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Objectives: To analyze the three‐dimensional stability and morphologic changes of tent space after the osteotome sinus floor elevation (OSFE) procedures without bone grafts. Materials and Methods: Forty‐six implants placed using the OSFE technique with simultaneous implant placement without bone grafts were included in this retrospective study. Cone‐beam computed tomography (CBCT) scans of the augmented sinuses were obtained pre‐ and postoperatively up to 48 months of follow‐up. The maxillary sinus cavity profiles were outlined using three‐dimensional virtual reconstruction and superimposition of CBCT scans. The three‐dimensional changes in the tent space were measured. A generalized estimating equation (GEE) was used to explore potential factors. Results: The implant survival rate was 97.8%. The mean volume of remaining tent space immediately after surgery was 96.8 ± 70.5 mm3, shrinking to 31.0 ± 24.9 mm3 after 48 months, while the mean percentage of remaining tent space volume decreased to 29.1 ± 20.7%. The tent space volume and the percentage of residual tent space volume only decreased significantly within 12 months after surgery (p =.008,.013). GEE results indicated positive correlations between the percentage of remaining tent space volume and implant protrusion length (p =.000) and apical height (p =.000), with a negative correlation between the sinus floor area immediately after surgery (p =.002) and the healing time (p =.022). Conclusions: The volume of the tent space rapidly shrank after OSFE without bone grafts. Several factors might influence the tent space stability. Long‐term clinical trials with larger sample sizes are necessary to further validate the results. [ABSTRACT FROM AUTHOR]

Peri-implantitis is a representative etiology that affects the long-term survival of dental implants. It is known that decontamination of the implant surface is essential for the successful outcome of regenerative therapy for peri-implantitis. In the present study, the stability of a novel separable dental implant (SDI) was evaluated and compared with a conventional non-separable dental implant (NDI) using biomechanical and histomorphometric analyses. In this animal study, 40 rabbits were implanted with two SDI fixtures in the left tibia and two NDI fixtures in the right tibia. The rabbits were sacrificed 3 and 6 weeks after implantation, and the implant samples were evaluated using resonance frequency analysis (RFA), micro-computed tomography (CT), removal torque testing, and histomorphometric analysis. SDI exhibited comparable or better osseointegration and implant stability to NDI. In particular, SDI showed significantly higher implant stability quotient (ISQ) values immediately and 6 weeks after implantation, while removal torque values were significantly higher at both 3 and 6 weeks. In addition, microgaps on the histomorphometric images were not observed and abnormal signs or inflammation did not occur at the connection between the top and bottom parts of the SDI. The novel SDI fixture demonstrated sufficient osseointegration and biomechanical stability compared with NDI in this animal study. In addition, the changeable top part of SDI indicates that it may be effective in easily treating peri-implantitis in clinical practice. Additional future studies on the stability and clinical application after loading to the fixture are necessary. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to analyze and compare three-dimensional volumetric bone changes and stability of simultaneously placed dental implants following sinus augmentation using deproteinized human demineralized tooth matrix (dpDTM) and deproteinized bovine bone mineral (DBBM). Methods: Twenty-four patients who required lateral maxillary sinus floor augmentation with simultaneous dental implant placement were randomly assigned to receive either dpDTM (n = 12) or DBBM (n = 12). Cone-beam computed tomography and resonance frequency analysis of implant stability were conducted immediately after surgery and 6 months postoperatively. Changes in the graft sinus floor and graft height volumes in the sagittal and coronal views, along with the implant stability quotient (ISQ), were analyzed and compared. Results: Volumetric graft alteration was comparable between dpDTM (120.33 ± 77.48 mm3) and DBBM (108.51 ± 65.15 mm3) (p = 0.690). Reduction in the average graft height was also comparable: dpDTM group ranged from − 0.59 to − 0.93 mm and the DBBM group ranged from − 0.55 to − 0.82 mm (p > 0.05) at most examined levels. However, greater reduction in the mesial-graft height occurred in the dpDTM group (− 1.08 ± 0.70 mm vs. −0.58 ± 0.39 mm, p = 0.04). The ISQ values increased similarly in both groups to reach 70 at 6 months. Conclusion: dpDTM demonstrated comparable stability in graft volume and height during the healing process compared to DBBM and could serve as a viable alternative to DBBM for sinus floor augmentation with simultaneous implant placement. [ABSTRACT FROM AUTHOR]

The aim of this study was to find in the literature data on the relationship between implant surface roughness and implant stability achieved, from the time of placement to three months afterward, to help us to know what type of surface roughness is more favorable to guarantee implant stability and osseointegration. A systematic review was conducted in accordance with the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-analysis) statement, and the protocol was registered on the Open Science Framework. The specific inclusion and exclusion criteria were selected using the PICOS framework. The databases Medline (PubMed), Scopus, the Web of Science and The Cochrane Library were searched up to October 2023. The selection of studies and data extraction were conducted by two independent reviewers. The review included a total of 11 studies. A total of 1331 dental implant placements were identified. Two of the eleven selected studies were on humans in vivo, eight were on animals in vivo, and one was on animals in vitro. A statistically significant correlation between surface roughness and implant stability as measured by resonance frequency analysis (RFA) was not identified in ten of the eleven selected studies. It appears that there is no correlation between primary stability and the degree of implant roughness. However, there appears to be a correlation between the roughness of the implant and the degree of osseointegration, as indicated by bone-implant contact values. This correlation is more closely related to secondary stability. The great methodological variability makes it difficult to compare data and draw conclusions, so it would be desirable to agree on a common methodology to help draw appropriate conclusions from published studies. [ABSTRACT FROM AUTHOR]

Background/purpose: Peri-implantitis is a representative etiology that affects the long-term survival of dental implants. It is known that decontamination of the implant surface is essential for the successful outcome of regenerative therapy for peri-implantitis. In the present study, the stability of a novel separable dental implant (SDI) was evaluated and compared with a conventional non-separable dental implant (NDI) using biomechanical and histomorphometric analyses. Materials and methods: In this animal study, 40 rabbits were implanted with two SDI fixtures in the left tibia and two NDI fixtures in the right tibia. The rabbits were sacrificed 3 and 6 weeks after implantation, and the implant samples were evaluated using resonance frequency analysis (RFA), micro-computed tomography (CT), removal torque testing, and histomorphometric analysis. Results: SDI exhibited comparable or better osseointegration and implant stability to NDI. In particular, SDI showed significantly higher implant stability quotient (ISQ) values immediately and 6 weeks after implantation, while removal torque values were significantly higher at both 3 and 6 weeks. In addition, microgaps on the histomorphometric images were not observed and abnormal signs or inflammation did not occur at the connection between the top and bottom parts of the SDI. Conclusion: The novel SDI fixture demonstrated sufficient osseointegration and biomechanical stability compared with NDI in this animal study. In addition, the changeable top part of SDI indicates that it may be effective in easily treating peri-implantitis in clinical practice. Additional future studies on the stability and clinical application after loading to the fixture are necessary.

