Search Results (19)

Background and Objectives: Dental implants are a reliable solution for tooth loss; however, systemic conditions like osteoporosis and diabetes, which affect bone quality, healing, and stability, underline the importance of understanding their impact on enhanced outcomes. This study evaluated the comparative effects of osteoporosis and diabetes on dental implant stability over 12 months, utilizing objective implant mobility and stability measures. Materials and Methods: This prospective cohort study involved 50 patients, divided into 21 with type 2 diabetes and 29 with osteoporosis, with implant stability assessed at 6 and 12 months using Osstell ISQ and Periotest M devices and statistical analysis identifying differences between groups and time intervals at a significance level of p < 0.05. Results: At 6 months, the osteoporosis group showed higher initial stability (mean ISQ: 67.04 ± 5.42) compared to the diabetes group (mean ISQ: 62.10 ± 5.46; p = 0.0215)), and by 12 months, both groups showed significant improvements in ISQ scores (osteoporosis: 68.93 ± 4.83; diabetes: 65.79 ± 3.87), with Periotest values indicating more significant reductions in implant mobility, particularly in diabetic patients (osteoporosis: −3.34 ± 1.59; diabetes: −2.81 ± 1.44; p = 0.0001). Conclusions: Osteoporosis and diabetes significantly impact implant stability through distinct osseointegration pathways, emphasizing the need for personalized treatment plans to improve patient outcomes. Full article

Background: While titanium implants are widely recognized for their clinical success, zirconia implants have emerged as a metal-free alternative. This study aimed to evaluate the influence of zirconia implant macrogeometry and bone density on primary implant stability. Methods: Two types of zirconia implants were tested—the Neodent^® Zi Ceramic Implant and the Straumann^® PURE Ceramic Implant, that were placed into polyurethane foam blocks mimicking different bone densities (10 PCF, 15 PCF, 20 PCF, 30 PCF, and 40 PCF). Each implant type was inserted and removed multiple times, with primary stability measured using resonance frequency analysis via the Osstell^® Beacon device. Statistical tests, including the Shapiro–Wilk test, t-tests, the Mann–Whitney U test, and the Kruskal–Wallis test, were applied, with significance set at 5% (p < 0.05). Results: The tapered Neodent^® Zi Ceramic Implant consistently showed higher ISQ values across all foam densities compared to the Straumann^® PURE Ceramic Implant (p = 0.035). Additionally, lower-density foams exhibited lower stability scores (p < 0.05). Conclusion: The study concludes that both the macrogeometry of zirconia implants and bone density significantly affect primary implant stability. Specifically, tapered implants demonstrated higher stability than cylindrical designs, suggesting that implant macrogeometry and bone density should be considered for optimal primary stability in clinical settings. Full article

Background: The long-term success of dental implants largely depends on achieving primary stability, previously described as crucial to obtaining osseointegration and immediate loading protocol requirements. Implant thread depths seem to be one of the key factors influencing primary stability, particularly in low-density bone. Insertion torque (IT) and resonance frequency analysis (RFA) are considered the most reliable tests to assess primary stability. The aim of this work was to evaluate how different thread depths of commercially available dental implants affect primary stability in low-density D3 bone. Materials and Methods: An in vitro study was carried out between February 2024 and March 2024. Twenty-four dental implants were divided into four groups (six implants each) according to their thread depths (Group A: 4 mm, Group B: 4.5 mm, Group C: 5 mm, Group D: 5.5 mm) and were inserted in D3-type artificial bone blocks. The main outcome variables were the IT and the Implant Stability Quotient (ISQ) measured in four different areas of the implant (buccal, lingual, mesial, and distal) with an Osstel^® ISQ reader. Descriptive and inferential analyses of the data were performed, and the significance value was set at 5%. Results: A total of 24 implants were analyzed. The highest IT values were obtained in Group D, with a mean of 54.03 Ncm (standard deviation (SD) = 8.99), while the lowest measurements were observed in Group A (mean = 25.12; SD: 2.96 N.cm). The mean ISQ values were consistently higher in Group D for each analyzed area, with a mean of 70.13 N.cm (SD = 1.12). Conclusions: Taking into consideration the limitations of this in vitro study, greater thread depths seem to increase the primary stability of dental implants placed in soft bone. Furthermore, a positive correlation was observed between all IT and ISQ values, regardless of the thread depth. Full article

