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Purpose: To investigate the relationship between the structural parameters of trabecular bone obtained from CBCT imaging and the primary stability of dental implants. Materials and Methods: Sixty patients underwent implant placement followed by primary stability evaluation via measurement of the insertion torque (IT) and the implant stability quotient (ISQ). Gray values (GV) and the fractal dimension (FD) were also measured using pretreatment CBCT images. Results: FD values showed a positive and significant relationship with ISQ and IT values (P = .017 and P = .004, respectively). Additionally, there was a positive and significant correlation between GV and IT (P = .004) as well as between GV and ISQ (P = .010). FD and GV showed a considerable difference between the maxillary and mandibular jaws and were higher in the mandible. Only FD was significantly different between men and women and was higher in men. In the two age groups (older and younger than 45 years), only GV was considerably higher in people older than 45 (P < .05). Conclusions: Both fractal dimension and gray values obtained from CBCT are efficient methods for predicting the primary stability of the implant due to their relationship with ISQ and IT values. [ABSTRACT FROM AUTHOR]

Aim: This is a report of the 5-year results of a two-group parallel randomized clinical trial comparing longitudinal implant stability, and clinical and radiographic peri-implant outcomes of mandibular overdentures retained by one (1-IOD group) or two (2-IOD group) implants. Methods: All participants received 4.1 mm diameter tissue-level implants (Straumann® Standard Plus – SLActive®, Institut Straumann AG), installed in the mandible midline (1-IOD; n = 23) or the lateral incisor-canine area bilaterally (2-IOD; n = 24), and loaded after 3 weeks. Implant Stability Quotient (ISQ) was measured using a resonance frequency device (Osstell® Mentor, Integration Diagnostics) at implant placement, after three weeks (loading), and at the 6-month, 1-, 3-, and 5-year follow-ups. Marginal bone loss and clinical implant outcomes (plaque, calculus, suppuration and bleeding) were assessed periodically up to 5 years after loading. Results: Only minor changes in marginal bone level were observed after 5 years (mean = 0.37; SD = 0.44 mm), and satisfactory and stable peri-implant parameters were observed throughout the 5-year follow-up. No significant differences between groups were found. Overall, the mean primary implant stability was considered high (> 70) for the two groups (1-IOD = 78.1 ± 4.5; 2-IOD = 78.0 ± 5.8). No noticeable changes were observed between implant insertion and loading. A marked increase was observed from insertion to the 6-month follow-up – the mean difference for the 1-IOD group was + 5.5 ± 5.5 (Effect size = 1.00), while for the 2-IOD group, the mean difference was + 6.0 ± 5.6 (Effect size = 1.08). No relevant changes were observed throughout the follow-up periods up to 5 years. Linear mixed-effect model regression showed no influence of the bone-related variables (p > 0.05) and the number of implants (p = 0.087), and a significant effect of the time variable (p < 0.001). Conclusion: Satisfactory peri-implant outcomes and stable secondary stability suggest good clinical performance and successful long-term osseointegration of the implants for single and two-implant mandibular overdentures. Using a single implant to retain a mandibular overdenture does not seem to result in detrimental implant loading over the five years of overdenture use. Clinical relevance: This study corroborates the use of a single implant to retain a mandibular denture. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to compare the implant stability quotient (ISQ) values of endosteal dental implants (DIs) inserted into narrow alveolar ridges via osseodensification (OD) versus manual screw expansion (SE). Methods: Nineteen patients were randomized into two groups. The patients ranged in age from 21 to 59 years, with 46 implant osteotomy sites and 41 DIs. Twenty DIs were installed using OD drilling (OD group), and 21 DIs were inserted using manual screw expander drills (SE group). Primary stability was measured at the surgery time, and secondary stability was measured at the 24th week using the Osstell ISQ device. A probability value < 0.05 was considered to be statistically significant. Results: No statistical difference was observed between the mean values of primary stability of the OD (ISQ: 67.06 ± 4.41) and SE (ISQ: 67.76 ± 4.79) groups (P = 0.518). No statistical difference was noted between the mean values of secondary implant stability of the OD (ISQ: 68.53 ± 6.70) and SE (68 ± 5.68) groups (P = 0.780). Conclusion: The OD technique is comparable with the manual SE counterpart in terms of primary and secondary stability.

Introduction: We aimed to compare the implant stability quotient (ISQ) values of endosteal dental implants (DIs) inserted into narrow alveolar ridges via osseodensification (OD) versus manual screw expansion (SE). Methods: Nineteen patients were randomized into two groups. The patients ranged in age from 21 to 59 years, with 46 implant osteotomy sites and 41 DIs. Twenty DIs were installed using OD drilling (OD group), and 21 DIs were inserted using manual screw expander drills (SE group). Primary stability was measured at the surgery time, and secondary stability was measured at the 24th week using the Osstell ISQ device. A probability value < 0.05 was considered to be statistically significant. Results: No statistical difference was observed between the mean values of primary stability of the OD (ISQ: 67.06 ± 4.41) and SE (ISQ: 67.76 ± 4.79) groups (P=0.518). No statistical difference was noted between the mean values of secondary implant stability of the OD (ISQ: 68.53 ± 6.70) and SE (68 ± 5.68) groups (P=0.780). Conclusion: The OD technique is comparable with the manual SE counterpart in terms of primary and secondary stability. [ABSTRACT FROM AUTHOR]

Initial stability of implants is an important factor for the osseointegration of dental implants. Initial stability of implants can be lost when the bone is insufficient in cases of immediate implantation or when the bone density is insufficient, making it difficult to ensure good initial stability. Many techniques have been used to increase bone density. This study tested the use of five methods to increase bone density in one patient. This study concluded that the five methods used were effective in densifying the bone and achieving clinically acceptable primary stability in low-density bone.

Purpose: To evaluate the effect of insertion depth, bone type, and implant diameter on the primary stability of short implants. Materials and Methods: Commercial dental implants with different lengths (6 and 8 mm; BLX, Straumann) were inserted into artificial bone specimens of good and poor quality at three different depth positions: equicrestal, 1-mm subcrestal, and 2-mm subcrestal. Insertion torque values were recorded spontaneously during the implant procedure. Both maximum insertion torque values (MITVs) and final insertion torque values (FITVs) were recorded. Subsequently, Periotest values (PTVs) and implant stability quotients (ISQs) were measured for all specimens. Results: The mean MITVs of all groups ranged from 31.8 to 46.2 Ncm. However, the mean FITVs of all groups ranged from 8.8 to 29 Ncm. Torque values decreased significantly when the implants were inserted into their final positions. When insertion depth was increased, the PTV and ISQ decreased. Long implants and implants inserted into good-quality bone yielded greater primary stability, and bone quality appeared to have a greater effect on primary stability. Conclusion: When 6-mm short implants are inserted in a subcrestal position, low primary stability may be yielded, particularly in poor-quality bone. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate various biomechanical parameters associated with the primary stability of Maestro and Due Cone implants placed in low-density artificial bones, prepared using high-speed drilling with irrigation and low-speed drilling without irrigation. The insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ) values were recorded for Maestro and Due Cone implants placed in low-density polyurethane blocks (10 and 20 pounds per cubic foot (PCF) with and without a cortical layer) prepared using high-speed and low-speed with or without irrigation using a saline solution, respectively. A three-way ANOVA model and Tukey's post-hoc test were conducted, presenting data as means and standard deviations. P-values equal to or less than 0.05 were considered statistically significant. No statistically significant differences in IT, RT, and ISQ between drilling speeds were observed. However, Maestro implants exhibited lower IT and RT values after high- and low-speed drilling across almost all polyurethane blocks, significantly evident in the 20 PCF density block for IT and in the 20 PCF density block with the cortical layer for the RT with low-speed drilling (IT: 47.33 ± 10.02 Ncm and 16.00 ± 12.49 Ncm for Due Cone and Maestro implants, respectively, with p

