posterior region of the maxilla have a high incidence of implant failure due to poor bone quality, especially when immediate implant loading is needed. Immediate Progressive Loading (IPL) can enhance bone quality and may offer an alternative solution when Immediate Implant loading is needed. Methods: Six patients (one male and five females; 34-62 years old) were included in this study. Twelve implants were inserted in the posterior region of the maxilla. Resonance Frequency Analysis (RFA) was performed at the time of implant placement and after 1, 2, 3 and 6 months. ISQ (Implant Stability Quotient) values were compared between the Delayed Loading (DL) group after 2 months and the Progressive Loading (PL) group and between different time points for each group. Results: At implant placement, the mean ISQ values for PL and DL implants were 63 and 57, respectively. One month after implant placement, the mean ISQ value for PL implants was 73. Two months after implant placement, the mean ISQ value for PL implants was 75. Three months after implant placement, the mean ISQ values for PL and DL implants were 76 and 69, respectively. Six months after implant placement, the mean ISQ values for PL and DL implants were 79 and 76, respectively. Conclusion: Despite its limitations, this pilot study indicated that compared to DL, PL can enhance bone density and implant stability, resulting in greater early functionality and fewer surgery sessions.
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Affiliation(s)
| | - Mohammed Ahmed Al Attas
- Department of Prosthodontic and Dental Implant, Riyadh Dental Center, King Saud Medical City, Riyadh, Saudi Arabia
| | - Raquel Zita Gomes
- Department of Oral Surgery, Faculty of Dental Medicine, University of Porto, Porto, Portugal
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Clinical Relevance of Bone Density Values from CT Related to Dental Implant Stability: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6758245. [PMID: 29955608 PMCID: PMC6000841 DOI: 10.1155/2018/6758245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/23/2018] [Indexed: 11/18/2022]
Abstract
Purpose The majority of the techniques used to assess the primary implant stability are subjective and empirical and can be used during or after the surgery. The aim of this study is to evaluate the bone density prior to surgery, in order to give recommendations to the clinician about the best surgical technique and the type of implant which is needed. Materials and Methods A surgeon operated on 75 patients for 269 implants over the period 2010–2014. He required a CT to plan the surgery and he documented the type, the diameters, and the lengths of the implants, the insertion torque, and the ISQ values. At a later stage another clinician measured bone density and cortical thickness. We endeavoured to get the most accurate superimposition between the implants placed by the surgeon and those placed by the clinician. Results In maxilla ISQ showed a significant positive correlation with HU values detected for coronal-buccal (r = 0.302; p = 0.020) and middle-lingual (r = 0.295; p = 0.023). Torque showed a positive correlation with cortical bone thickness at the middle of the ridge (ρ = 0.196; p = 0.032). Conclusion It is important to take into consideration the Hounsfield Units and the cortical thickness as predictive parameters during the preoperative assessment, with regard to the choice of the implant type as well as the surgical technique.
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35
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Resonance Frequency Analysis of Dental Implants With 2 Types of Surface Treatment Submitted to Immediate Loading. IMPLANT DENT 2018; 27:282-287. [DOI: 10.1097/id.0000000000000764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Rios HF, Borgnakke WS, Benavides E. The Use of Cone-Beam Computed Tomography in Management of Patients Requiring Dental Implants: An American Academy of Periodontology Best Evidence Review. J Periodontol 2017; 88:946-959. [DOI: 10.1902/jop.2017.160548] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hector F. Rios
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Wenche S. Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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37
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Alkhader M, Hudieb M, Khader Y. Predictability of bone density at posterior mandibular implant sites using cone-beam computed tomography intensity values. Eur J Dent 2017; 11:311-316. [PMID: 28932139 PMCID: PMC5594958 DOI: 10.4103/ejd.ejd_14_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: The aim of this study was to investigate the predictability of bone density at posterior mandibular implant sites using cone-beam computed tomography (CBCT) intensity values. Materials and Methods: CBCT cross-sectional images for 436 posterior mandibular implant sites were selected for the study. Using Invivo software (Anatomage, San Jose, California, USA), two observers classified the bone density into three categories: low, intermediate, and high, and CBCT intensity values were generated. Results: Based on the consensus of the two observers, 15.6% of sites were of low bone density, 47.9% were of intermediate density, and 36.5% were of high density. Receiver-operating characteristic analysis showed that CBCT intensity values had a high predictive power for predicting high density sites (area under the curve [AUC] =0.94, P < 0.005) and intermediate density sites (AUC = 0.81, P < 0.005). The best cut-off value for intensity to predict intermediate density sites was 218 (sensitivity = 0.77 and specificity = 0.76) and the best cut-off value for intensity to predict high density sites was 403 (sensitivity = 0.93 and specificity = 0.77). Conclusions: CBCT intensity values are considered useful for predicting bone density at posterior mandibular implant sites.