Background/Objective: To ensure that implants are able to support prosthetic rehabilitation, a stable and functional union between the bone and the implant surface is crucial to its stability and success. To increase bone volume and density and excel bone-implant contact, a novel drilling method, called osseodensification (OD), was performed. To assess the effectiveness of the osseodensification drilling protocol versus the conventional surgical technique on implant stability. Methods: Bone Level Tapered Straumann implants were placed side-by-side with both OD and subtractive conventional drilling (SD) in 90 patients from CESPU—Famalicão clinical unit. IT was measured using a manual torque wrench, and the Implant stability quotient (ISQ) value was registered using the Osstell^® IDX. Results: According to the multifactorial ANOVA, there were statistically significant differences in the mean IT values due to the arch only (F(1.270) = 4.702, p-value = 0.031 < 0.05). Regarding the length of the implant, there were statistically significant differences in the mean IT in the OD group (p = 0.041), with significantly lower mean IT values for the Regular implants compared to the Long. With respect to the arch, the analyses of the overall ISQ values showed an upward trend in both groups in the maxilla and mandible. High levels of IT also showed high ISQ values, which represent good indicators of primary stability. Conclusions: OD does not have a negative influence on osseointegration compared to conventional subtractive osteotomy. Full article

The approach employed for the site preparation of the dental implant is a variable factor that affects the implant’s primary stability and its ability to integrate with the surrounding bone. The main objective of this in vitro study is to evaluate the influence of different techniques used to prepare the implant site on the primary stability of the implant in two different densities of artificial bone. Materials and Methods: A total of 150 implant sites were prepared in rigid polyurethane blocks to simulate two distinct bone densities of 15 pounds per cubic foot (PCF) and 30 PCF, with a 1-mm-thick simulated cortex. The implant sites were equally distributed among piezoelectric surgery (PES), traditional drills (TD), and black ruby magnetic mallet inserts (MM). Two methods have been employed to evaluate the implant’s primary stability, Osstell and micro-tomography. Results: In the present study, we observed significant variations in the implant stability quotient (ISQ) values. More precisely, our findings indicate that the ISQ values were generally higher for 30 PCF compared to 15 PCF. In terms of the preparation technique, PES exhibited the greatest ISQ values, followed by MM, and finally TD. These findings corresponded for both bone densities of 30 PCF (PES 75.6 ± 1.73, MM 69.8 ± 1.91, and TD 65.8 ± 1.91) and 15 PCF (PES 72.3 ± 1.63, MM 62.4 ± 1.77, and TD 60.6 ± 1.81). By utilizing Micro-CT scans, we were able to determine the ratio of the implant occupation to the preparation site. Furthermore, we could calculate the maximum distance between the implant and the wall of the preparation site. The findings demonstrated that PES had a higher ratio of implant to preparation site occupation, followed by TD, and then the MM, at a bone density of 30 PCF (PES 96 ± 1.95, TD 94 ± 1.88, and MM 90.3 ± 2.11). Nevertheless, there were no statistically significant differences in the occupation ratio among these three approaches in the bone density of 15 PCF (PES 89.6 ± 1.22, TD 90 ± 1.31, and MM 88.4 ± 1.17). Regarding the maximum gap between the implant and the site preparation, the smallest gaps were seen when TD were used, followed by MM, and finally by PES, either in a bone density 15 PCF (PES 318 ± 21, TD 238 ± 17, and MM 301 ± 20 μm) or in a bone density 30 PCF (PES 299 ± 20, TD 221 ± 16, and MM 281 ± 19 μm). A statistical analysis using ANOVA revealed these differences to be significant, with p-values of < 0.05. Conclusion: The outcomes of this study indicate that employing the PES technique and osteo-densification with MM during implant insertion may enhance the primary stability and increase the possibility of early implant loading. Full article

