Assessment of Factors that Affect Primary Stability of Minimally Invasive Implant (MII): An in vitro Study

김용완,민승기,왕제원,신경수 대한구강악안면임플란트학회 2022 대한구강악안면임프란트학회지 Vol.26 No.1

Purpose: This study aimed to evaluate the factors affecting the primary stability of a new implant design based on minimally invasive implantation (MAGICORE®; INNOBIOSURG Co. Ltd., Daejeon, Korea) using the evaluation index of Periotest value (PTV), implant stability quotient (ISQ), and implant stability test (IST). Materials and Methods: A total of 1056 implants were implanted in artificial bone, imitating human bones D1, D2, D3, and D4. The PTV, ISQ, and IST values of all implants were measured according to the manufacturer’s guidelines for each measuring instrument. To compare the factors affecting the stability of the implant for each measurement method, one-way ANOVA was performed, and posthoc analysis was performed using the Games–Howel test (p < .05). In addition, a stepwise multiple linear regression analysis was performed to evaluate the weight of each factor. Results: Implants with diameters greater than 5.0 mm showed significantly lower PTV values and higher ISQ and IST values. Implants with 11 mm length showed the lowest PTV and highest ISQ and IST values. A cuff size of 2 mm showed the highest implant stability among all the measurement methods. In this study, poor bone quality decreased the primary stability. Conclusion: As the cuff size increased, the stability decreased, and the larger the diameter of the implant, the longer the length and higher the primary stability. The bone quality and diameter of the implant contributed more to the stability of the implant than to the length of the implant and cuff size.

임플랜트 고정체의 형태가 임플랜트 초기안정성에 미치는 영향

오갑용,박성화,김석규,Oh, Gap-Yong,Park, Sung-Hwa,Kim, Seok-Gyu 대한치과보철학회 2007 대한치과보철학회지 Vol.45 No.1

Statement of problem: Current tendencies of the implant macrodesign are tapered shapes for improved primary stability, but there are lack of studies regarding the relationship between the implant macrodesign and primary stability. Purpose: The purpose is to investigate the effect of implant macrodesign on the implant primary stability by way of resonance frequency analysis in the bovine rib bones with different kinds of quality. Material and method: Fifty implants of 6 different kinds from two Korean implant systems were used for the test. Bovine rib bones were cut into one hundred pieces with the length of 5 cm. Among them forty pieces of rib bones with similar qualities were again selected. For the experimental group 1, the thickness of cortical part was measured and 20 pieces of rib bones with the mean thickness of 1.0mm were selected for implant placement. For the experimental group 2, the cortical parts of the remaining 20 pieces of rib bones were totally removed and then implants were placed on the pure cancellous bone according to the surgical manual. After placement of all implants, the implant stability quotient(ISQ) was measured by three times, and its statistical analysis was done. Results: There are statistically significant differences in ISQ values among 4 different kinds of Avana system implants in the experimental group 2. For the experimental group 1, Avana system implants showed significantly different ISQ values, but when differences in the thickness of cortical parts were statistically considered, did not show any significant differences in ISQ values. Among Oneplant system implants, there are no significant differences in ISQ values for the experimental group 2 as well as for the experimental group 1. Conclusion: Within the limits of this study, bone quality and implant design have some influences on the primary stability of implants. Especially in the bone of poor quality, tapered shape of implants are more favorable for the primary stability of implants.

The evaluation of implant stability measured by resonance frequency analysis in different bone types

Naser Sargolzaie,Sarah Samizade,Hamidreza Arab,Habibollah Ghanbari,Leila Khodadadifard,Amin Khajavi 대한구강악안면외과학회 2019 대한구강악안면외과학회지 Vol.45 No.1