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Affiliation(s)
- Mustafa Alkhader
- Department of Oral Surgery and Medicine, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Malik Hudieb
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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38
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Akoğlan M, Tatli U, Kurtoğlu C, Salimov F, Kürkçü M. Effects of different loading protocols on the secondary stability and peri-implant bone density of the single implants in the posterior maxilla. Clin Implant Dent Relat Res 2017; 19:624-631. [PMID: 28493347 DOI: 10.1111/cid.12492] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Immediate or early loading of dental implants becomes a clinically feasible concept. PURPOSE The aim was to evaluate the effects of different loading protocols (immediate, early, and delayed) on secondary stability and peri-implant bone density of single implants in the posterior maxilla. MATERIALS AND METHODS Thirty-nine implants (Dentium, South-Korea) were placed in 39 patients. After placement, implant stability values (ISQ) and baseline peri-implant bone density values derived from cone-beam computed tomography were recorded. Thirteen implants were included randomly in each loading groups. The secondary ISQ values were recorded during follow-up visits. Peri-implant bone density values were measured 1 year after placement again. Data was statistically analyzed. RESULTS Immediate-loaded group showed the lowest ISQ values, 1 month after placement. During the next follow-up visits, delayed-loaded group showed the lowest ISQ values while other groups showed comparable results. Early loading increased the peri-implant bone density greater than the other groups. CONCLUSIONS The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement. Density increment can be judged as the radiological findings of loaded-bone, which may also reduce the need for histomorphometric analysis of human biopsy to evaluate the bone reaction around the implants.
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Affiliation(s)
- Mücahide Akoğlan
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Ufuk Tatli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Cem Kurtoğlu
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Fariz Salimov
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Mehmet Kürkçü
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Presurgical Cone Beam Computed Tomography Bone Quality Evaluation for Predictable Immediate Implant Placement and Restoration in Esthetic Zone. Case Rep Dent 2017; 2017:1096365. [PMID: 28321342 PMCID: PMC5340929 DOI: 10.1155/2017/1096365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 01/17/2017] [Accepted: 02/01/2017] [Indexed: 12/25/2022] Open
Abstract
Despite numerous advantages over multislice computed tomography (MSCT), including a lower radiation dose to the patient, shorter acquisition times, affordable cost, and sometimes greater detail with isotropic voxels used in reconstruction, allowing precise measurements, cone beam computed tomography (CBCT) is still controversial regarding bone quality evaluation. This paper presents a brief review of the literature on accuracy and reliability of bone quality assessment with CBCT and a case report with step-by-step predictable treatment planning in esthetic zone, based on CBCT scans which enabled the clinician to evaluate, depending on bone volume and quality, whether immediate restoration with CAD-CAM manufactured temporary crown and flapless surgery may be a treatment option.