Background: With the growing use of dental implants, there is an urgent need to determine a prosthetic placement protocol by assessing implant stability and monitoring healing. Implant Stability Quotient (ISQ) values are produced using dental non-invasive devices through resonance frequency analysis, considered as indicators for measuring primary stability (i.e., at implant placement), monitoring biological stability (osseointegration), and prosthetic loading. A systematic and detailed comparison of ISQ measurement devices, for a given patient population, is lacking in the literature. This aspect is the subject of the present work, with the devices being two that are widely used in clinical practice (Osstell^® and Osseo^®100). The aim of this study was to evaluate the reliability of ISQ measurement using two standard devices most commonly used in clinical practice and to highlight any differences when comparing measurements at undefined time intervals. Methods: We enrolled 50 patients (16 males and 34 females) with a mean age of 55.4 years, who indicated dental implant placement and met the inclusion criteria. The sample was divided into two equal groups based on bone density: A (D1–D2 bone density) and B (D3–D4 bone density); each had 25 patients with 40 implants. ISQ was measured using two devices: Osstell^® and Osseo 100^®, at different time points (A: three and B: four follow-ups). Results: All enrolled patients completed the study without adverse events; all implants placed were successful, with no implant failure. In each of the study groups, ISQ values increased gradually with increasing follow-up time, and there was no significant difference between Osstell and Osseo 100 values at follow-up times except for the T1 follow-up in group A. Temporal comparisons for the two devices revealed significant differences in T0 vs. T2 in group A, whereas significant differences existed in T0 vs. T1, T2, and T3 in group B. Our findings indicated that the overall effect significantly depended on bone density rather than on the device used to measure ISQ. Conclusion: Regardless of the devices used, the ISQ measurement effectively monitors healing after implant insertion and allows prosthetic load to be modulated according to the ISQ value, especially when prosthetizing implants placed in fine trabecular bone (D4 or regenerated bone). Full article

The aim of this prospective study is to investigate implant stability and the reliability of different measuring devices according to implant placement site and duration in patients aged over 65 years. The study evaluated 60 implants (diameter: 3.5/4.0/4.5/5.0 mm and length: 8.5/10.0/11.5 mm) in 60 patients aged ≥ 65 years. The implant placement sites were divided into six evenly distributed sections (n = 10), i.e., maxillary right-posterior, A; maxillary anterior, B; maxillary left-posterior, C; mandibular right-posterior, D; mandibular anterior, E; mandibular left-posterior, F. Participants visited the hospital six times: implant surgery, 1V; stitch removal, 2V; 1-month follow-up, 3V; 2-month follow-up, 4V; before final restoration delivery, 5V; and after final restoration delivery, 6V. The implant stability was evaluated with the Osstell Mentor (ISQ), Periotest M (PTV), and Anycheck (IST). The mean values of ISQ, PTV, and IST were analyzed (α = 0.05). ISQ, PTV, and IST results of 4V and 5V were significantly higher than those of 1V (p < 0.05). The lowest ISQ results occurred in the E location at 4V and 5V (p < 0.05). In all mandibular locations, IST results of 6V were significantly higher than those of 1V, 2V, 3V, and 4V (p < 0.05). ISQ results were negatively correlated with PTV and positively correlated with IST, and PTV was negatively correlated with IST. By considering various factors affecting the stability of the implant, it is necessary to determine the appropriate implant load application time. This could help increase the implant success rate in elderly patients. And as a diagnostic device for implant stability and the evaluation of osseointegration in elderly patients, Anycheck was also able to prove its relative reliability compared to Osstell ISQ Mentor and Periotest M. Full article