Purpose: To compare the stability of short vs standard (ie, regular-length) implants in the edentulous mandible. Materials and Methods: In this prospective clinical study, 20 patients with edentulous mandibles received four implants each--two short implants (4 mm) in the region of the first molar and two standard implants (= 10 mm) in the interforaminal region. Implant stability was assessed using resonance frequency analysis immediately after implant placement and at the day of the abutment connection after 3 months of healing in order to provide an implant stability quotient (ISQ). Results: Implant stability in the two implant groups at placement (ISQ: short 66.2; standard 68.2) and at abutment connection (ISQ: short 74.9; standard 75.7) did not differ substantially or statistically significantly (both P > .05). Findings did not change after statistically controlling for potential confounders such as bone quality and bone crest width. At abutment connection, 95% of the short and 97.5% of the standard implants demonstrated sufficient stability for conventional loading (P > .05). Conclusions: Short dental implants demonstrate similar primary and secondary stability compared to standard implants and seem to be a promising treatment option for rehabilitation of patients with edentulous mandibles. [ABSTRACT FROM AUTHOR]

Purpose: To determine the optimal implant diameter under limited bone width by comparing the effects of implants with different diameters on implant stability, peri-implant bone stability, and osseointegration. In addition, to evaluate the reliability of resonance frequency analysis (RFA) in detecting osseointegration and marginal bone level (MBL). Materials and Methods: Mandibular premolars and first molars of seven beagle dogs were extracted. After 8 weeks, their mandibular models and radiographic information were collected to fabricate implant templates. Implant sites were randomly divided into three groups according to diameter: Ø3.3, Ø4.1, and Ø4.8 mm. Implant stability quotient (ISQ) measurement and radiographic evaluation were performed after surgery (baseline) and at 4, 8, and 12 weeks. Three dogs were euthanized at 4 weeks to observe osteogenesis and implant-tissue interface biology. Four dogs were euthanized at 12 weeks to observe osseointegration. Hard tissue sections were prepared to analyze osteogenesis (fluorescence double labeling) and osseointegration (methylene blue-acid fuchsin staining). Results: At baseline and at 4, 8, and 12 weeks, the ISQ values of Ø4.1- and Ø4.8-mm implants did not differ (P > .05), but both had higher values than the Ø3.3-mm implants (P < .05). The mean marginal bone resorption (MBR) associated with Ø3.3-, Ø4.1-, and Ø4.8-mm implants was 0.65 ± 0.58 mm, 0.37 ± 0.28 mm, and 0.73 ± 0.37 mm, respectively. The buccal MBR of Ø4.8-mm implants was significantly higher than that of Ø4.1-mm implants (P < .05). The bone-to-implant contact (BIC) percentage at 12 weeks did not differ for any group (P > .05). The correlation coefficients between the ISQ and MBL of the Ø3.3-, Ø4.1-, and Ø4.8-mm implants were -0.84 (P < .01), -0.90 (P < .001), and -0.93 (P < .001), respectively, while that between the ISQ and BIC was 0.15 (P > .05). Conclusions: During the early healing stage, the performance of Ø4.1- and Ø4.8-mm implants in terms of implant stability was better than that of Ø3.3-mm implants. Implant diameter may not influence BIC percentage. RFA can be used to evaluate implant stability and MBL but is not suitable to assess the degree of osseointegration. [ABSTRACT FROM AUTHOR]

Abstract Background Long-term success of implant restoration depends on many factors one of them is the sufficient implant stability which is lowered in compromised bone density sites such as the maxilla as it is categorized as type III & IV bone, so searching for a new innovation and updates in implant material and features is very mandatory. So, the aim of this study was to compare between two implant materials (roxolid and traditional titanium) on the primary and secondary stability of implant retained maxillary overdenture. Methods Eighteen completely edentulous patients were selected. All patients received maxillary implant-retained overdentures and lower complete dentures; patients were divided equally into two groups according to the type of implant materials. Group A received a total number of 36 implants made of roxolid material and Group B received a total number of 36 implants made of traditional titanium alloys. Implant stability was assessed using ostell device, the primary implant stability was measured at the day of implant installation however, secondary implant stability was measured after six weeks of implant placement. Paired t-test was used to compare between primary and secondary stability in the same group and an independent t-test was used to compare between the two groups with a significant level

Aim: The present systematic review compares the stability, crestal bone levels and efficacy of osseodensification (OD) drilling techniques for dental implant placement to traditional drilling methods. Settings and Design: The Cochrane online library, PubMed, Scopus, and other well-known online resources are used in the research. Using a systematic review design, the current study examines published qualitative studies with an emphasis on analysis. Materials and Methods: Using precise keywords, a thorough search of pertinent databases was carried out in accordance with PRISMA standards. Studies testing dental implant stability, crestal bone levels and clinical results using both OD and traditional procedures were covered by the inclusion criteria. Statistical Analysis Used: The risk of bias and quality of included studies was assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomized controlled trials. Results: A total of 170 patients and 334 implants from Egypt, India, and Brazil were included in eight papers that made up the systematic review. In several clinical situations, osseodensification outperformed standard drilling in terms of implant durability, bone development, and torque data. Statistical analysis presented the lowest risks, while blinded outcome assessment, allocation concealment, random sequence generation, incomplete outcome data and experimental technique revealed higher risks. Bias assessment found various risks across different components. Conclusion: The thorough examination of eight papers demonstrates that osseodensification is a technique with great promise in the field of dental implants. It exhibits superior torque values, bone development, and stability when compared to traditional drilling. The overall results highlight the potential of osseodensification to improve clinical outcomes and advance the science of dental implantology, even in the face of variances in bias concerns.

Background: Long-term success of implant restoration depends on many factors one of them is the sufficient implant stability which is lowered in compromised bone density sites such as the maxilla as it is categorized as type III & IV bone, so searching for a new innovation and updates in implant material and features is very mandatory. So, the aim of this study was to compare between two implant materials (roxolid and traditional titanium) on the primary and secondary stability of implant retained maxillary overdenture. Methods: Eighteen completely edentulous patients were selected. All patients received maxillary implant-retained overdentures and lower complete dentures; patients were divided equally into two groups according to the type of implant materials. Group A received a total number of 36 implants made of roxolid material and Group B received a total number of 36 implants made of traditional titanium alloys. Implant stability was assessed using ostell device, the primary implant stability was measured at the day of implant installation however, secondary implant stability was measured after six weeks of implant placement. Paired t-test was used to compare between primary and secondary stability in the same group and an independent t-test was used to compare between the two groups with a significant level < 0.05. Results: Independent t-test revealed a significant difference between the two groups with p -value = 0.0141 regarding primary stability and p-value < 0.001 regarding secondary stability, as roxolid implant group was statistically higher stability than titanium group in both. Paired t- test showed a statistically significant difference in roxolid implant group with p-value = 0.0122 however, there was non-statistically significant difference in titanium group with p-value = 0.636. Mann Whitney test showed a significant difference between the two groups regarding amount of change in stability with p value = 0.191. roxolid implant group showed a higher amount of change in stability than the titanium implant group. Conclusion: Within the limitation of this study, it could be concluded that: Roxolid implants showed promising results regarding primary and secondary stability compared to conventional Titanium implants and can be a better alternative in implant retained maxillary overdentures. Trial registration: Retrospectively NCT06334770 at 26–3-2024. [ABSTRACT FROM AUTHOR]

This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone‐level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health‐related quality of life (OHRQoL), and patient satisfaction at a 2‐year follow‐up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone‐level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant‐supported screw‐retained complete porcelain‐fused‐to‐metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2‐year follow‐up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone‐level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition. [ABSTRACT FROM AUTHOR]