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Rodríguez X, Lucas-Taulé E, Elnayef B, Altuna P, Gargallo-Albiol J, Peñarrocha Diago M, Hernandez-Alfaro F. Anatomical and radiological approach to pterygoid implants: a cross-sectional study of 202 cone beam computed tomography examinations. Int J Oral Maxillofac Surg 2016; 45:636-40. [DOI: 10.1016/j.ijom.2015.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 11/15/2015] [Accepted: 12/14/2015] [Indexed: 11/26/2022]
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Gramanzini M, Gargiulo S, Zarone F, Megna R, Apicella A, Aversa R, Salvatore M, Mancini M, Sorrentino R, Brunetti A. Combined microcomputed tomography, biomechanical and histomorphometric analysis of the peri-implant bone: a pilot study in minipig model. Dent Mater 2016; 32:794-806. [PMID: 27063459 DOI: 10.1016/j.dental.2016.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/09/2016] [Accepted: 03/22/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To present a practical approach that combines biomechanical tests, microcomputed tomography (μCT) and histomorphometry, providing quantitative results on bone structure and mechanical properties in a minipig model, in order to investigate the specific response to an innovative dental biomaterial. METHODS Titanium implants with innovative three-dimensional scaffolds were inserted in the tibias of 4 minipigs. Primary stability and osseointegration were investigated by means of insertion torque (IT) values, resonance frequency analysis (RFA), bone-to-implant contact (BIC), bone mineral density (BMD) and stereological measures of trabecular bone. RESULTS A significant positive correlation was found between IT and RFA (r=0.980, p=0.0001). BMD at the implant sites was 18% less than the reference values (p=0.0156). Peri-implant Tb.Th was 50% higher, while Tb.N was 50% lower than the reference zone (p<0.003) and they were negatively correlated (r=-0.897, p=0.006). SIGNIFICANCE μCT increases evaluation throughput and offers the possibility for qualitative three-dimensional recording of the bone-implant system as well as for non-destructive evaluation of bone architecture and mineral density, in combination with conventional analysis methods. The proposed multimodal approach allows to improve accuracy and reproducibility for peri-implant bone measurements and could support future investigations.
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Affiliation(s)
- Matteo Gramanzini
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145 Naples, Italy; CEINGE scarl, Via G. Salvatore 486, 80145 Naples, Italy.
| | - Sara Gargiulo
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145 Naples, Italy; CEINGE scarl, Via G. Salvatore 486, 80145 Naples, Italy.
| | - Fernando Zarone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University "Federico II", Via Pansini 5, 80131 Naples, Italy.
| | - Rosario Megna
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145 Naples, Italy.
| | - Antonio Apicella
- Department of Architecture and Industrial Design, Second University of Naples, Borgo San Lorenzo, 81031 Aversa, Italy.
| | - Raffaella Aversa
- Department of Architecture and Industrial Design, Second University of Naples, Borgo San Lorenzo, 81031 Aversa, Italy.
| | | | - Marcello Mancini
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145 Naples, Italy.
| | - Roberto Sorrentino
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University "Federico II", Via Pansini 5, 80131 Naples, Italy; Department of Architecture and Industrial Design, Second University of Naples, Borgo San Lorenzo, 81031 Aversa, Italy.
| | - Arturo Brunetti
- Department of Advanced Medical Sciences, University "Federico II", Via Pansini 5, 80145 Naples, Italy; CEINGE scarl, Via G. Salvatore 486, 80145 Naples, Italy.