Objectives: Bone density seems to be an important factor affecting implant stability. The relationship between bone density and primary and secondary stability remains under debate. The aim of this study was to compare primary and secondary stability measured by resonance frequency analysis (RFA) between different bone types and to compare implant stability at different time points during 3 months of follow-up. Materials and Methods: Our study included 65 implants (BioHorizons Implant Systems) with 3.8 or 4.6 mm diameter and 9 or 10.5 mm length in 59 patients. Bone quality was assessed by Lekholm–Zarb classification. After implant insertion, stability was measured by an Osstell device using RFA at three follow-up visits (immediately, 1 month, and 3 months after implant insertion). ANOVA test was used to compare primary and secondary stability between different bone types and between the three time points for each density type. Results: There were 9 patients in type I, 18 patients in type II, 20 patients in type III, and 12 patients in type IV. Three implants failed, 1 in type I and 2 in type IV. Stability values decreased in the first month but increased during the following two months in all bone types. Statistical analysis showed no significant difference between RFA values of different bone types at each follow-up or between stability values of each bone type at different time points. Conclusion: According to our results, implant stability was not affected by bone density. It is difficult to reach a certain conclusion about the effect of bone density on implant stability as stability is affected by numerous factors.

Comparion of stability in titanium implants with different surface topographies in dogs

Nam-Sook Kim,Mong-Sook Vang,Hong-So Yang,Sang-Won Park,Ha-Ok Park,Hyun-Pil Lim 대한치과보철학회 2009 The Journal of Advanced Prosthodontics Vol.1 No.1

STATEMENT OF PROBLEM. A few of studies which compared and continuously measured the stability of various surface treated implants in the same individual had been performed. PURPOSE. We aim to find the clinical significance of surface treatments by observing the differences in the stabilization stages of implant stability. MATERIAL AND METHODS. Eight different surface topographies of dental implants were especially designed for the present study. Machined surface implants were used as a control group. 4 nano-treated surface implants (20 nm TiO2 coating surface, heat-treated 80 nm TiO2 coating surface, CaP coating surface, heat treated CaP coating surface) and 3 micro-treated surface implants [resorbable blast media (RBM) surface, sandblast and acid-etched (SAE) surface, anodized RBM surface] were used as experiment groups. All 24 implants were placed in 3 adult dogs. Periotest® & ISQ values measured for 8 weeks and all animals were sacrificed at 8 weeks after surgery. Then the histological analyses were done. RESULTS. In PTV, all implants were stabilized except 1 failed implants. In ISQ values, The lowest stability was observed at different times for each individual. The ISQ values were showed increased tendency after 5 weeks in every groups. After 4 to 5 weeks, the values were stabilized. There was no statistical correlation between the ISQ values and PTV. In the histological findings, the bone formation was observed to be adequate in general and no differences among the 8 surface treated implants. CONCLUSIONS. In this study, the difference in the stability of the implants was determined not by the differences in the surface treatment but by the individual specificity.

The rate and stability of mandibular block bone graft in recent 5 years

Park, Jong-Cheol,Kim, Yun-Ho,Choi, Hong-Seok,Oh, Jong-Shik,Shin, Sang-Hun,Kim, Yong-Deok Korean Association of Maxillofacial Plastic and Re 2017 Maxillofacial Plastic Reconstructive Surgery Vol.39 No.-

Background: The purposes of the present study were to compare implant stabilities of mandibular block bone graft and bovine bone graft and to evaluate influencing factors for implant stability in mandibular block bone (MBB) graft. Methods: This retrospective study investigated 1224 cases and 389 patients treated by one surgeon in the Department of Oral and Maxillofacial Surgery of Pusan National University Dental Hospital (Yangsan, Korea) between January 2010 and December 2014. Proportions that MBB graft cases constitute in all implant restoration cases and in all bone graft cases were measured. Implant stability quotient (ISQ) values were achieved by the same surgeon before loading. The average ISQ values of the experimental groups were compared. In addition, ISQ values of influencing factors, such as age, sex, implant size, and implant placement site, were compared within the MBB group using $Osstell^{TM}$ Mentor ($Osstell^{(R)}$, $G{\ddot{o}}teborg$, Sweden). Paired t test and ANOVA were conducted for statistical analysis with a significance level of 0.05. Results: Fifty-five percent of all implant restoration cases performed bone graft while MBB cases constituted 34% of all implant restoration cases and 61% of all bone graft cases. Comparing ISQ values according to bone graft materials, the MBB group manifested sufficient implant stability by presenting comparable ISQ value to that of the experimental group without bone graft. Among the reviewed factors, females, mandibular molar regions, and implants in larger diameter displayed greater implant stabilities. Conclusions: Satisfactory implant stability was accomplished upon administration of MBB graft. Within the limitation of this study, gender, implant site, and implant diameter were speculated to influence on implant stability in MBB graft.