Objectives: To determine the correlation between the primary implant stability quotient and the implant percussion sound frequency. Materials and Methods: A total of 14 pigs' ribs were scanned using a dental cone beam computed tomography (CBCT) scanner to classify the bone specimens into three distinct bone density Hounsfield units (HU) value categories: D1 bone: >1250 HU; D2: 850–1250 HU; D3: <850 HU. Then, 96 implants were inserted: 32 implants in D1 bone, 32 implants in D2 bone, and 32 implants in D3 bone. The primary implant stability quotient (ISQ) was analyzed, and percussion sound was recorded using a wireless microphone connected and analyzed with frequency analysis software. Results: Statistically significant positive correlations were found between the primary ISQ and the bone density HU value (r = 0.719; p < 0.001), and statistically significant positive correlations between the primary ISQ and the percussion sound frequency (r = 0.606; p < 0.001). Furthermore, significant differences in primary ISQ values and percussion sound frequency were found between D1 and D2 bone, as well as between D1 and D3 bone. However, no significant differences were found in primary ISQ values and percussion sound frequency between D2 and D3 bone. Conclusion: The primary ISQ value and the percussion sound frequency are positively correlated. [ABSTRACT FROM AUTHOR]

Objective: Recent years have seen a rise in the usage of dental implants to restore lost teeth. The stability of a dental implant is the main factor in determining its success. Implant stability is influenced by various factors. Several approaches have been employed clinically to evaluate stability at different time intervals. One non-invasive way to assess implant stability is by resonance frequency analysis. Utilizing the resonance frequency analysis method, this study seeks to understand how implant length and diameter affect primary and secondary stability. Methods: The current prospective study was conducted in the Prosthodontics Department of Institute of Dentistry, CMH Lahore Medical College. The duration of the study was six months. A total of 90 implants of sizes 4.5 x 8.5 mm and 4 x 10mm were placed. Resonance frequency measurements were recorded using OsstellTM AB device for primary stability at implant insertion and at 12 weeks for secondary stability. All the measurements were carried out by only one of the researchers to minimize inter-observer bias. Results: The average primary stability was 70.33±6.60, and the average secondary stability was 71.43±5.44. The data was stratified for age, gender, and implant site, and the mean primary and secondary stability of both sizes didn't show any statistically significant differences. Conclusion: Without forfeiting implant stability, both implant sizes (4 x 10mm and 4.5 x 8.5mm) can be used interchangeably, depending on available space and anatomical constraints. [ABSTRACT FROM AUTHOR]

Objectives: Bioactive surfaces were designed to increase the interaction between the surface and the cells. This may speed up the biological stability and loading protocols. Materials and methods: 36 patients with D3-D4 bone density were recruited and allocated into two groups. 30 bioactive (test group) and 30 traditional (control group) surfaced implants were placed. Insertion torque value (Ncm), insertion torque curve integral (cumulative torque, Ncm), torque density (Ncm/sec), implant stability quotient (ISQ) measured at three timepoints (baseline (T0), 30 (T30) and 45 (T45) days after surgery), and marginal bone loss (MBL) at 6 months of loading were assessed. Results: The mean ISQ and standard deviation at T0, T30, T45 were respectively 74.57 ± 7.85, 74.78 ± 7.31, 74.97 ± 6.34 in test group, and 77.12 ± 5.83, 73.33 ± 6.13, 73.44 ± 7.89 in control group, respectively. Data analysis showed significant differences between groups in ΔISQ at T0-T30 (p = 0.005) and T30-T45 (p = 0.012). Control group showed a significant decrease in ISQ at T30 (p = 0.01) and T45 (p = 0.03) compared to baseline, while no significant change was observed in test group. Due to the stability of the ISQ value ≥ 70, 26 test group and 23 control group implants were functionally loaded after 45 days. Conversely, due to the ISQ < 70 at T45, four test group implants and one control group implant were loaded after 90 days, and 6 control group implants were loaded after 180 days. Neither insertion torque nor ISQ at baseline were correlated with bone density (in Hounsfield units). There was no significant correlation between cumulative torque and ISQ at baseline. There was a significant positive slope in the correlation between torque density and ISQ at baseline, more accentuated in D3 than D4. This correlation remained significant for the test group in D3 bone at day 30 and 45 (p < 0.01 in both time frames), but not in D4 bone, and it was not significant in CG. Conclusions: The bioactive surface showed better behavior in terms of implant stability in D3-D4 bone quality in the early stages of bone healing. Clinical relevance This study demonstrated that the transition from primary to secondary stability is improved using bioactive surface, especially in cases of poor bone environment (D3/D4 bone). [ABSTRACT FROM AUTHOR]

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Aim: The present systematic review compares the stability, crestal bone levels and efficacy of osseodensification (OD) drilling techniques for dental implant placement to traditional drilling methods. Settings and Design: The Cochrane online library, PubMed, Scopus, and other well-known online resources are used in the research. Using a systematic review design, the current study examines published qualitative studies with an emphasis on analysis. Materials and Methods: Using precise keywords, a thorough search of pertinent databases was carried out in accordance with PRISMA standards. Studies testing dental implant stability, crestal bone levels and clinical results using both OD and traditional procedures were covered by the inclusion criteria. Statistical Analysis Used: The risk of bias and quality of included studies was assessed using the Newcastle- Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomized controlled trials. Results: A total of 170 patients and 334 implants from Egypt, India, and Brazil were included in eight papers that made up the systematic review. In several clinical situations, osseodensification outperformed standard drilling in terms of implant durability, bone development, and torque data. Statistical analysis presented the lowest risks, while blinded outcome assessment, allocation concealment, random sequence generation, incomplete outcome data and experimental technique revealed higher risks. Bias assessment found various risks across different components. Conclusion: The thorough examination of eight papers demonstrates that osseodensification is a technique with great promise in the field of dental implants. It exhibits superior torque values, bone development, and stability when compared to traditional drilling. The overall results highlight the potential of osseodensification to improve clinical outcomes and advance the science of dental implantology, even in the face of variances in bias concerns. [ABSTRACT FROM AUTHOR]

Objective: To compare implant stability and clinical outcome in implant placement between osteotome sinus floor elevation (OSFE) with biphasic calcium phosphate (BCP) which consisted of 30% of hydroxyapatite (HA) and 70% of beta-tricalcium phosphate (β -TCP) grafting material and OSFE without using bone grafting material. The research questions is whether the BCP provides any benefit in OSFE or not. Materials and methods: Thirty patients (30 implants) with a single edentulous area of upper premolar or molar were randomly separated into OSFE with BCP (n = 15) and OSFE without grafting (n = 15). The patients were reevaluated 3, 6, 9, and 12 months after implant loading. The clinical assessments (implant stability quotient (ISQ), implant survival-failure rate, and surgical complication) were analyzed. Together with radiographic assessments in 2D (endo-sinus bone gain (ESBG), mean marginal bone change (MMBC)) and 3D (endo-sinus bone gain in CBCT (ESBG-CT)) were evaluated, with a mean follow-up time of at least 12 months of functional loading and prosthetic complication. Results: 20 remaining implants (OSFE with BCP, n = 10; OSFE without grafting, n = 10) were analyzed. Mean ISQ was 79.18 ± 3.43 in 1-year follow-up (ISQ; OSFE with BCP = 78.72 ± 3.46, OSFE without grafting = 79.65 ± 3.52). ISQ in both groups increased steadily without significant differences in each follow-up. (p = 0.56). In radiographic evaluation, at 6-, 9-, and 12-month, OSFE without grafting group showed statistically significant lower MMBC (p < 0.05). The 1-year clinical results showed that 2 implants failed in OSFE with BCP, and 1 implant failed in OSFE without grafting. Conclusions: Graft material “BCP” (HA30:TCP70) coupled with OSFE presents no extraordinary benefit in implant stability, clinical and radiographic outcome in 1-year follow-up. Clinical relevance: Clinically, OSFE with grafting materials provides no additional benefit. Clinical trial registration number: TCTR20210517008 (date of registration: May 17, 2021) [ABSTRACT FROM AUTHOR]