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Gómez-Polo M, Ortega R, Gómez-Polo C, Martín C, Celemín A, Del Río J. Does Length, Diameter, or Bone Quality Affect Primary and Secondary Stability in Self-Tapping Dental Implants? J Oral Maxillofac Surg 2016; 74:1344-53. [PMID: 27070843 DOI: 10.1016/j.joms.2016.03.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/08/2016] [Accepted: 03/12/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Implant stability is a clinically valuable measurement of the strength of implant anchorage in the bone during placement and in the post-osseointegration period. This study aimed to determine 1) the effect of implant diameter and length and bone quality on measurements of primary and secondary stability (insertion torque [IT] and implant stability quotient [ISQ]), 2) the correlation between IT and primary and secondary ISQ, and 3) differences in ISQ in the post-osseointegration period (secondary stability) compared with immediate post-placement (primary) stability. PATIENTS AND METHODS In this longitudinal clinical study, titanium self-tapping implants were inserted in edentulous patients. The implants were grouped according to 3 independent variables: length (10 and 11.5 mm), diameter (3.75 and 4.25 mm), and bone quality (Lekholm and Zarb classification) to analyze primary and secondary implant stability (outcome variables). Statistical analyses were performed using the Student t test for paired data, 1-way analysis of variance, and the Tukey procedure for multiple pairwise comparisons. RESULTS Data were collected on 88 self-tapping implants inserted in 63 partially edentulous patients. IT and implant stability were affected by diameter (3.75-mm implants, 26.5-N/cm IT and 74.0 ISQ; 4.25-mm implants, 33.8-N/cm IT and 77.0 ISQ) and bone type (type 1 + 2, 34.86-N/cm IT and 77.4 ISQ; type 3, 27.09-N/cm IT and 75.6 ISQ; type 4, 20.63-N/cm IT and 70.5 ISQ; P < .01 for all comparisons). Secondary ISQ was affected by diameter only (77.41 for 3.75- vs 75.51 for 4.25-mm implants). IT correlated with primary ISQ (R = 0.56; P < .01), although no clear correlation with secondary stability was found. CONCLUSIONS IT and primary ISQ in self-tapping implants differed in patients with different bone quality and implant diameter but did not differ between the 2 implant lengths compared in this study. Secondary stability was not substantially affected by any of these factors. Although IT was closely related to primary ISQ, it was unrelated to secondary ISQ. Very high primary ISQ values tended to decrease, whereas intermediate and low values tended to increase, in the transition to secondary stability.
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Affiliation(s)
- Miguel Gómez-Polo
- Doctor in Dental Surgery and Part-Time Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - Rocío Ortega
- Doctor in Dental Surgery and Assistant Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Cristina Gómez-Polo
- Doctor in Dental Surgery and Part-Time Professor, Department of Surgery, Medicine School, University of Salamanca, Salamanca, Spain
| | - Cristina Martín
- Doctor in Dental Surgery and Assistant Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Alicia Celemín
- Medicine Doctor and Full-Time Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Jaime Del Río
- Medicine Doctor and Full-Time Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Temmerman A, Rasmusson L, Kübler A, Thor A, Quirynen M. An open, prospective, non-randomized, controlled, multicentre study to evaluate the clinical outcome of implant treatment in women over 60 years of age with osteoporosis/osteopenia: 1-year results. Clin Oral Implants Res 2016; 28:95-102. [DOI: 10.1111/clr.12766] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Andy Temmerman
- Section of Periodontology; Department of Oral Health Sciences; KU Leuven & Dentistry; University Hospitals; KU Leuven; Leuven Belgium
| | - Lars Rasmusson
- Department of Oral and Maxillofacial Surgery; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Alexander Kübler
- Department of Oral and Maxillofacial Plastic Surgery; University of Wuerzburg; Würzburg Germany
| | - Andreas Thor
- Department of Oral and Maxillofacial Surgery; Institute of Surgical Sciences; Uppsala University; Uppsala Sweden
| | - Marc Quirynen
- Section of Periodontology; Department of Oral Health Sciences; KU Leuven & Dentistry; University Hospitals; KU Leuven; Leuven Belgium
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Dental Cone Beam Computed Tomography Analyses of the Anterior Maxillary Bone Thickness for Immediate Implant Placement. IMPLANT DENT 2015; 24:664-8. [DOI: 10.1097/id.0000000000000340] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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45