Purpose: To observe whether the initial implant stability, evaluated by two different methods--the insertion torque value (ITV) and implant stability quotient (ISQ)--may be influenced by different clinical conditions as well as to understand whether it is possible to establish an overall positive correlation between both methods and whether the obtained correlation is maintained for each clinical variable under scope. Materials and Methods: The initial implant stability was evaluated by assessing and recording the ITV and the ISQ for each implant included in the study. The independent evolution of each method was observed considering clinical conditions grouped by gender (male or female), age (= 60 or > 60 years), arch (mandible or maxilla), location (incisors, canines and premolars, or molars), implant geometry (aggressive tapered or traditional parallel), diameter (3.5, 3.75, 4.3, or 5 mm), length (= 10 or < 10 mm), and immediate implantation (yes or no). The Mann-Whitney-Wilcoxon and Kruskal-Wallis localization tests were used to identify intragroup differences. To determine the level of correlation between both methods, the Spearman rank correlation was used. Results: The intragroup comparisons showed that the mandible (P = .03), short implants (P = .03), and delayed implantation (P= .07) subgroups exhibited higher ITVs. The other groups did not show significant differences. The higher ISQ measurements were obtained in the mandible (P = .0002), younger patients (P = .02), diameters of 3.75 mm and 4.3 mm (P = .04), and delayed implantation (P < .0001) subgroups. No differences were found for the other groups. A strong overall correlation (rho = 0.541; P = 8.023e-06) was found between both methods for ITVs up to 40 Ncm once they were accompanied by a linear increase in the ISQ to a value up to 78. From this value, the overall correlation decreased (rho = 0.237; P = .0055). Regarding the clinical conditions, different levels of significant correlations were found for both genders, older patients, maxilla, molar area, aggressive tapered implant geometries, diameters of 4.3 mm, diameters of 5 mm, lengths = 10 mm, and implants placed in healed bone. The other clinical conditions under scope did not exhibit an important correlation between both methods. Conclusion: When analyzed separately, clinical conditions such as the arch, implant length and diameter, patient age, and timing of implantation showed an influence on the ITV and the ISQ. An important overall correlation between both methods was found for ITVs of = 40 Ncm. This correlation was maintained for several of the clinical conditions studied. [ABSTRACT FROM AUTHOR]

Purpose: Immediate dental implants revolutionized the field of implant dentistry with significant advantages over conventional implants. The lack of adequate bone in the extraction socket raises the question of the appropriate timing of implant loading. Platelet concentrates have been used widely to accelerate bone regeneration in the maxillofacial region. This study evaluates the effect of platelet concentrates on bone healing and implant stability in the maxillary and mandibular molar regions. Bone regeneration is regulated by several growth factors, particularly vascular endothelial growth factor (VEGF) and transforming growth factor-ß1 (TGF-ß1); therefore, quantification of these factors in platelet concentrates and its correlation with bone healing has been assessed in this study. Materials and Methods: The primary aim of this randomized clinical trial was to compare the stability of immediate dental implants in the maxillary and mandibular molar regions treated with platelet-rich fibrin (PRF) versus concentrated growth factors (CGF) using resonance frequency analysis (RFA). The secondary objectives were to evaluate the bone regenerate around implants with the use of PRF and CGF and to quantify growth factors VEGF and TGF-ß1 in the prepared CGF and PRF and their correlation with bone healing, if any. A total of 36 patients were randomized into three groups (12 each): control, PRF, and CGF. In all patients, immediate implants were placed either with or without platelet concentrate (PRF or CGF). Implant stability was measured using RFA immediately postoperatively and at 4, 8, and 12 or 16 weeks (12 weeks for mandible and 16 weeks for maxilla) postoperatively. Radiodensity and the bone gap (horizontal/vertical) were measured on intraoral periapical radiographs immediately postoperatively and at 8 weeks and 12 or 16 weeks postoperatively. Results: On comparing the implant stability quotient (ISQ), radiodensity/grayscale (GS), and horizontal and vertical bone gap (HG and VG), there was no significant difference noted between the three groups at any point in time. On ISQ analysis at 8 weeks, the control group showed a significant improvement (P = .04), whereas at 12 or 16 weeks, significant improvement was seen in PRF (P = .03) and CGF groups (P = .02). In GS assessment, only the control group showed significant improvement at 12 or 16 weeks (P = .009). In horizontal and vertical bone gap analysis all three groups showed significant improvement at 8 weeks (control [P < .001], PRF [P = .001], CGF [P = .01]) as well as 12 or 16 weeks (control [P < .001], PRF [P < .001], CGF [P = .006]). The enzyme-linked immunosorbent assay (ELISA) quantification of VEGF and TGF-ß1 showed significant concentration of VEGF in PRF as compared to the plasma, while concentration of TGF-ß1 was found to be comparable in both groups. Conclusion: The application of platelet concentrates seems to enhance stability of implants, but intergroup results were nonsignificant at all time points. There was no statistically significant difference between the three groups when comparing quality (radiodensity/grayscale) and quantity (horizontal and vertical gap reduction) of bone regenerate. Studies with larger sample sizes are required to make conclusive assertions regarding efficacy of platelet concentrates in dental implants. [ABSTRACT FROM AUTHOR]

Alveolar bone quality at the implantation site affects the initial stability of dental implant treatment. However, the relationship between bone quality and osseointegration has yet to be evaluated. Herein, we aimed to investigate the effect of bone quality on dental implant stability in osseointegration formation changes. Patients underwent computed tomography imaging before dental implantation at the posterior. Hounsfield units were measured at the platform, middle, and tip sites. Implant stability was measured using resonance frequency analysis immediately and at 3 months postoperatively, in which the difference in implant stability quotients (ISQ) was defined as the change between primary and secondary fixation. In multiple regression analysis, the dependent variable was the change between the immediate and secondary fixations. We included 81 implants that conformed to the criteria. Primary fixation yielded the following results: R2 = 0.117, F = 2.529, and P =.047. The difference between the maxilla and mandible of the implantation site (P =.02) and the platform-site Hounsfield units (P =.019) were identified as significant factors. The following results were obtained regarding the change between the immediate and secondary fixation: R2 = 0.714, F = 40.964, and P <.001. The difference between diameter (P =.008) and the immediate ISQ (P <.001) were identified as significant factors. Overall, the bone quality of the implantation site affected initial fixation; however, it had limited effect on secondary fixation. Our findings clarified the period where bone quality affects dental implant treatment and is expected to advance dental implant treatment. [ABSTRACT FROM AUTHOR]

Objectives: This in vitro study is aimed at assessing whether implant primary stability is influenced by implant length in artificial bone with varying densities. Materials and methods: A total of 120 truncated-conical implants (60 long-length: 3p L, 3.8 × 14 mm; 60 short-length: 3p S, 3.8 × 8 mm) were inserted into 20, 30, and 40 pounds per cubic foot (PCF) density polyurethane blocks. The insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) values were recorded for each experimental condition. Results: In 30 and 40 PCF blocks, 3p S implants exhibited significantly higher IT values (90 and 80 Ncm, respectively) than 3p L (85 and 50 Ncm, respectively). Similarly, RT was significantly higher for 3p S implants in 30 and 40 PCF blocks (57 and 90 Ncm, respectively). However, there were no significant differences in RFA values, except for the 20 PCF block, where 3pS implants showed significantly lower values (63 ISQ) than 3p L implants (67 ISQ) in both the distal and mesial directions. Conclusions: These results demonstrated that the implant’s length mainly influences the IT and RT values in the polyurethane blocks that mimic the mandibular region of the bone, resulting in higher values for the 3p S implants, while the RFA values remained unaffected. However, in the lowest density block simulating the maxillary bone, 3p L implants exhibited significantly higher ISQ values. Clinical relevance: Therefore, our data offer valuable insights into the biomechanical behavior of these implants, which could be clinically beneficial for enhancing surgical planning. [ABSTRACT FROM AUTHOR]