Background: In orthodontic treatment, mini-screws can provide maximum anchorage conditions. If the miniscrew stability is compromised, this could jeopardize the outcomes of the orthodontic treatment or biomechanics. Photobiomodulation therapy (PBMt) is beneficial for biological tissues since it promotes wound healing with its anti-inflammatory and osteo-stimulatory properties. Objectives: The purpose of this study was to evaluate the effects of 810-nm Diode PBMt on the stability of orthodontic mini-screws for three months. Trial Design: Parallel, allocation ratio 1:1. Methods: Using a split-mouth technique, a total of 40 mini-screws were randomly allocated (1:1) to either a placebo laser application (P group) or a laser PBMt (L group). An 810-nm diode laser irradiation of 1 W output power, operating in continuous wave mode for 50 s, was applied in a sweeping movement at a 22 mm distance from the mini-screws. The allocated mini-screws first received PBMt at baseline, then every other day for five days, and then at each orthodontic visit (every three weeks) for a period of three months. At each visit, the stability of the mini-screws was measured by the Osstell Implant Stability Quotient (Osstell ISQ) at three points: lower, upper, and distal to the mini-screw. Results: The lower, upper, and distal ISQ values of irradiated and non-irradiated mini-screws significantly decreased at each point over time (p < 0.001). No significant difference was found in the global ISQ values between the laser and the placebo group (p > 0.05). Conclusion: PBM did not significantly increase the stability of orthodontic mini-screws over a period of three months. Trial Registration: Protocol was approved by the Research Ethics Committee of the Faculty of Dental Medicine of Saint Joseph University, Beirut, Lebanon University (#USJ/2019/161). Full article

This study evaluated dental implant stability, vertical bone gain, bone density, and crestal bone loss using different crestal sinus lift techniques (osteotomy, Densah burs, and piezosurgery). A total of 21 patients were randomly divided into three groups: Group 1: patients were treated using a Densah drill crestal sinus lift, Group 2: patients were treated using a piezoelectric crestal sinus lift and Group 3: patients were treated using an osteotome crestal sinus lift. The patients in all three groups underwent bone grafting and implant placement. An Osstell device was used to determine the implant stability by recording the values of the implant stability quotient (ISQ). CBCT was performed before and 6 months after implant placement for radiographic evaluation and comparison among the groups. All dental implants were completely successful, and statistically significant differences from baseline to 6 months were noted in all groups (p < 0.05). The Densah burs technique resulted in the best implant stability of all groups, while the osteotome technique demonstrated better vertical bone augmentation. However, the values for bone density and crestal bone loss showed no significant difference among all treated groups (p > 0.05). All three techniques were successful for crestal sinus lifts with good clinical outcomes at a 6-month follow-up. The Densah group demonstrated better implant stability, shorter surgery time, and fewer complications; however, the vertical bone gain was greater with the osteotome technique. Full article

This study aimed to investigate the effect of static magnetic field (SMF) generated by innovative cover screws made of NeFeB on early bone healing around dental implants. The study was carried out on humans in a private dental practice. Eight 3i implants (Biomet, Palm Beach, FL, USA) were placed in the posterior mandible at 3.6 and 3.7. The control implants were closed with a conventional screw (G1), while the test implants were closed with a Supercharged^® screw (G2). Both groups were compared for stability at 0, 7, 14, 21, 50, and 90 days using a resonant frequency analyzer with Ostell Mentor (Osstell AB, Gothenburg, Sweden). After 50 days, the Supercharged^® cover screw was removed. A significant increase in implant stability quotient (ISQ), corresponding to a lower degree of bone resorption, was observed in G2 throughout the follow-up period (p < 0.05), while an initial ISQ decrease was observed until day 21 in G1. In conclusion, the effect of SMF seems to be in the early stages of osseointegration and increases the stability of dental implants. Full article