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Cortes ARG, Eimar H, Barbosa JDS, Costa C, Arita ES, Tamimi F. Sensitivity and Specificity of Radiographic Methods for Predicting Insertion Torque of Dental Implants. J Periodontol 2015; 86:646-55. [DOI: 10.1902/jop.2015.140584] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Campos MJDS, de Souza TS, Mota Júnior SL, Fraga MR, Vitral RWF. Bone mineral density in cone beam computed tomography: Only a few shades of gray. World J Radiol 2014; 6:607-12. [PMID: 25170398 PMCID: PMC4147441 DOI: 10.4329/wjr.v6.i8.607] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 03/11/2014] [Accepted: 04/25/2014] [Indexed: 02/06/2023] Open
Abstract
Cone beam computed tomography (CBCT) has often been used to determine the quality of craniofacial bone structures through the determination of mineral density, which is based on gray scales of the images obtained. However, there is no consensus regarding the accuracy of the determination of the gray scales in these exams. This study aims to provide a literature review concerning the reliability of CBCT to determine bone mineral density. The gray values obtained with CBCT show a linear relationship with the attenuation coefficients of the materials, Hounsfield Units values obtained with medical computed tomography, and density values from dual energy X-ray absorciometry. However, errors are expected when CBCT images are used to define the quality of the scanned structures because these images show inconsistencies and arbitrariness in the gray values, particularly when related to abrupt change in the density of the object, X-ray beam hardening effect, scattered radiation, projection data discontinuity-related effect, differences between CBCT devices, changes in the volume of the field of view (FOV), and changes in the relationships of size and position between the FOV and the object evaluated. A few methods of mathematical correction of the gray scales in CBCT have been proposed; however, they do not generate consistent values that are independent of the devices and their configurations or of the scanned objects. Thus, CBCT should not be considered the examination of choice for the determination of bone and soft tissue mineral density at the current stage, particularly when values obtained are to be compared to predetermined standard values. Comparisons between symmetrically positioned structures inside the FOV and in relation to the exomass of the object, as it occurs with the right and left sides of the skull, seem to be viable because the effects on the gray scale in the regions of interest are the same.
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Ho JT, Wu J, Huang HL, Chen MYC, Fuh LJ, Hsu JT. Trabecular bone structural parameters evaluated using dental cone-beam computed tomography: cellular synthetic bones. Biomed Eng Online 2013; 12:115. [PMID: 24207062 PMCID: PMC3826852 DOI: 10.1186/1475-925x-12-115] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/07/2013] [Indexed: 11/10/2022] Open
Abstract
Objective This study compared the adequacy of dental cone beam computed tomography (CBCT) and micro computed tomography (micro-CT) in evaluating the structural parameters of trabecular bones. Methods The cellular synthetic bones in 4 density groups (Groups 1–4: 0.12, 0.16, 0.20, and 0.32 g/cm3) were used in this study. Each group comprised 8 experimental specimens that were approximately 1 cm3. Dental CBCT and micro-CT scans were conducted on each specimen to obtain independent measurements of the following 4 trabecular bone structural parameters: bone volume fraction (BV/TV), specific bone surface (BS/BV), trabecular thickness (Tb.Th.), and trabecular separation (Tb.Sp.). Wilcoxon signed ranks tests were used to compare the measurement variations between the dental CBCT and micro-CT scans. A Spearman analysis was conducted to calculate the correlation coefficients (r) of the dental CBCT and micro-CT measurements. Results and Conclusion Of the 4 groups, the BV/TV and Tb.Th. measured using dental CBCT were larger compared with those measured using micro-CT. By contrast, the BS/BV measured using dental CBCT was significantly less compared with those measured using micro-CT. Furthermore, in the low-density groups (Groups 1 and 2), the Tb.Sp. measured using dental CBCT was smaller compared with those measured using micro-CT. However, the Tb.Sp. measured using dental CBCT was slightly larger in the high-density groups (Groups 3 and 4) than it was in the low density groups. The correlation coefficients between the BV/TV, BS/BV, Tb.Th., and Tb.Sp. values measured using dental CBCT and micro-CT were 0.9296 (p < .001), 0.8061 (p < .001), 0.9390 (p < .001), and 0.9583 (p < .001), respectively. Although the dental CBCT and micro-CT approaches exhibited high correlations, the absolute values of BV/TV, BS/BV, Tb.Th., Tb.Sp. differed significantly between these measurements. Additional studies must be conducted to evaluate using dental CBCT in clinical practice.
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Affiliation(s)
| | | | | | | | | | - Jui-Ting Hsu
- School of Dentistry, College of Medicine, China Medical University, Taichung 404, Taiwan.
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