Some evidence supports the influence of implant macro-design on primary stability. Additionally, tactile perception can be used to assess implant stability when placing the implant. This research aimed to quantify the primary and secondary stability of three implant systems with two different macro geometries (cylindrical and conical) determined based on the insertion torque and the implant stability quotient (ISQ) at the moment of implant placement as a function of implant-related factors (length, width, dental arch, and implant location in the arch), intraoperative factors (bone density determined subjectively by the clinician's tactile perception), and patient-related factors (age, gender, and bone density determined objectively based on cone beam computed tomography (CBCT). Methods: 102 implants from three implant systems with two different macro geometries (conical and cylindrical) were placed in 53 patients. The insertion torque, the ISQ at the implant placement (ISQ0), and the bone quality according to the clinician's tactile sensation were recorded on the day of the surgery. After a three-month healing period, the ISQ was re-evaluated (ISQ3). Results: The cylindrical implants exhibited significantly higher insertion torque and ISQ values at the moment of the surgery and after three months compared to the conical implants. The cylindrical implants also showed significantly lower indices of tactile evaluation of bone quality during the implant placement surgery. However, no differences were demonstrated in the bone density measured objectively using CBCT. (4) Conclusions: The cylindrical implants achieved the highest values for primary stability (Newtons × centimeter (Ncm) and ISQ) and secondary stability (ISQ after three months). The insertion torque was the variable that most influenced the ISQ on the day of the surgery. The implant location (incisors–canines, bicuspids–molars) and the implant macro geometry were the variables that most influenced the secondary stability (ISQ at three months). [ABSTRACT FROM AUTHOR]

Background: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratchet from the dental implant kit and ISQ values generated from the Osstell device. Results: Twenty patients (13 female and 7 male) with an age range of 25-65 years received twenty immediate dental implants. The insertion torque value ranged from 15 to 50 N/cm with a mean of 28 N/cm. At the same time, the ISQ values ranged between 50 and 80 ISQ values, with a mean of 63 ISQ values. The results showed a statistically significant positive correlation between the insertion torque of the dental implant measured by torque rachet and ISQ values checked with Osstell. Conclusion: The insertion torque can be used as a reliable method to estimate the primary stability of the immediately inserted dental implants in the maxillary non-molar sites comparable to the Osstell device ISQ values. In addition, torque ratchet is readily available in the dental implant kit at no additional cost, making it a valuable choice over the Osstell device.

Purpose: To compare the effects of regular implant drills to osseodensifying drills used in clockwise and counterclockwise motions on bone dimension change and primary implant stability. Materials and Methods: A total of 40 bone models were made (20 × 15 × 4 mm) from porcine tibia to represent implants placed in soft bone. Implant osteotomies were prepared in the bone models using one of the following techniques: (1) regular implant drills in a clockwise direction (group A), (2) regular implant drills in a counterclockwise direction (group B), (3) osseodensifying drills in a clockwise direction (group C), and (4) osseodensifying drills in a counterclockwise direction (group D). Bone-level tapered titanium alloy implants (4.1 × 10 mm) were placed following osteotomy creation. The implant stability quotient (ISQ) was measured after implant placement. Each bone model was scanned with an optical scanner to convert to Standard Tessellation Language (STL) files before and after the osteotomy creation. Presurgical and postsurgical STL files were superimposed, and the dimensional changes were measured at 1, 3, and 7 mm from the crestal bone. Histomorphometric analysis was done, and bone-to-implant contact percentage (BIC%) was calculated. Results: There were no significant differences in ISQ values (P = .239) between any of the groups. Histomorphometric analysis showed implants in group D had significantly higher BIC% than groups A (P = .020) and B (P = .009). The amount of bone expansion decreased with distance from the crest (P < .001). Groups B (P = .039) and D (P = .001) showed significant expansions at all levels compared with group A. No other statistically significant differences in dimensional change were found between groups. Conclusion: Both regular and osseodensification burs used in a counterclockwise motion contribute to expansion of bone dimension compared to conventional drilling methods. [ABSTRACT FROM AUTHOR]

Aim of the study: This study compered the effect of two different implant surface treatments (Direct laser metal forming and Acid etching) on implant stability in All-on-4 implant retained mandibular overdentures. Materials and methods: 14 male patients were selected to participate in this study. For each patient, four implants were inserted at the inter-foraminal region using the All-on-4 concept. Patients were randomly divided into two groups according to surface treatment of dental implants. Primary and secondary implant stability were measured and compared by resonance frequency analysis using the osstell device at the time of implant insertion, 3 months and 6 months after implant insertion.Results: Comparison was performed between the straight implants of both groups and revealed that implant stability of group I is significantly higher than group II after 3months and after 6 months, while revealed insignificant difference between them at the time of insertion. Comparison was performed between the angled implants of both groups and revealed that implant stability of group I is significantly higher than group II after 3months and after 6 months, while revealed insignificant difference between them in time of insertion.Conclusions: Direct Metal Laser Forming surface treatment increases the secondary stability of angled implants supporting All-On-4 temporary prosthesis.

Purpose: To evaluate the effect of different drilling techniques on implant stability at different time intervals. Materials and Methods: Patients were randomly allotted into three groups based on drilling technique for osteotomy: conventional drilling technique; simplified drilling technique; or modified conventional drilling technique. In 30 patients (n = 10 each group), a total of 44 implants were placed. In the conventional drilling technique, drills with increasing diameters were used. In the simplified drilling technique, only pilot and final-diameter drills were used. In the modified conventional drilling technique, all the drills were used in sequential order in the clockwise direction except the last drill, which was used in the counterclockwise direction. Implant stability quotient was recorded immediately after placing implants and at 1 and 3 months. Statistical analysis was performed with two-way analysis of variance (ANOVA) and Student t test. Results: Two-way ANOVA showed that drilling technique (P < .001) and time (P = .002) did have a statistically significant effect on implant stability quotient. The modified conventional drilling technique showed a drop in secondary implant stability at 1 month that was negligible compared to the other techniques. After 1 month, there was a significant increase in implant stability quotient with the modified conventional drilling technique compared to the conventional drilling technique (P = .001). The least crestal bone loss during 3 months of follow-up was with the modified conventional drilling technique (0.37 ± 0.06). Conclusion: Secondary stability increased with the modified conventional drilling technique in 3 months and showed a negligible drop at 1 month. This novel drilling technique had an early shift from a decrease to an increase in stability pattern, along with the least crestal bone loss at 3 months. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Cones currently available in the market are rigid, and unless they are custom-specific designed, are unable to correctly adapt to the shape of the patient's bone. Therefore, flexible metaphyseal cones have been recently introduced to reduce potential bone trauma during implantation. Even if a preliminary clinical study on their use has shown promising results, no biomechanical study evaluates and quantifies their mechanical efficacy and safety. Two commercial versions of flexible cones were analyzed in this study using finite element analysis, based on a previously validated model. Each cone geometry was modeled both as flexible and as rigid, and implanted following surgical guidelines. Three activities were simulated in this study and compared among configurations: surgical impaction, walking, and chair rise. During impaction, results showed considerably reduced stress in the flexible cones in comparison with rigid ones; the stress resulted was also better distributed and more homogeneous all over the cortical bone, with lower bone peaks. Considering the 2 different activities, the analysis did not show any remarkable differences between flexible and rigid cones both in terms of bone stress and implant micromotion. The findings demonstrate that metaphyseal flexible cones allow macrodeformation during impaction due to their flexibility, and therefore, are safer in comparison with rigid cones. However, for the daily tasks investigated, results showed no major differences between rigid and flexible cones in terms of bone stress, implant stability, and micromotion. Therefore, their mechanical performances can be considered similar to the rigid cone. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the use of a flexible synthetic polymer bone graft to provide implant stability during implant placement in a dense cortical bone model. In the control group (Group 1), sockets were prepared on polyurethane blocks according to the standard implant socket drilling protocol; both oversizing and deepening were applied in Group 2; and only oversizing was applied in Group 3. In Groups 2 and 3, flexible synthetic polymer bone grafts were placed in the sockets prior to implant placement. The implants were placed at the bone level in all groups. The highest torque value obtained was recorded as the insertion torque. In this study, 75 implant sites were included across three groups. The torque values of the implants in the control group were significantly higher than those of the implants with the oversized and deepened sockets and the oversized-only sockets (p < 0.05; p < 0.01). The torque values of the implants with the oversized and deepened sockets were significantly higher than those of the implants with the oversized-only sockets (p < 0.01). In this study, a flexible synthetic polymer bone graft was shown to be effective in achieving implant stability in the management of implants where there has been a loss of primary stability. [ABSTRACT FROM AUTHOR]