Objectives: Assessing implant stability is integral to dental implant therapy. This study aimed to construct a multi-task cascade convolution neural network to evaluate implant stability using cone-beam computed tomography (CBCT). Methods: A dataset of 779 implant coronal section images was obtained from CBCT scans, and matching clinical information was used for the training and test datasets. We developed a multi-task cascade network based on CBCT to assess implant stability. We used the MobilenetV2-DeeplabV3+ semantic segmentation network, combined with an image processing algorithm in conjunction with prior knowledge, to generate the volume of interest (VOI) that was eventually used for the ResNet-50 classification of implant stability. The performance of the multitask cascade network was evaluated in a test set by comparing the implant stability quotient (ISQ), measured using an Osstell device. Results: The cascade network established in this study showed good prediction performance for implant stability classification. The binary, ternary, and quaternary ISQ classification test set accuracies were 96.13%, 95.33%, and 92.90%, with mean precisions of 96.20%, 95.33%, and 93.71%, respectively. In addition, this cascade network evaluated each implant’s stability in only 3.76 s, indicating high efficiency. Conclusions: To our knowledge, this is the first study to present a CBCT-based deep learning approach CBCT to assess implant stability. The multi-task cascade network accomplishes a series of tasks related to implant denture segmentation, VOI extraction, and implant stability classification, and has good concordance with the ISQ. Full article

Previous studies have shown that the most reliable way to evaluate the success of an implant is by bone-to-implant contact (BIC). Recent techniques allow modifications to the implant surface that improve mechanical and biological characteristics, and also upgrade osseointegration. Objective: The aim was to evaluate the osseointegration in rabbit tibia of two different titanium dental implant surfaces: shot-blasted with Al₂O₃ (SB) and the same treatment with an acid-etching by immersion for 15 s in HCl/H₂SO₄ (SB + AE). Material and methods: Roughness parameters (R_a, R_t, and R_z) were determined by white light interferometer microscopy. Surface wettability was evaluated with a contact angle video-based system using water, di-iodomethane, and formamide. Surface free energy was determined by means of Owens and Wendt equations. Scanning electron microscopy equipped with X-ray microanalysis was used to study the morphology and determine the chemical composition of the surfaces. Twenty-four grade 4 titanium dental implants (Essential Klockner^®) were implanted in the rabbit’s tibia, 12 for each surface treatment, using six rabbits. Six weeks later the rabbits were sacrificed and the implants were sent for histologic analysis. Resonance frequency analysis (RFA) was recorded both at the time of surgery and the end of the research with each device (Osstell Mentor and Osstell ISQ). Results: The roughness measurements between the two treatments did not show statistically significant differences. However, the effect of the acid etching made the surface slightly more hydrophilic (decreasing contact angle from 74.7 for SB to 64.3 for SB + AE) and it presented a higher surface energy. The bone-to-implant contact ratio (BIC %) showed a similar tendency, with 55.18 ± 15.67 and 59.9 ± 13.15 for SB and SB + AE implants, respectively. After 6 weeks of healing, the SB + AE showed an implant stability quotient (ISQ) value of 76 ± 4.47 and the shot-blasted one an ISQ value of 75.83 ± 8.44 (no statistically significant difference). Implants with different surface properties had distinctive forms of behavior regarding osseointegration. Furthermore, the Osstell system was an invasive and reliable method to measure implant stability. Conclusion: Both surfaces of implants studied showed high osseointegration. The SB and SB + AE implants used in our study had similar behavior both in terms of BIC values and RFA. The RFA systems in Osstell Mentor and Osstell ISQ confirmed nearly perfect reproducibility and repeatability. Full article

Our aim was to analyze the correlation between the IT evaluated by a surgical motor and the primary implant stability (ISQ) measured by two RFA devices, Osstell and Penguin, in an in vitro model. This study examines the effect of bone type (soft or dense), implant length (13 mm or 8 mm), and implant design (CC: conical connection; IH: internal hexagon), on this correlation. Ninety-six implants were inserted using a surgical motor (IT) into two types of synthetic foam blocks. Initial measurements for both the peak IT and ISQ were recorded at the point when implant insertion was stopped by the surgical motor, and the final measurements were recorded when the implant was completely inserted into the synthetic blocks using only the RFA devices. Our null hypothesis was that there is a good correlation between the devices, independent of the implant length, design, or bone type. We found a positive, significant correlation between the IT, and the Osstell and Penguin devices. Implant length and bone type did not affect this correlation. The correlation between the devices in the CC design was maintained; however, in the IH design it was maintained only between the RFA devices. We concluded that there is a high positive correlation between the IT and ISQ from a mechanical perspective, which was not affected by bone type or implant length but was affected by the implant design. Full article

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

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