Dental implants are a mainstream solution for missing teeth. For the improvement of dental implant surface treatment and design, short dental implants have become an alternative to various complex bone augmentation procedures, especially those performed at the posterior region of both the maxilla and mandible. The objective of this study was to evaluate the effect of various insertion methods on the primary stability of short dental implants. Commercial dental implants were inserted into artificial mandibular bone specimens using various insertion methods (equicrestal position, subcrestal position 1.5 mm, and lateral cortical anchorage) in accordance with an implant surgical guide. Insertion torque value (ITV) curves were recorded while implant procedures were performed. Both maximum ITVs (MITVs) and final ITVs (FITVs) were evaluated. Subsequently, Periotest values (PTVs) and implant stability quotients (ISQs) were measured for all specimens. A Kruskal–Wallis test was conducted to analyze the results for four primary stability parameters, and the Dunn test was used for a post hoc pairwise comparison when a difference was identified. For all groups, their mean MITVs ranged from 33.6 to 59.4 N cm, whereas their mean FITVs ranged from 17.5 to 43.5 N cm. Insertion torque value, ISQ, and PTV decreased significantly when implants were inserted into subcrestal positions. When implants were inserted in the lateral bicortical position, the four aforementioned parameters yielded greater values. When 6-mm short implants were inserted in a lateral cortical anchorage position, high primary stability was yielded. [ABSTRACT FROM AUTHOR]

Different strategies are known to improve implant primary stability (PS) and the bone-to-implant contact in post-extractive conditions, such as the macro-geometry of screws and apical threads, which can enhance the mechanical characteristics. In any case, the role of the apical area design in maintaining or improving the PS, especially in low-quality bone, still remains unclear. Thus, the present study aimed at evaluating in vitro the Insertion Torque (IT), Removal Torque (RT), and Resonance Frequency Analysis (RFA) of different implant apical threads in a cylindrical (EE) and in three conical implants (T3, TAC, Intra-lock) inserted in simulated post-extraction conditions on low-density polyurethane foams of 10 and 20 pounds per cubic foot (PCF), with and without the addition of a cortical sheet of 30 PCF in density. The IT, RT, and RFA values of all the implants tested were directly proportional to the polyurethane density and to the presence of the cortical sheet, but TAC and Intra-lock implants, which had the latest-generation thread design, always showed significantly higher values (e.g., IT: 18.6 and 18.6 Ncm, RT: 10.8 and 13.7 Ncm, RFA mean: 46 and 43 ISQ, in the 20 PCF density with the cortical sheet for TAC and Intra-lock, respectively). In particular, TAC implants also reached the highest RFA values in the lowest-density foam (19 ISQ). In conclusion, the present in vitro study demonstrated that TAC and Intra-lock apical designs and macro-geometries could play a key role in determining the PS and the polyurethane-implant contact in simulated post-extraction conditions in low-density artificial bone.

Purpose: The purpose of this study was to determine the minimum torque required to attach the transducer to the implant to measure the implant stability quotient (ISQ) with two different devices and to estimate if finger-generated torque would be reliable for this purpose. Materials and Methods: One hundred implants were inserted into a uniform polyurethane block. The implants were distributed into 10 groups, with 10 implants each. The transducers were manually attached by a female operator (G female) and by a male operator (G male) using the standard connector provided by the manufacturers. For the remaining groups, the transducers were placed using a connector adapted to a digital torque wrench with different torque settings: 3 Ncm (G 3Ncm), 4 Ncm (G 4Ncm), 5 Ncm (G 5Ncm), 6 Ncm (G 6Ncm), 10 Ncm (G 10Ncm), 13 Ncm (G 13Ncm), 17 Ncm (G 17Ncm), and 20 Ncm (G 20Ncm). The stability was measured for all groups using both the Osstell and the Penguin resonance frequency analyzers. The minimum, medium, and maximum finger grip torque were accessed on 100 volunteers. Results: For Osstell, the conjugated confidence intervals were homogenous for four groups (G 10Ncm, G 13Ncm, G 17Ncm, and G 20Ncm), and for Penguin, they were homogenous for six groups (G 5Ncm, G 6Ncm, G 10Ncm, G 13Ncm, G 17Ncm, and G 20Ncm). The minimum finger-generated force was 2.18 ± 1.05 Ncm, the medium force was 4.25 ± 1.57 Ncm, and the maximum force was 7.51 ± 2.52 Ncm, measuring with a digital torque meter. Conclusion: For an accurate measurement of ISQ, the minimum torque necessary to insert the transducer into the implant for Osstell was 10 Ncm, while for Penguin, it was 5 Ncm. Therefore, when using Osstell to assess implant stability, the authors suggest the use of a torque wrench to ensure 10 Ncm of force is applied when tightening the transducer into the implant to obtain accurate stability measurements. When using Penguin, the maximum finger-generated tightening force is enough. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of drilling protocol and bone density on the primary stability of implants with different macrogeometries currently used in clinical practice. Materials and Methods: This in vitro study compared the designs of two implants: Biomimetic Coral, a parallel-walled design with a slightly expanded platform and a symmetric progressive thread; and tapered Biomimetic Ocean, a reverse coronal design with an asymmetric progressive thread. The drilling alternatives were grouped according to the standard sequence for each type, plus an extra drill for hard bone, using laminated blocks with different densities. The insertion torques and implant stability quotient (ISQ) values were obtained with a surgical motor and resonance frequency analysis (RFA), respectively. Results: A total of 120 implants (n = 60 Ocean, n = 60 Coral) were inserted and analyzed without registering any deviation from the protocol. The Coral implants presented significantly higher insertion torque values (P < .001), consistent with optimal osseointegration, for the standard drill, the dense bone drill, and the screw tap. Insertion torque was not affected by the drilling sequence (P = .124), and the effect of interaction between the implant design and drilling sequence was not significant (P = .940). Statistically significant differences were observed in insertion torque values due to the type of implant but not due to the bone density. The ISQ values were significantly higher (P < .001) for the Coral design. In both the Ocean and Coral implants, ISQ was affected by the drilling sequence (P < .001), as the ISQ values were higher in the standard sequence with screw tap drilling than in the standard sequence with a dense bone drill. A positive correlation was found between the insertion torque and ISQ values. Conclusion: The macrogeometry of the implant and the drilling sequence have a significant effect on both primary stability values (ISQ and insertion torque). The values for the Coral implant were statistically higher but still within the range required to achieve proper osseointegration. These results support the drilling sequence recommended by the manufacturer for this type of implant, using larger-diameter drills and screw taps in sites with harder or cortical bone. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Primary implant stability (PIS) is known to vary with recipient bone mass and density, dental implant design and surgical technique. The objective of this preliminary study was to compare rotational and lateral PIS of same-coronal-diameter conical and parallel implants, using insertion torque recorded with a dental implant motor set and implant stability quotient obtained from resonance frequency analysis (performed with both Osstell and Penguin systems) as measures of rotational and lateral stability, respectively. Additionally, the relationship between PIS and alveolar ridge width (ARW) was explored in both implant types. Sixty dental implants (30 tapered and 30 parallel) were randomly placed with a split-mouth design in 17 patients. Bone density and ARW were estimated from cone beam computed tomography images taken with radiological-surgical templates. Density and width values were similar in the 2 groups (P >.05). Implant coronal diameters were 3.75 mm in all cases, while consistent with the manufacturer's recommendations, final drill bit diameters used were 3.25 and 3.4 mm for parallel and tapered implants, respectively. Insertion torque was higher (P <.05) with parallel implants, but between-group differences in implant stability quotient were not significant (P >.05). In tapered implants, insertion torque was inversely correlated with ARW (P <.001). Notably, significant differences were observed between resonance frequency analysis values from Osstell and Penguin systems (P <.001). In conclusion, future studies should explore how PIS may be influenced by final drill bit size regardless of implant design and potential limits on the effectiveness of tapered implants to achieve good stability in thick low-density bone. [ABSTRACT FROM AUTHOR]