Percutaneous osseointegrated implants for individuals with lower limb amputation can increase mobility, reduce socket related pain, and improve quality of life. It would be useful to have an evaluation method to assess the interface between bone and implant. We assessed outpatient radiographs from the Intraosseous Transcutaneous Amputation Prosthesis clinical trial using an interface scoring system which summed and weighted equally measures of implant collar cortical ongrowth and radiolucency along the implant stem/bone interface. Radiographs from 12 participants with unilateral transfemoral amputations (10 males, 2 females, mean age = 43.2, SD = 7.4 years) in the clinical trial from cohort I (implanted in 2008/09) or cohort II (implanted in 2013/14) were collated (mean image span = 7.2, SD = 2.4 years), scale normalised, zoned, and measured in a repeatable way. Interface scores were calculated and then compared to clinical outcomes. Explanted participants received the lowest interface scores. A higher ratio of stem to residuum and shorter residuum's produced better interface scores and there was an association (weak correlation) between participants with thin cortices and the lowest interface scores. A tapered, cemented, non curved stem may provide advantageous fixation while stem alignment did not appear critical. In summary, the interface score successfully demonstrated a non-invasive evaluation of percutaneous osseointegrated implants interfaces when applied to the Intraosseous Transcutaneous Amputation Prosthesis clinical trial. The clinical significance of this work is to identify events leading to aseptic or septic implant removal and contribute to clinical guidelines for monitoring rehabilitation, design and surgical fixation choices. [ABSTRACT FROM AUTHOR]

The prevention of implant-associated infections is becoming increasingly clinically important in the field of dentistry. Extensive investigations into the development of innovative antibacterial materials that interact effectively to reinforce their functionality are currently being conducted in the biomedical sector. In the present study, a novel dental nano putty (D-nP) has been developed using demineralized bone matrix (DBM), calcium sulfate hemihydrate (CSH), curcumin nanoparticles (CU-NPs), and silver nanoparticles (AgNPs). The produced D-nP was evaluated using physicochemical, mechanical, and in vitro analyses. Surface characterization, particularly the analysis of calcium and phosphorus content, was performed before and after immersion in the simulated body fluid (SBF). In addition, the impact of surface treatment on biological activity was studied. The results showed that the mechanical properties of the D-nP were outstanding and its performance is promising. D-nP exhibited excellent antibacterial activity against Actinomyces naeslundii (5.22 ± 0.07 mm) and Streptococcus oralis (5.41 ± 0.1 mm). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was conducted using MG-63 osteoblast cells, which exhibited 95 % viability in D-nP. Based on these characterization results, the D-nP developed in this study exhibited excellent performance for tooth tissue in bone repair. [Display omitted] • DBM/CSH/CU-NPs/AgNPs based D-nP was successfully prepared. • Dental apatite formation of D-nP were enhanced due to CU-NPs and AgNPs. • D-nP exhibited outstanding mechanical, antibacterial, biocompatibility, and bioactivity properties. [ABSTRACT FROM AUTHOR]

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ABSTRACT Objectives To determine the correlation between the primary implant stability quotient and the implant percussion sound frequency. Materials and Methods A total of 14 pigs' ribs were scanned using a dental cone beam computed tomography (CBCT) scanner to classify the bone specimens into three distinct bone density Hounsfield units (HU) value categories: D1 bone: >1250 HU; D2: 850–1250 HU; D3:

Aim: This study aimed to assess the effectiveness of photobiomodulation therapy (PBM) in enhancing bone integration with dental implants. Method: PubMed, ScienceDirect, the Cochrane Library, Scopus, and Google Scholar were searched. Studies assessing PBM effectiveness with defined intervention/control groups were included, while those lacking specified laser types, involving severe maxillofacial defects or surgery, and not reporting outcomes related to dental implant osseointegration post-PBM therapy were excluded. The studies' risk of bias was assessed using Robvis for randomized controlled trials (RCTs) and ROBINS-I for non-RCTs. The meta-analysis was conducted utilizing a random-effects model at a significance level of 0.01. Results: The study reviewed 26 papers involving 571 patients undergoing dental implant procedures with PBM/Low-Level Laser Therapy (LLLT) or placebo/control. Implant stability quotients (ISQ) analysis showed a non-significant difference (p = 0.06, mean difference: 1.02, 95 % CI: 0.28 to 1.75, I2=28 %), while the Periotest method indicated significant improvement in stability (p < 0.01, mean difference: -0.51, 95 % CI: -0.78 to -0.24, I2=71 %). PBM resulted in a significant bone density increase (p < 0.01, mean difference: 26, 95 % CI: 6.93 to 45.06, I2=91 %), but marginal bone loss showed no significant difference (p = 0.11, mean difference: 0.00, 95 % CI: -0.06 to 0.05, I2=45 %). Implant survival rate did not significantly differ (p = 0.73, mean difference: 1.56, 95 % CI: 0.38 to 6.46, I2=0 %). Most studies raised concerns regarding randomization. Conclusion: PBM could improve implant stability, as assessed with Periotest, and increase bone density, enhancing osseointegration. However, implant stability assessed with ISQ, marginal bone loss, and implant survival rate were comparable between the study groups.

Introduction: Dental implant osseointegration is crucial for the long term success of implant-supported restorations. Photofunctionalisation (PF), a novel surface modification technique, has been proposed as a means to enhance implant osseointegration. Aim: To evaluate the current evidence regarding the effects of PF on dental implant osseointegration. Materials and Methods: A comprehensive search was conducted in electronic databases, including PubMed, Directory of Open Access Journals, and Google Scholar, for studies published up until August 2022. The search strategy combined keywords related to dental implants, PF, and osseointegration. Two independent reviewers screened the titles, abstracts, and full texts of the identified studies, following predefined inclusion and exclusion criteria. Data extraction and quality assessment using the Cochrane Collaboration’s tool for randomised clinical trials, the ROBINS-I tool for non randomised studies, and the The Newcastle-Ottawa Scale (NOS) for observational studies were performed. Results: A total of five studies met the inclusion criteria and were included in the systematic review. The outcomes assessed included implant stability, osseointegration, and survival rates. The findings of the included studies suggested that PF of dental implants may promote osseointegration by enhancing early bone formation, increasing implant stability, and improving Bone-To-Implant (BIC) contact. Conclusion: The available evidence suggests that PF of dental implants may have a positive impact on osseointegration. However, due to the limited number of studies, further research is needed to provide more definitive conclusions regarding the clinical benefits of photofunctionalised dental implants in pathologically compromised bone sites.

Background: Implant replacement is among the treatment options for severe peri-implantitis. The aim of this single-cohort study was to evaluate the feasibility of replacing compromised implants affected by advanced peri-implantitis with new implants with a porous trabecular metal (TM) structure. Materials and Methods: Patients with one or more implants in the posterior region showing a defect depth >50% of implant length, measured from the residual crest, were consecutively included. Two months after implant removal, patients received a TM implant combined with a xenograft and a resorbable membrane. The implant stability quotient (ISQ) was measured at placement and re-assessed five months later (at uncovering), then after 6, 12, and 24 months of function. Marginal bone loss was radiographically evaluated. Results: Twenty consecutive cases were included. One patient dropped out due to COVID-19 infection, and nineteen cases were evaluated up to 24 months. At placement, the mean ISQ was 53.08 ± 13.65 (standard deviation), which increased significantly to 69.74 ± 9.01 after five months of healing (p < 0.001) and to 78.00 ± 7.29 after six months of loading (p < 0.001). Thereafter, the ISQ remained stable for up to 24 months (80.55 ± 4.73). All implants successfully osseointegrated and were restored as planned. After two years, the average marginal bone level change was −0.41 ± 0.38 mm (95% confidence interval −0.60, −0.21), which was limited yet significantly different from the baseline (p < 0.05). Conclusions: The treatment of advanced peri-implant defects using TM implants inserted two months after explantation in combination with guided bone regeneration may achieve successful outcomes up to two years follow-up, even in the presence of low primary stability. [ABSTRACT FROM AUTHOR]

Many studies have been exploring the use of bone graft materials (BGMs) and mesenchymal stem cells in bone defect reconstruction. However, the regeneration potential of Algipore (highly purified hydroxyapatite) and Biphasic (hydroxyapatite/beta-tricalcium phosphate) BGMs combined with bone marrow–derived mesenchymal stem cells (BMSCs) remains unclear. Therefore, we evaluated their osseointegration capacities in reconstructing peri-implant bone defects. The cellular characteristics of BMSCs and the material properties of Algipore and Biphasic were assessed in vitro. Four experimental groups—Algipore, Biphasic, Algipore+BMSCs, and Biphasic+BMSCs—were designed in a rabbit tibia peri-implant defect model. Implant stability parameters were measured. After 4 and 8 weeks of healing, all samples were evaluated using micro-CT, histological, and histomorphometric analysis. In the energy-dispersive X-ray spectroscopy experiment, the Ca/P ratio was higher for Algipore (1.67) than for Biphasic (1.44). The ISQ values continuously increased, and the PTV values gradually decreased for all groups during the healing period. Both Algipore and Biphasic BGM promoted new bone regeneration. Higher implant stability and bone volume density were observed when Algipore and Biphasic BGMs were combined with BMSCs. Biphasic BGM exhibited a faster degradation rate than Algipore BGM. Notably, after eight weeks of healing, Algipore with BSMCs showed more bone–implant contact than Biphasic alone (p < 0.05). Both Algipore and Biphasic are efficient in reconstructing peri-implant bone defects. In addition, Algipore BGM incorporation with BSMCs displayed the best performance in enhancing implant stability and osseointegration potential. [ABSTRACT FROM AUTHOR]

Introduction: Dental implant osseointegration is crucial for the long term success of implant-supported restorations. Photofunctionalisation (PF), a novel surface modification technique, has been proposed as a means to enhance implant osseointegration. Aim: To evaluate the current evidence regarding the effects of PF on dental implant osseointegration. Materials and Methods: A comprehensive search was conducted in electronic databases, including PubMed, Directory of Open Access Journals, and Google Scholar, for studies published up until August 2022. The search strategy combined keywords related to dental implants, PF, and osseointegration. Two independent reviewers screened the titles, abstracts, and full texts of the identified studies, following predefined inclusion and exclusion criteria. Data extraction and quality assessment using the Cochrane Collaboration's tool for randomised clinical trials, the ROBINS-I tool for non randomised studies, and the The Newcastle-Ottawa Scale (NOS) for observational studies were performed. Results: A total of five studies met the inclusion criteria and were included in the systematic review. The outcomes assessed included implant stability, osseointegration, and survival rates. The findings of the included studies suggested that PF of dental implants may promote osseointegration by enhancing early bone formation, increasing implant stability, and improving Bone-To-Implant (BIC) contact. Conclusion: The available evidence suggests that PF of dental implants may have a positive impact on osseointegration. However, due to the limited number of studies, further research is needed to provide more definitive conclusions regarding the clinical benefits of photofunctionalised dental implants in pathologically compromised bone sites. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of a workflow for reproducible patient and breast positioning on implant stability during high-dose-rate multi-catheter breast brachytherapy. Methods: Thirty patients were treated with our new positioning control workflow. Implant stability was evaluated based on a comparison of planning-CTs to control-CTs acquired halfway through the treatment. To assess geometric stability, button–button distance variations as well as Euclidean dwell position deviations were evaluated. The latter were also quantified within various separated regions within the breast to investigate the location-dependency of implant alterations. Furthermore, dosimetric variations to target volume and organs at risk (ribs, skin) as well as isodose volume changes were analyzed. Results were compared to a previously treated cohort of 100 patients. Results: With the introduced workflow, the patient fraction affected by button–button distance variations > 5 mm and by dwell position deviations > 7 mm were reduced from 37% to 10% and from 30% to 6.6%, respectively. Implant stability improved the most in the lateral to medial breast regions. Only small stability enhancements were observed regarding target volume dosimetry, but the stability of organ at risk exposure became substantially higher. D0.2ccm skin dose variations > 12.4% and D0.1ccm rib dose variations > 6.7% were reduced from 11% to 0% and from 16% to 3.3% of all patients, respectively. Conclusion: Breast positioning control improved geometric and dosimetric implant stability for individual patients, and thus enhanced physical plan validity in these cases. [ABSTRACT FROM AUTHOR]

Background: Dental implantology has witnessed substantial progress in recent years, driven by a growing emphasis on optimizing bone regeneration around dental implants. Nanoparticles have emerged as a potential tool for enhancing osseointegration and bone tissue regeneration. Materials and Methods: This human clinical trial enrolled 60 adult participants requiring dental implants. Patients were randomly assigned to one of two groups: a control group receiving conventional dental implants, and an experimental group receiving dental implants with nanoparticle-coated surfaces. Radiographic imaging, histological analysis of bone biopsies, and implant stability assessments were conducted at three and six months post-implantation. Results: Histological examination of bone biopsies revealed a statistically significant increase in new bone formation in the experimental group compared to the control group at both three and six months (P < 0.05). Radiographic assessment demonstrated a 25% higher bone density around nanoparticle-coated implants (P < 0.01) at the six-month mark. Implant stability quotient (ISQ) measurements indicated a 20% greater stability in the experimental group (P < 0.05) at the same time point. Conclusion: This human clinical trial provides strong evidence that the incorporation of nanoparticles on dental implant surfaces enhances bone regeneration and osseointegration in a human population.