Combining tooth extraction and implant placement reduces the number of surgical procedures that a patient must undergo. Thus, the present study aimed to compare the stability of two types of conical implants (TAC and INTRALOCK) and another cylindrical one (CYROTH), inserted with a range of angulation of 15–20 degrees in low-density polyurethane blocks (10 and 20 pounds per cubic foot, PCF) with or without a cortical lamina (30 PCF), which potentially mimicked the post-extraction in vivo condition. For this purpose, a total of 120 polyurethane sites were prepared (10 for each implant and condition) and the Insertion Torque (IT), Removal Torque (RT), and Resonance Frequency Analysis (RFA) were measured, following a Three-Way analysis of variance followed by Tukey's post hoc test for the statistical analysis of data. The IT and RT values registered for all implant types were directly proportional to the polyurethane density. The highest IT was registered by INTRALOCK implants in the highest-density block (32.44 ± 3.28 Ncm). In contrast, the highest RFA, a well-known index of Implant Stability Quotient (ISQ), was shown by TAC implants in all clinical situations (up to 63 ISQ in the 20 PCF block without the cortical sheet), especially in lower-density blocks. Although more pre-clinical and clinical studies are required, these results show a better primary stability of TAC conical implants in all tested densities of this post-extraction model, with a higher ISQ, despite their IT. [ABSTRACT FROM AUTHOR]

In the placement of dental implants, the primary fixation between the dental implant and the bone is of great importance and corresponds to compressive mechanical fixation that aims to prevent micromovement of the implant. The aim of this research was to determine the role of roughness and the type of dental implant (tissue-level or bone-level) in implant stability, measured using resonance frequency analysis (RFA) and insertion torque (IT). We analyzed 234 titanium dental implants, placed in fresh calf ribs, at the half-tissue level and half-bone level. The implant surface was subjected to grit-blasting treatments with alumina particles of 120, 300, and 600 μm at a projection pressure of 2.5 bar, resulting in three types of roughness. Roughness was determined via optical interferometry. The wettability of the surfaces was also determined. Implant stability was measured using a high-precision torquemeter to obtain IT, and RFA was used to determine the implant stability quotient (ISQ). The results show that rough surfaces with Sa values of 0.5 to 4 μm do not affect the primary stability. However, the type of implant is important; bone-level implants obtained the highest primary stability values. A good correlation between the primary stability values obtained via IT and ISQ was demonstrated. New in vivo studies are necessary to know whether these results can be maintained in the long term. [ABSTRACT FROM AUTHOR]

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Different strategies are known to improve implant primary stability (PS) and the bone-to-implant contact in post-extractive conditions, such as the macro-geometry of screws and apical threads, which can enhance the mechanical characteristics. In any case, the role of the apical area design in maintaining or improving the PS, especially in low-quality bone, still remains unclear. Thus, the present study aimed at evaluating in vitro the Insertion Torque (IT), Removal Torque (RT), and Resonance Frequency Analysis (RFA) of different implant apical threads in a cylindrical (EE) and in three conical implants (T3, TAC, Intra-lock) inserted in simulated post-extraction conditions on low-density polyurethane foams of 10 and 20 pounds per cubic foot (PCF), with and without the addition of a cortical sheet of 30 PCF in density. The IT, RT, and RFA values of all the implants tested were directly proportional to the polyurethane density and to the presence of the cortical sheet, but TAC and Intra-lock implants, which had the latest-generation thread design, always showed significantly higher values (e.g., IT: 18.6 and 18.6 Ncm, RT: 10.8 and 13.7 Ncm, RFA mean: 46 and 43 ISQ, in the 20 PCF density with the cortical sheet for TAC and Intra-lock, respectively). In particular, TAC implants also reached the highest RFA values in the lowest-density foam (19 ISQ). In conclusion, the present in vitro study demonstrated that TAC and Intra-lock apical designs and macro-geometries could play a key role in determining the PS and the polyurethane-implant contact in simulated post-extraction conditions in low-density artificial bone. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the implant stability quotient (ISQ) values of implants placed in bone with and without dehiscence bone defects over 12 weeks and to compare the ISQ values between the two groups. Materials and Methods: Twenty-two patients with an edentulous area at the posterior mandible were enrolled. Thirty OsseoSpeed EV Astra Tech implants (Dentsply Sirona), 4.2 mm in diameter, were placed. Twenty implants were placed without bone regeneration (no dehiscence group), while 10 presented with favorable bone defects and received simultaneous guided bone regeneration with dental implant placement (dehiscence group). At the time of implant placement, 2, 4, 8, and 12 weeks, resonance frequency analysis was utilized. The changes in ISQ values within group were analyzed with repeated-measures analysis of variance (ANOVA), and the mean ISQ values between the no dehiscence and dehiscence groups were compared using unpaired t tests. Results: All implants were successfully integrated without complication. The no dehiscence group demonstrated mean ISQ values of 74.30 ± 6.01, 69.58 ± 5.30, 71.10 ± 5.80, 75.08 ± 3.93, and 77.85 ± 3.18 at baseline, 2, 4, 8, and 12 weeks, respectively. The dehiscence group demonstrated mean ISQ values of 69.85 ± 7.00, 63.40 ± 8.47, 59.90 ± 10.23, 72.55 ± 3.10, and 76.20 ± 2.68 at baseline, 2, 4, 8, and 12 weeks, respectively. The dehiscence group showed significantly lower mean ISQ values at 2 weeks (P = .021) and at 4 weeks (P = .007) after implant placement compared with those of the no dehiscence group. Conclusion: Within the 12-week healing period, all implants demonstrated successful osseointegration and achieved stability in favorable bone defects. Nevertheless, clinicians should consider that significantly lower implant stability can occur in the first month. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze the implant stability quotient (ISQ) values recorded by three commercially available resonance frequency analysis (RFA) instruments from a large cohort of implants in order to determine their accuracy and agreement with one another both for static measurements of ISQ at a given time and for change in ISQ over time. Materials and Methods: A cohort of n = 210 implants had their primary stability, secondary stability, or both evaluated in both the mesiodistal (MD) and buccolingual (BL) directions by means of ISQ using three different RFA instruments: Osstell ISQ (OISQ), Osstell IDx (OIDX), and the Penguin (PG). ISQ values were recorded both at the time of implant placement and at 3 months postinsertion prior to definitive restoration. All values were tabulated for a blinded statistical analysis using Bland- Altman plots to determine if the outcome values were in agreement both for primary and secondary stability. In addition, a subgroup was evaluated to determine if change in ISQ was also in agreement. An intraclass correlation (ICC) was used to measure the reliability of the measurements for each instrument. Results: Bland-Altman plots confirmed that there was a high agreement for MD values between OISQ and OIDX, with 72.7% of readings being within one ISQ unit and 94.7% within four units. Comparing PG to OISQ, the respective values at one and four units were 15.3% and 82.3%, and comparing PG to OIDX, the respective values were 16.3% and 85.2%. In general, there was a greater uncertainty in the BL values having wider variability and demonstrating less agreement between instruments, with the percentage of readings falling within four units reducing to 85.9% (OISQ vs OIDX), 72.3% (PG vs OISQ), and 74.3% (PG vs OIDX). For change in ISQ over time, 92.3% of values were in agreement to within four units between instruments OISQ and OIDX in the MD direction and 73% in the BL direction. The respective percentage changes of values in agreement within four units for PG vs OISQ were 76.9% and 60.3% and for PG vs OIDX were 80% and 53.8%. The paired t test from mixed effects revealed that there was a significant difference for mean MD values between PG vs OISQ; P = .015 with a mean 0.823 units higher was recorded for PG. Similarly for PG vs OIDX, P = .008 with a mean 0.871 units higher was recorded for PG. For mean BL values between PG vs OIDX, P = .000 with a mean 1.161 units higher was recorded for PG, and finally, for OISQ vs OIDX, P = .005 with a mean 0.597 units higher was recorded for OISQ. However, the maximum upper and lower bound estimated bias between any two instruments was only 1.86 units and 0.46 units both for PG vs OIDX in the BL direction, and it is doubtful that this is of clinical relevance even if statistically significant. ICC revealed that for static MD measurements, there was an 85% reliability between all three instruments (range: 79% to 97%). For BL measurements, the reliability value was 66% (range: 69% to 71%). When considering ICC for changes in ISQ values over time in the MD direction, there was a 70% reliability between all three instruments (range: 58% to 94%). For BL measurements, the reliability value was 58% (range: 46% to 91%). Conclusion: Differences exist between instruments to some extent, most notably between the Penguin and the two instruments from Osstell, which showed good agreement to each other. While differences in evaluating ISQ with the PG were statistically significant, they were less than 1.86 units at the upper bound limit, and it is doubtful that this is of clinical relevance. Increased variability and reduced reliability for BL values render these less clinically sound when trying to assess primary stability. [ABSTRACT FROM AUTHOR]

Abstract Background A novel type of implant (Straumann® BLX implant) has been developed for certain stability from the mechanical and biological aspects and is expected for the implant placement in atrophic maxilla with sinus floor elevation (SFE). Purpose The aim of this study was to evaluate the primary stability in the implants with different macrodesigns in an SFE simulated model. Primary stabilities defined as maximum insertion torque (MIT) and implant stability quotient (ISQ) were compared between this novel type of implant and other types. Materials and Methods Five types of Straumann® 10 mm length implants (Standard Plus; SP, Tapered Effect; TE, Bone Level; BL, Bone Level Tapered; BLT and BLX) and two types of Straumann® 6 mm length implants (SP short, BLX short) were used in this study. Each implant was inserted through 5 mm–thick porcine iliac crest blocks (an SFE simulated model). Primary stability was evaluated by using MIT and ISQ. Results The mean value of MIT for BLX group showed significantly higher values than SP, BL (p

This prospective study compared the stability of implants placed using piezoelectric surgery (piezo group) and those placed using conventional rotary drills (bur group) during the first 90 days postoperatively. Teeth in the posterior maxillary regions of 21 patients were randomly assigned to 2 groups. The implant stability quotient (ISQ) was measured at days 0, 7, 14, 21, 28, 42, 56, and 90 postoperatively. Twenty-eight of 29 implants were successfully integrated at day 90 (1 implant in the test group was lost). Although both groups showed a significant overall increase in implant stability with time (P <.0001) and a high final mean ISQ value, no statistically significant difference in stability was seen between the groups. The bur group showed greater variance in ISQ values than the piezo group did (P <.001) at all time points. Long-term studies with larger samples are needed to investigate the bone response to the use of piezoelectric surgery for implant preparation. [ABSTRACT FROM AUTHOR]

CONCLUSION Independent of implant design and surgical technique, high implant and abutment survival rates were observed for patients implanted with both the 3.75-mm-wide implant and the 4.5-mm-wide implant. Outcomes comprised implant stability, implant survival, soft tissue status, skin height and revision surgery. Prospective 5 year outcomes of different implant designs and surgical techniques in 68 patients with bone anchored hearing implants Keywords: bone conduction; bone-anchored hearing; hearing loss; implant stability quotient; tissue preservation; wide diameter implant EN bone conduction bone-anchored hearing hearing loss implant stability quotient tissue preservation wide diameter implant 65 69 5 12/16/22 20230101 NES 230101 Key Points Both the 4.5-mm-wide implant and the 3.75-mm-wide implant have excellent survival rates at 5-year follow-up. [Extracted from the article]

IntroductionThe aim of this study was to evaluate the influence of different implant morphologies and immediate provisionalization options on the change of implant stability.Methods94 Patients were randomized to receive implants from Straumann® BL/Straumann® BLT/Astra OsseoSpeed® TX, meanwhile having the same opportunity to receive healing abutment or immediate provisionalization. Implant stability quotient (ISQ) and marginal bone loss (MBL) were recorded at following timepoints. Parametric statistic was used for data analysis.ResultsData showed that ISQ and MBL values of conical/straight/straight with micro-thread neck implants had no significant difference.DiscussionImmediate provisionalization options could move the dip point of ISQ values ahead or delayed around one week, which were also relevant to implant systems. MBL values were proved to be unaffected by both two factors mentioned above.

Introduction: Osseointegration is considered a prerequisite for the long-term success of dental implants, and many researchers have considered the stability of the implant when placed in the bone. Many techniques include undersized drilling, densifying burs, magnetic mallets, and expanders. These methods have led to higher initial insertion torque values. The present study aims to evaluate the effectiveness of expanders, densifying burs, and magnetic mallet methods for preparing the implant site in low-density bone and compare them in terms of achieving good initial implant stability., Materials and Methods: The present study was conducted in an ex vivo animal model using bovine rib bones. This study was performed on 20 bovine ribs; each rib had four implant site preparations divided into four groups according to the drilling method: a control group of the conventional technique (n=20), the expanders group (n=20), the densification burs group (n=20), and the magnetic mallet group (n=20). The measured values were Primary Insertion Torque and Implant Stability Quotient (ISQ)., Results: The highest average insertion torque was in the magnetic Mallet group, where the average was 43.75 N/cm 2 , followed by the burs group, where the average was 43.00 N/cm 2 , then the expanders group with an average of 32.80 N/cm 2 , then the conventional preparation group with 19.30 N/cm 2  as the lowest average among the study groups. The highest ISQ mean was in the burs group, where the mean was 80.30, followed by the magnetic Mallet group, where the mean was 80.20, then the expanders group with a mean of 68.90, then the conventional preparation group with 50.10 as the lowest mean among the study groups., Conclusion: Within the limitation of this study, we conclude that all methods used were better than conventional preparation in both ISQ and insertion torque, with the magnetic mallet group outperforming the insertion torque and the Densah burs outperforming the ISQ., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: Damascus University Ethical Committee Issued protocol number DN-290421-245. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sheikh ibrahim et al.)

Dental implants are fixtures that replace a natural tooth that has been missing. The outcome depends on the safety and longevity of the bone-implant relationship. The process of direct and strong anchoring of an implant due to the surrounding bone tissue growing around it is called osseointegration. The establishment of an osseointegrated contact depends on a variety of systemic and local variables and diagnostic methods. Resonance frequency analysis is one of the methods used to analyze implant stability. The surface topography, mainly surface texture and roughness, also helps in promoting a favorable interaction between the implant and biological tissues. This case report aimed to indicate the importance of implant surfaces showing primary and secondary stability and implant stability quotient (ISQ) values that can be analyzed by resonance frequency analysis (RFA) using the Osstell implant device, which can be a useful tool used to determine the risk of failure., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dhalla et al.)