The microstructural architecture of remodeled bone in the peri-implant region of screw implants plays a vital role in the distribution of strain energy and implant stability. We present a study in which screw implants made from titanium, polyetheretherketone and biodegradable magnesium-gadolinium alloys were implanted into rat tibia and subjected to a push-out test four, eight and twelve weeks after implantation. Screws were 4 mm in length and with an M2 thread. The loading experiment was accompanied by simultaneous three-dimensional imaging using synchrotron-radiation microcomputed tomography at 5 μm resolution. Bone deformation and strains were tracked by applying optical flow-based digital volume correlation to the recorded image sequences. Implant stabilities measured for screws of biodegradable alloys were comparable to pins whereas non-degradable biomaterials experienced additional mechanical stabilization. Peri-implant bone morphology and strain transfer from the loaded implant site depended heavily on the biomaterial utilized. Titanium implants stimulated rapid callus formation displaying a consistent monomodal strain profile whereas the bone volume fraction in the vicinity of magnesium-gadolinium alloys exhibited a minimum close to the interface of the implant and less ordered strain transfer. Correlations in our data suggest that implant stability benefits from disparate bone morphological properties depending on the biomaterial utilized. This leaves the choice of biomaterial as situational depending on local tissue properties.

The aim of this study was to find in the literature data on the relationship between implant surface roughness and implant stability achieved, from the time of placement to three months afterward, to help us to know what type of surface roughness is more favorable to guarantee implant stability and osseointegration. A systematic review was conducted in accordance with the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-analysis) statement, and the protocol was registered on the Open Science Framework. The specific inclusion and exclusion criteria were selected using the PICOS framework. The databases Medline (PubMed), Scopus, the Web of Science and The Cochrane Library were searched up to October 2023. The selection of studies and data extraction were conducted by two independent reviewers. The review included a total of 11 studies. A total of 1331 dental implant placements were identified. Two of the eleven selected studies were on humans in vivo, eight were on animals in vivo, and one was on animals in vitro. A statistically significant correlation between surface roughness and implant stability as measured by resonance frequency analysis (RFA) was not identified in ten of the eleven selected studies. It appears that there is no correlation between primary stability and the degree of implant roughness. However, there appears to be a correlation between the roughness of the implant and the degree of osseointegration, as indicated by bone-implant contact values. This correlation is more closely related to secondary stability. The great methodological variability makes it difficult to compare data and draw conclusions, so it would be desirable to agree on a common methodology to help draw appropriate conclusions from published studies.

Some evidence supports the influence of implant macro-design on primary stability. Additionally, tactile perception can be used to assess implant stability when placing the implant. This research aimed to quantify the primary and secondary stability of three implant systems with two different macro geometries (cylindrical and conical) determined based on the insertion torque and the implant stability quotient (ISQ) at the moment of implant placement as a function of implant-related factors (length, width, dental arch, and implant location in the arch), intraoperative factors (bone density determined subjectively by the clinician’s tactile perception), and patient-related factors (age, gender, and bone density determined objectively based on cone beam computed tomography (CBCT). Methods: 102 implants from three implant systems with two different macro geometries (conical and cylindrical) were placed in 53 patients. The insertion torque, the ISQ at the implant placement (ISQ0), and the bone quality according to the clinician’s tactile sensation were recorded on the day of the surgery. After a three-month healing period, the ISQ was re-evaluated (ISQ3). Results: The cylindrical implants exhibited significantly higher insertion torque and ISQ values at the moment of the surgery and after three months compared to the conical implants. The cylindrical implants also showed significantly lower indices of tactile evaluation of bone quality during the implant placement surgery. However, no differences were demonstrated in the bone density measured objectively using CBCT. (4) Conclusions: The cylindrical implants achieved the highest values for primary stability (Newtons × centimeter (Ncm) and ISQ) and secondary stability (ISQ after three months). The insertion torque was the variable that most influenced the ISQ on the day of the surgery. The implant location (incisors–canines, bicuspids–molars) and the implant macro geometry were the variables that most influenced the secondary stability (ISQ at three months).

Purpose: This study aimed to investigate the influence of oversized drilling on the stability of the implant and the bone response during osseointegration. Materials and Methods: The trial was designed as a prospective, parallel-group randomized controlled clinical trial with 20 implants placed in the posterior region of the maxilla. The sample size was divided into two groups, 10 each, with implants being placed with manufacturer-recommended implant osteotomy preparation according to the manufacturer guidelines in one group (MR group) vs oversized osteotomy preparation (3 to 5 mm) in the other group (oversized drilling [OD] group). The implant stability was monitored for 3 months by means of resonance frequency analysis, while the crestal bone levels were recorded using parallel technique periapical radiography for 6 months. Patient-reported outcomes including pain, swelling, satisfaction, and implant survival were all monitored throughout the study. Results: In the MR group, a mean decrease in implant stability quotient (ISQ) values was detected during the first 4 weeks, after which a gradual increase in values was recorded. In comparison, the OD group showed a rapid increase in ISQ value over the entire follow-up period from baseline and up to week 12. Regarding crestal bone level, follow-up showed a significant difference when comparing baseline and 6-month radiographs (P = .00) between the OD group, 0.908 mm ± 0.343, and the MR group, 1.3 ± 0.23 mm. Conclusion: Within the limitations of this study, the results suggest that the oversized osteotomy technique may lead to earlier implant stability and postsurgical recovery compared with the manufacturer-recommended technique for osteotomy preparation. However, further studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine whether the Periotest device could be used to reliably and reproducibly determine the prosthetic readiness of one-piece ceramic implants. Materials and Methods: Periotest values were measured on one-piece ceramic implants from two manufacturers, CeraRoot and Straumann PURE. Measurements were taken at the time of placement and up to 9 months after placement. The survival of the implants was assessed up to 12 months following placement. Data were modeled on R software utilizing the Cox Proportional Hazards model and Generalized Additive Model (GAM) regression. Results: In all, stability testing was performed on 320 placed implants in 202 patients. The overall implant survival rate after 12 months of follow-up was 96.9%. The mean Periotest value (PTV) at the time of placement was -2.0 for the surviving implants, while it was only +0.6 for the failed implants. The PTV showed a gradual and steady increase leading up to 12 to 16 weeks. The mean PTV recorded at 12 weeks was -3.2. The Periotest device provided accurate and reproducible stability measurements following the prescribed protocol, thus helping to determine readiness for prosthetic loading. Conclusion: Within the limitation of this study, the preliminary findings suggest that the Periotest is an objective tool for stability assessment of one-piece ceramic implants. Further follow-up is needed to evaluate whether the Periotest can be suggested as a monitoring device of stability after the prosthetic phase of the implants is completed. [ABSTRACT FROM AUTHOR]