Combining tooth extraction and implant placement reduces the number of surgical procedures that a patient must undergo. Thus, the present study aimed to compare the stability of two types of conical implants (TAC and INTRALOCK) and another cylindrical one (CYROTH), inserted with a range of angulation of 15–20 degrees in low-density polyurethane blocks (10 and 20 pounds per cubic foot, PCF) with or without a cortical lamina (30 PCF), which potentially mimicked the post-extraction in vivo condition. For this purpose, a total of 120 polyurethane sites were prepared (10 for each implant and condition) and the Insertion Torque (IT), Removal Torque (RT), and Resonance Frequency Analysis (RFA) were measured, following a Three-Way analysis of variance followed by Tukey’s post hoc test for the statistical analysis of data. The IT and RT values registered for all implant types were directly proportional to the polyurethane density. The highest IT was registered by INTRALOCK implants in the highest-density block (32.44 ± 3.28 Ncm). In contrast, the highest RFA, a well-known index of Implant Stability Quotient (ISQ), was shown by TAC implants in all clinical situations (up to 63 ISQ in the 20 PCF block without the cortical sheet), especially in lower-density blocks. Although more pre-clinical and clinical studies are required, these results show a better primary stability of TAC conical implants in all tested densities of this post-extraction model, with a higher ISQ, despite their IT.

Background: A novel type of implant (Straumann® BLX implant) has been developed for certain stability from the mechanical and biological aspects and is expected for the implant placement in atrophic maxilla with sinus floor elevation (SFE). Purpose: The aim of this study was to evaluate the primary stability in the implants with different macrodesigns in an SFE simulated model. Primary stabilities defined as maximum insertion torque (MIT) and implant stability quotient (ISQ) were compared between this novel type of implant and other types. Materials and Methods: Five types of Straumann® 10 mm length implants (Standard Plus; SP, Tapered Effect; TE, Bone Level; BL, Bone Level Tapered; BLT and BLX) and two types of Straumann® 6 mm length implants (SP short, BLX short) were used in this study. Each implant was inserted through 5 mm–thick porcine iliac crest blocks (an SFE simulated model). Primary stability was evaluated by using MIT and ISQ. Results: The mean value of MIT for BLX group showed significantly higher values than SP, BL (p < 0.01), and TE (p < 0.05) groups. The mean value of ISQ for BLX group was significantly higher than the other groups (p < 0.01). The mean value of MIT and ISQ for BLX and BLX short group were significantly higher than those for SP and SP short group (p < 0.01). Conclusions: In an SFE simulated ex vivo model, BLX group showed the highest values. These results suggest that implant selection can play a crucial role in the achievement of primary stability during SFE and simultaneous implant placement. [ABSTRACT FROM AUTHOR]

Objectives: Fractal analysis is a mathematical method used for the calculation of bone trabeculation and lacunarity. This study aims to evaluate the relationship between resonance frequency analysis (RFA) and fractal dimension (FD) of peri-implant bone to determine the preload stability of implants. Materials and methods: In this study, the results of the fractal analysis calculated from the resonance frequency analysis results taken in the 3rd month of the patients who underwent 2-stage implant by the same doctor and the radiographs taken in the same session were evaluated. A hundred implants in 20 patients were applied in this study. The implant stability quotient (ISQ) values of the implants and fractal dimension values of the peri-implant bone were calculated. Results: The findings showed that the ISQ1 (p = 0.008), ISQ2 (p = 0.038), ROI2 (p = 0.013), and ROI3 (p < 0.001) values were statistically significantly higher in men than women. The ISQ1 (p = 0.003), ISQ2 (p = 0.013), ROI1 (p = 0.011), and ROI3 (p < 0.001) of the mandible were statistically higher than the maxilla. The fractal dimension cut-off value to assess prosthetic loading was found 1.198. Conclusion: Fractal analysis is a non-invasive method that can be used in conjunction with clinical examination in the prosthetic loading decision of implants. It is a valuable parameter that can be used without the need for an extra device when it is necessary to reduce the clinical study time. Clinical relevance: Calculating the fractal dimension of the peri-implant bone is a practical, economical, and applicable method for clinicians. FD calculated from panoramic radiographs used for diagnosis in routine treatments in clinics where access to the necessary devices for ISQ measurement is not available will contribute to clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the relationship between mandibular bone structure parameters measured on preimplant cone beam computed tomography (CBCT) images and primary implant stability. Materials and Methods: Twenty-one hemimandibles were scanned on the 3D Accuitomo 170 CBCT. Next, an implant was placed in each hemimandible, after which insertion torque and implant stability quotient (ISQ) measurements were acquired. The following measurements were performed on the preimplant CBCT scans: bone surface, bone volume, fractal dimension, connectivity, trabecular thickness and spacing and skeleton analysis. Measurements were performed using various regions of interest in the vicinity of the implant site. In addition, cortical thickness was measured. The correlation between bone structure parameters, insertion torque and ISQ was calculated. Results: The overall correlation was low to medium (R= 0.002-0.723). For the bone around the entire implant site, the highest correlation with ISQ was found for skeleton analysis and trabecular thickness. The highest overall correlation between bone structure and ISQ was found in the coronal region. For insertion torque, no significant correlation was found for the bone around the entire implant; the highest overall correlation was found in the apical region. The highest number of significant correlations between bone structure and primary implant stability were found for trabecular thickness and fractal dimension. Conclusion: While each of the investigated bone structure parameters can have a predictive value in terms of primary implant stability, they should be measured at specific regions surrounding a planned implant site and can provide complementary information regarding the local bone quality. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this in vivo study is to compare the variation in implant stability quotient (ISQ) values of implants using resonance frequency analysis (RFA) to access the immediately loaded (within 24 h) implants at different time intervals using Penguin RFA system. Materials and Methods: Ten Nobel Replace Tapered RP implants were placed in posterior mandible region of patients. Patients were included in the study after fulfilling the inclusion criteria. Prior to enrolling in the study, thorough information about the procedure was provided to the patients, and written consent was obtained for the same. Immediate loading was done within 24 h using tooth-colored self-cure acrylic resin. Penguin RFA System was used to measure the ISQ of dental implants. The ISQ values were recorded immediately after implant placement, after 4 weeks, after 8 weeks, and after 12 weeks. Results: The mean ISQ values of the immediately loaded implants at the time of placement were 82.60, after 4 weeks were 80.60, after 8 weeks were 83.70, and after 12 weeks were 87.10. There was a statistically significant difference between the ISQ values at the time of placement of implants and after 12 weeks. Conclusion: This study concluded that immediate loading in posterior mandible single tooth region is a safe and predictable option.

Background: In this study, we determined the effect of bone density on implant stability. Methodology: Two hundred and sixty dental implant sites in 128 patients were assessed for resonance frequency analysis (RFA) following implant insertion, at 6 months and 12 months. The implant stability quotient (ISQ) was determined. Results: The mean ± standard deviation bone density in anterior mandible was 862.8 ± 203.4 Hounsfield units (HU), in posterior mandible was 528.4 ± 115.6 HU, in anterior maxilla was 594.2 ± 95.2 HU, and in posterior maxilla was 438.1 ± 110.2 HU. The mean insertion torque in successful implants was 38.2 ± 7.1 Ncm and in failed implants was 22.4 ± 4.2 Ncm. The mean RFA value in successful implants was 65.4 ± 5.8 and in failed implants was 45.8 ± 4.1 ISQ. A statistically significant (P < 0.05) difference was obtained. Conclusion: Within the limitation of the study, we observed that successful implants exhibited higher RFA and insertion torque and were higher into failed implants suggesting a correlation of bone quality and implant stability parameters.