Background: Dental implants have become the standard for replacing missing teeth. However, patients’ demands for shorter treatment times and the desire for aesthetics in their results can complicate the rehabilitation process, particularly when poor-quality bone is involved. In order to address these challenges, new methods of treating implant surfaces have been introduced. These methods aim to make the implants superhydrophilic and bioactive, enhancing their functionality and interactions with the surrounding tissues. Aim: The aim of the study was to retrospectively examine the efficacy of a superhydrophilic and bioactive implant for treatment of the edentulous maxillary anterior area. The study also aimed to evaluate whether this improved implant surface, by enhancing the osseointegration processes, could serve as a factor in speeding up the loading protocols. Materials and Methods: For this retrospective study, a total of 13 implants were included: 6 delayed restored implants and 7 immediately loaded implants placed in the anterior maxillary area. Clinical, radiographic, and esthetic outcomes were assessed. Baseline measurements of the insertion torque value (ITV) and stability implant quotient (ISQ) were recorded for all implants. In the early-loaded group, these measurements were also taken 30 days (t30) and 45 days (t45) after the placement of the implant to monitor their changes over time. Marginal bone loss (MBL) was calculated according to the changes in marginal bone level on intraoral X-rays taken at two different time points: at baseline and one year after loading. To evaluate the esthetic results, the pink esthetic score (PES) and the white esthetic score (WES) were assessed. For this evaluation, intraoral photographs were taken one year after implant loading. Results: A total of 7 implants were immediately restored, with a mean ITV of 32.29 ± 9.01 Ncm and a mean ISQ of 72.71 ± 2.81. These implants were placed in a bone environment with a mean density of 410.00 ± 194.42 HU. On the other hand, 6 implants with delayed loading had a mean ITV of 28.50 ± 3.27 Ncm, an ISQ of 67.92 ± 8.43, and a mean bone density of 607.50 ± 140.83 HU. The mean PES and WES after 1 year were, respectively, 8.71 ± 1.89 and 8.57 ± 0.79 for immediate and 8.33 ± 1.36 and 9.17 ± 1.33 for delayed-loaded implants. At 12 months after loading, the immediately loaded group had a MBL of 0.29 ± 0.29 mm, while the delayed-loaded group had a MBL of 0.33 ± 0.25. No statistically significant differences between the two treatment groups were found for any of the evaluated outcomes. Conclusions: Despite the limitations of this study, the obtained results may support the use of a superhydrophilic and bioactive implant surface for implant-prosthetic rehabilitation in critical loading protocols with satisfactory esthetic results.

Background/purpose: Implant stability is crucial for successful osseointegration. Marginal bone level is considered an important indicator of long-term implant success and stability. The purposes of this study were to investigate 1) the effect of age, gender, bone density, implant length, and implant diameter on insertion torque (IT), primary implant stability quotient (ISQ), and secondary ISQ, 2) the impact of age, gender, bone density, implant length, implant diameter, IT, and ISQ on marginal bone loss (MBL). Materials and methods: Ninety patients who needed implant therapy were enrolled and overall 156 implants were installed to support single crowns. IT and ISQ were recorded for all implants during surgery and ISQ measurements were performed at follow-up visits. Age, gender, bone density, implant length and diameter were also registered. Radiographic evaluation of MBL was performed postoperative immediate (baseline), 3, 6, 9, 12, 18, and 24 months using digital periapical radiographs. Results: Age had little effect on IT and primary ISQ (P > 0.05). Generally, males had higher IT and primary ISQ, but no significant differences between genders were detected. Bone density showed significant effects on IT and primary ISQ. Correlation analysis revealed high positive correlations between IT/bone density and primary ISQ/implant diameter. Significant impacts of bone density and IT on MBL were found. Conclusion: Implant diameter had a more profound impact than length on IT/primary ISQ. Bone density played a considerable role in IT/primary ISQ determination. Bone density and IT had more impacts than primary ISQ on MBL.

Background/purpose: Immediate implant placement (IIP) with and without immediate provisionalization (Ipro) may yield satisfactory results in appropriate indications and treatment, especially in the esthetic zone. The aim of this study was to compare implant stability, marginal bone loss (MBL), survival rates, and patient satisfaction between IIP with Ipro and IIP without Ipro. Materials and methods: Seventy patients, each with a failed maxillary anterior tooth, were randomly assigned to IIP with Ipro (Group A: n = 35) or IIP without Ipro (Group B: n = 35). Implant stability quotient (ISQ) and standardized periapical radiographs were performed at surgery and at 3, 6, 9, and 12 months postoperatively to investigate implant stability and MBL, respectively. Survival was assessed 1 year after surgery. Patient satisfaction was evaluated with a visual analogue scale (VAS). Results: Primary ISQ and MBL were not significantly different between groups A and B immediately after surgery (P ＞ 0.05). Implant survival was 100% in both groups, and only one mechanical complication was observed. Patient satisfaction was good at definitive crown delivery and postoperatively 1-year in both groups. However, the immediate postoperative VAS score in Group A was significantly higher than that in Group B (P

Background/Purpose: A dental implant is an orthodontic prosthesis inserted into the patient's jawbone by a surgical procedure to compensate for a lost tooth. Upon osseointegration (bone-implant fusion), the abutment and crown can be attached to the implant to complete the implantation process. To guarantee the successful implantation of dental prosthetics, it's vital to monitor the primary stability in micro-displacement. This research aims to create a two-degree-of-freedom (2 DOF) mathematical model of dental implant prosthetics, which will be used to evaluate the micro-displacement under electromagnetic excitation. This mathematical model development will verify the functionality and accuracy of the electromagnetic RFA technique by estimating the resonance frequency and associated micro frequency of dental implants. Methods: Dental implant systems are evaluated according to the frequency of vibration corresponding to the maximum micro-displacement (micro-mobility). The stiffness and damping values of the mathematical model were determined using Finite Element Analysis (FEA). Using concepts and equations of vibration, the maximum displacement of the implant is determined. Results: Variations in input frequency ranges have also been compared to observe the micro displacement and resonance frequencies. In MATLAB, an input frequency of 5 to 15 kHz was provided. The maximum micro displacements and the resonance frequencies were plotted in the time domain and frequency domain using Fast Fourier Transform (FFT) in MATLAB. Conclusions: The findings of this research reveal that input frequency ranges of 5 to 15 kHz can be used to determine the resonance frequencies of a dental implant and the corresponding micro-displacements. there is a need in the medical field for a non-invasive device with a 2 DOF modeling concept that can detect even small changes in implant stability which ultimately determines both the short- and long-term clinical effectiveness of implant treatment.

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Research regarding bone density assessment using cone beam computed tomography (CBCT) in low bone density regions is sparse. This in vitro study aimed to evaluate the predictability of CBCT for low bone density regions and its correlations with primary implant stability when placing tapered design implants with a stepped osteotomy. Eighteen porcine mandibular condyles were used as simulated low bone density regions. Hounsfield units (HU), obtained via multislice computed tomography, and gray values (GVs), obtained via CBCT, were measured 3 times at 1-month intervals. The maximum implant insertion torque (MIT) and implant stability quotient (ISQ) were recorded as the taper design implants were placed using a stepped osteotomy. Hounsfield units and GV were measured as 335.05–803.07 and 389.98–906.40, respectively. For repeated measurements of HU and GV, the intraclass correlation coefficients were 0.989 and 0.980; the corresponding value for mean HU and GV was 0.768. Bland-Altman plots showed a mean difference between HU and GV of −78.15. Pearson correlation coefficients revealed a strong correlation between HU and GV (r = 0.91, P <.01). The mean ± SD values for MIT and ISQ were 36.44 ± 6.64 Ncm and 80.85 ± 2.03, respectively, but no statistically significant correlations were found with GV and HU. Within the study's limitations, GV showed similar bone density estimation compared with HU in soft bones. Tapered implant placement with a stepped osteotomy achieved stable primary implant stability in soft bones. However, these in vitro results need to be approved in further clinical studies. [ABSTRACT FROM AUTHOR]