Introduction: Diabetes mellitus is a chronic metabolic disorder leading to hyperglycemia and causes various complications due to vasculopathy. Adequate dental rehabilitation including dental implants plays a key role in promoting the eating habits of diabetics and better metabolic control. Aim: We performed a systematic literature review to investigate the effect of diabetes mellitus on the stabilization and osseointegration of dental implants. Methods: PubMed and Scopus were searched until October 2021. Inclusion criteria: (i) study population included diabetics type I or II, (ii) outcomes were the dental implant failure or resonance frequency analysis, (iii) studies that investigate the effect of diabetes mellitus on the stabilization and osseointegration of dental implants, (iv) studies that were published in English, (v) studies that were published in journals with peer review system, (vi) studies including humans and not animals, (vii) studies that compared diabetics with non-diabetics, and (ix) quantitative studies. Results: 29 studies met the inclusion criteria. Regarding implant failure, 4 studies found statistically significant more frequent implant failure in diabetics, while 5 studies found that implant failure was more frequent in diabetics but was not statistically significant. In contrast, 10 studies found that implant failure was more frequent in non-diabetics but was not statistically significant. 7 studies found that all diabetics and non-diabetics retained their implant during the study. In 6 studies that performed the resonance frequency analysis, no statistically significant difference was found between diabetics and non-diabetics. In 3 studies, the mean value of the implant stability quotient increased statistically significant in non-diabetics, while in 3 studies the mean value of the implant stability quotient increased statistically significant in diabetics. Conclusions: Implant failure is not higher for diabetics than for non-diabetics. Diabetics seem to be able to achieve a rate of dental implants survival like that of non-diabetics. With regards to the resonance frequency analysis, no difference is found between diabetics and non-diabetics. [ABSTRACT FROM AUTHOR]

This study aimed to assess the effectiveness of photobiomodulation therapy (PBM) and leukocyte plasma-rich fibrin (L-PRF) in enhancing or accelerating osseointegration by promoting dental implant stability. The study included 15 patients lacking posterior mandibular teeth. Each participant received two implants in the mandibular edentulous area at the lower posterior region. The implants on the right side were categorized into three groups: Group A (650 nm laser), Group B (976 nm laser), and Group C with L-PRF (10 implants each). The left side served as the control. L-PRF was applied at the implant base before placement. Laser irradiation was performed on the buccal and lingual sides of the implants. Osseointegration was assessed using the AnyCheck system from Neo-Biotic Company. The Implant Stability Quotient (ISQ), ranging from 0-100, was measured post-operatively and after three months. There was a significant increase in stability after three months, particularly with 650 nm laser photobiomodulation followed by L-PRF application. The differences in ISQ among the three groups were statistically significant. After three months, implant stability was significantly higher both buccally and lingually in Group A, using powers of 75 mW and 100 mW, respectively, compared to the control ( P <0.01). These findings indicate that PBM and L-PRF can significantly enhance osseointegration and improve dental implant stability in the posterior mandible. Patients and clinicians should consider the potential benefits of these interventions in implant dentistry, especially in cases involving the posterior mandible, where stability is crucial for successful implant outcomes., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s).)

This study aimed to evaluate various biomechanical parameters associated with the primary stability of Maestro and Due Cone implants placed in low-density artificial bones, prepared using high-speed drilling with irrigation and low-speed drilling without irrigation. The insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ) values were recorded for Maestro and Due Cone implants placed in low-density polyurethane blocks (10 and 20 pounds per cubic foot (PCF) with and without a cortical layer) prepared using high-speed and low-speed with or without irrigation using a saline solution, respectively. A three-way ANOVA model and Tukey's post-hoc test were conducted, presenting data as means and standard deviations. P -values equal to or less than 0.05 were considered statistically significant. No statistically significant differences in IT, RT, and ISQ between drilling speeds were observed. However, Maestro implants exhibited lower IT and RT values after high- and low-speed drilling across almost all polyurethane blocks, significantly evident in the 20 PCF density block for IT and in the 20 PCF density block with the cortical layer for the RT with low-speed drilling (IT: 47.33 ± 10.02 Ncm and 16.00 ± 12.49 Ncm for Due Cone and Maestro implants, respectively, with p < 0.01; RT: 44.67 ± 22.81 Ncm and 20.01 ± 4.36 Ncm for Due Cone and Maestro implants, respectively, with p < 0.05) and among the same implant types inserted in different bone densities. Additionally, the study found that for all bone densities and drilling speeds, both implants registered ISQ values exceeding 60, except for the lowest-density polyurethane block. Overall, it can be inferred that low-speed drilling without irrigation achieved biomechanical parameters similar to conventional drilling with both implant types, even with lower IT values in the case of Maestro implants. These findings suggest a promising potential use of low-speed drilling without irrigation in specific clinical scenarios, particularly when focusing on preparation depth or when ensuring proper irrigation is challenging., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

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

Purpose: Concerns have been expressed about the possibility of high insertion torque (IT) causing necrosis, impaired osseointegration, and crestal bone loss over time. The present study investigated the relationship between primary stability and implant success, including early and late maintenance of crestal bone levels. Materials and Methods: Implants were placed in patients at three study centers. Every effort was made to achieve the highest possible primary stability, which was measured with IT and implant stability quotient (ISQ). The IT and ISQ at insertion and reopening (3 to 4 months), as well as bone levels at several points in time, were recorded. The correlations between IT, ISQ, and immediate and 3-year crestal bone loss were investigated through linear regression analyses. Results: Average IT was 76.1 ± 20.8 Ncm, while the average ISQ score was 80.4 ± 8.4. The implant success rate at 36 months was 98.6%. The crestal bone loss around most implants (41.0%) ranged from 0.05 to 0.5 mm. None of the osseointegrated implants had crestal bone loss greater than 2.5 mm. The linear regression analysis showed no correlation among early or 3-year crestal bone loss and IT, ISQ at surgery, and ISQ at reopening. Conclusion: The implants studied avoided any negative effects deriving from the high IT values (> 50 Ncm) applied during 3 years of follow-up. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to examine the success rate and development of implant stability of photofunctionalized implants with low and extremely low primary stability. Materials and Methods: Primary implant stability was evaluated by measuring implant stability quotients (ISQs) at placement (initial ISQ). Of 301 consecutive implants placed over 2 years, 55 implants (in 38 patients) with initial ISQs less than 60 were included. All implants were photofunctionalized by chairside treatment with ultraviolet light for 15 minutes using a photo device immediately prior to placement, and the generation of superhydrophilicity and hemophilicity was confirmed. The rate of implant stability development was evaluated by calculating the osseointegration speed index (OSI), defined as the ISQ increase per month. Results: Most of the 55 implants (90.9%) were in complex cases and placed in site-developmental sites with simultaneous or staged guided bone regeneration and/or sinus elevation or fresh extraction sites. The success rate was 98.2% after 2 to 3 years of follow-up. The ISQ for all implants was 50.4 ± 7.7 at placement and 74.3 ± 5.7 at stage-two surgery (P < .001) after an average of 7.1 months of healing. All ISQ values were greater than 60 at the stage-two surgery. ISQ increases were inversely correlated with initial ISQ (R = 0.789) and resulted in consistently high ISQs at the stage-two surgery regardless of the degree of the initial ISQ. Implants with absent primary stability for which ISQ measurement was not possible at placement also attained ISQs of 75 or greater at the stage-two surgery. The OSIs of low initial stability (55 or lower) implants ranged from 3.9 to 4.7, which was considerably higher than the OSIs of as-received implants reported in the literature (0.36 to 2.8). Conclusion: Photofunctionalized implants placed with low, extremely low, or absent primary stability showed a high success rate, which was corroborated with a rapid increase in implant stability during the healing. Photofunctionalization was more effective for implants with lower primary stability, indicating that the technology was particularly effective in mitigating the challenging conditions. [ABSTRACT FROM AUTHOR]

Background: Primary and secondary implant stability is of high importance for survival and success of dental implants in the short and long term. Measurements of implant stability during healing provide the opportunity to monitor the course of the osseointegration process. Purpose To compare implant stability quotient (ISQ) by resonance frequency analysis (RFA), recorded with two different devices after implant placement. Materials and methods: Patients with the need of single tooth extraction in posterior sites of the maxilla and the mandible were treated in a surgical center. All patients received additional augmentation with a bovine bone substitute and platelet‐rich fibrin (PRF) after atraumatic tooth extraction. After a healing period of 10 weeks, 28 self‐tapping titanium‐implants were placed. Implant stability was recorded with two different devices (Osstell and Penguin) at the time of implant insertion (T0), 10 days later (T1), and after 7 (T2), or 17 weeks (T3). Results: No implant was lost, and no postoperative complication occurred during follow‐up. Patient cohort comprised 9 female (32.1%) and 19 male patients (67.9%), with a mean age of 52.8 years, 64.3 years, respectively. Mean overall insertion torque was 43.6 Ncm at implant placement with no significant difference between implant location, age, or gender. No patient dropped out. During observation period, a significant increase in mean ISQ was recorded with both devices. Significant positive correlations between insertion torque and ISQ were recorded with both devices at T0, T2, and T3. No significant differences were observed in ISQ‐values between both devices, and measuring directions at any point of measurement. Conclusions: Within the limitations of this cohort study, both devices were suitable for RFA‐measurement and revealed comparable results. Due to the cordless design, handling of the Penquin device was more comfortable. Reusability of the Penguin MultiPeg‐transducers may offer an additional benefit with regard on ecological aspects. [ABSTRACT FROM AUTHOR]

Background: Lateral sinus augmentation and simultaneous insertion of dental implants is a highly predictable procedure and associated with high rate of implants success. Aims: To evaluate implant stability changes following maxillary sinus augmentation utilizing deproteinized bovine bone alone or mixed with platelet-rich fibrin. Materials and Methods: A total of 34 lateral sinus augmentation procedures were performed and 50 dental implants simultaneously installed. The lateral sinus augmentation cases were allocated randomly into 3 groups: Group A comprised 13 procedures and 21 dental implants utilizing solely deproteinized bovine bone. Group B involved 10 cases and 16 dental implants using deproteinized bovine bone mixed with leukocyte and platelet-rich fibrin. Group C included 11 operations and 13 dental implants employing deproteinized bovine bone mixed with advanced platelet-rich fibrin. Resonance frequency analysis test was performed immediately after implant installation and 24 weeks postoperatively for the measurement of the implant stability. Results: Implant stability quotient values increased significantly for all study groups 24 weeks after dental implants installation (P= 0.001). The implant stability quotient at T1 (day of implant installation) was 56.93 ±12.01 for group A, 58.34 ±12.82 for group B, and 61.35 ±8.47 for group C. The implant stability quotient at T2 (24 weeks after implant insertion) was 69.17 ±5.10, 69.43 ±5.32, and 68.50 ±7.44, respectively. Conclusion: The addition of leukocyte and platelet-rich fibrin or advanced platelet-rich fibrin to the bovine bone for sinus floor augmentation did not increased the implant stability quotient value in comparison to the bovine bone alone. [ABSTRACT FROM AUTHOR]

Background: In this study, we determined the effect of bone density on implant stability. Methodology: Two hundred and sixty dental implant sites in 128 patients were assessed for resonance frequency analysis (RFA) following implant insertion, at 6 months and 12 months. The implant stability quotient (ISQ) was determined. Results: The mean ± standard deviation bone density in anterior mandible was 862.8 ± 203.4 Hounsfield units (HU), in posterior mandible was 528.4 ± 115.6 HU, in anterior maxilla was 594.2 ± 95.2 HU, and in posterior maxilla was 438.1 ± 110.2 HU. The mean insertion torque in successful implants was 38.2 ± 7.1 Ncm and in failed implants was 22.4 ± 4.2 Ncm. The mean RFA value in successful implants was 65.4 ± 5.8 and in failed implants was 45.8 ± 4.1 ISQ. A statistically significant (P < 0.05) difference was obtained. Conclusion: Within the limitation of the study, we observed that successful implants exhibited higher RFA and insertion torque and were higher into failed implants suggesting a correlation of bone quality and implant stability parameters. [ABSTRACT FROM AUTHOR]

Smile is an important factor which enhances our beauty. A well-formed complete smile is the basis for facial esthetics. To bring out a beautiful smile, a full set of dentition is necessary. The replacement of missing teeth with implant-borne restorations has become the treatment of choice these days. According to recent reports, the successful implant placement in fresh extraction socket is made possible by modifying the surface of implants. The present case report highlights on the high survival rate of immediate implant loading placed successfully in fresh extraction socket which was confirmed by implant stability quotient (resonance frequency analysis) to assess implant stability noninvasively.

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. [ABSTRACT FROM AUTHOR]

Introduction: The high success rate of implants has made implant-based prostheses attractive to edentulous patients. Osseointegration lasts 4-6 months, increasing to 6-8 months in cases requiring bone grafts and guided bone regeneration. Many efforts have been made to accelerate osseointegration, including low level laser (LLL) and light emitting diode (LED) photobiomodulation. Materials and methods: Twelve patients underwent bimaxillary immediate implant surgery with particulate bone grafts between the socket wall and the implant, and the transmucosal abutment was attached on implants at the same time. The intervention side was exposed to LED radiation for 20 minutes a day one day preoperatively and 10 consecutive sessions, starting from the day of surgery. A trained operator measured and recorded the implant stability quotient (ISQ) value on both sides immediately after surgery as well as one month and three months postoperatively. Results: The ISQ value was 37.54 on the non-irradiated side immediately after surgery; it decreased to 35.09 one month postoperatively and increased to 46.45 at three months after the operation. The ISQ value was 36.73 on the irradiated side immediately after surgery and it increased to 47.36 and 71.18 at one month and three months postoperatively, respectively. There were significant differences between the ISQ values on the irradiated side at all the three time intervals, but also a significant difference on the non-irradiated side, except for two other two time intervals of immediately and one month after surgery. Although there was no significant difference between the two sides in terms of the ISQ value immediately after surgery, the ISQ value was significantly higher on the irradiated versus non-irradiated side at one month and three months postoperatively. Conclusion: Low level laser radiation resulted in a favorable increase in the ISQ value in three months. Light emitting diode has lso led to a clinically significant increase in the ISQ value after three months because implants with ISQ values >54 could be loaded. [ABSTRACT FROM AUTHOR]

This in vitro study aimed to investigate the influence of bone density, implant size, and surgical procedure on the primary stability (PS) of orthodontic mini-implants (OMIs). In total, 640 OMIs of various sizes (2.0 × 7, 2.3 × 7, 2.0 × 11 and 2.3 × 11 mm) were inserted in the artificial bone of different densities (D1–D4). Placement was performed with an insertion angle of 90° or 60° to the bone surface and in 320 cases without predrilling, which resulted in 64 groups. PS was measured on the basis of implant stability quotient (ISQ) and insertion torque (IT). With regard to all possible influencing parameters, the mean PS differed between 39.20 and 60.00 (ISQ), and 10.00 and 39.00 Ncm (IT). The effect of OMI size and surgical procedure was dependent on bone quality. For example, implant size had less effect in high-density bone and was stronger with decreasing density. Overall, implant length had a greater influence than the diameter, and a high correlation was found among both PS measurement techniques. Therefore, a suitable choice of implant size and surgical protocol with regard to bone density can positively influence PS. In principle, ISQ and IT are suitable for measuring OMI stability. [ABSTRACT FROM AUTHOR]