Root guided implants - a novel approach for the precision placement of immediate implants: A case series

Pramod Kumar(Pramod Kumar ),Prasanth T(Prasanth T ),Satisha TS(Satisha TS ),Nitin Gupta(Nitin Gupta ),Sumita Manandhar(Sumita Manandhar ) 대한치과이식임플란트학회 2022 The Korean Academy of Implant Dentistry Vol.41 No.3

Immediate implant placement is the current modality to provide implant placement following tooth extraction. Immediate implants in posterior multirooted teeth pose challenges in terms of proper angulation and parallelism. Engaging the inter-radicular septal bone provides the advantage of primary stability. Osteotomy site preparation through the septal bone with roots of the natural teeth as a guide provides a precise osteotomy procedure with minimal collateral damage to the adjacent area. This case series aimed to assess the success of immediate implant placement in posterior multirooted teeth using the residual roots as anatomical guides. Three cases of grossly decayed posterior teeth were treated with immediate implant placement. The osteotomy site was prepared using the roots as surgical guides. Implant stability was assessed by resonance frequency analysis (RFA) immediately after placement and 6 months post-op. Healing was uneventful in all cases. Optimal implant stability quotient (ISQ) values of above 70 were achieved, which are suggestive of good primary stability. The desired angulation and parallelism were obtained by utilizing the residual roots as anatomical guides. Six months post-surgically, the patient presented with healthy peri-implant tissue and successful osseointegration. Root-guided implant placement is a novel technique wherein residual roots provide a surgical guide for the placement of immediate implants in multirooted posterior teeth.

The effect of undersizing and tapping on bone to implant contact and implant primary stability: A histomorphometric study on bovine ribs

Danilo Alessio Di Stefano,Vittoria Perrotti,Gian Battista Greco,Claudia Cappucci,Paolo Arosio,Adriano Piattelli,Giovanna Iezzi 대한치과보철학회 2018 The Journal of Advanced Prosthodontics Vol.10 No.3

PURPOSE. Implant site preparation may be adjusted to achieve the maximum possible primary stability. The aim of this investigation was to study the relation among bone-to-implant contact at insertion, bone density, and implant primary stability intra-operatively measured by a torque-measuring implant motor, when implant sites were undersized or tapped. MATERIALS AND METHODS. Undersized (n=14), standard (n=13), and tapped (n=13) implant sites were prepared on 9 segments of bovine ribs. After measuring bone density using the implant motor, 40 implants were placed, and their primary stability assessed by measuring the integral of the torque-depth insertion curve. Bovine ribs were then processed histologically, the bone-toimplant contact measured and statistically correlated to bone density and the integral. RESULTS. Bone-toimplant contact and the integral of the torque-depth curve were significantly greater for undersized sites than tapped sites. Moreover, a correlation between bone to implant contact, the integral and bone density was found under all preparation conditions. The slope of the bone-to-implant/density and integral/density lines was significantly greater for undersized sites, while those corresponding to standard prepared and tapped sites did not differ significantly. CONCLUSION. The integral of the torque-depth curve provided reliable information about bone-to-implant contact and primary implant stability even in tapped or undersized sites. The linear relations found among the parameters suggests a connection between extent and modality of undersizing and the corresponding increase of the integral and, consequently, of primary stability. These results might help the physician determine the extent of undersizing needed to achieve the proper implant primary stability, according to the planned loading protocol.

Evaluation of Dental Implant Stability with or without Photoactivated Surface Treatment

허유리,강재석,손미경 대한구강악안면임플란트학회 2021 대한구강악안면임프란트학회지 Vol.25 No.2

Purpose: This study aimed to evaluate the stability of two implant groups treated either only with sandblasting and acid etching or photoactivation after sandblasting and acid etching, using resonance frequency analysis (RFA). Materials and Methods: We investigated 50 implants in 25 patients (12 men and 13 women). Twenty-five implants were treated with sandblasting and acid etching, and 25 with photoactivation. We recorded the implant stability quotient (ISQ) value on the day of implant placement and consecutively every 2 weeks for 16 weeks for each implant. RFA was used for the direct measurement of implant stability. We compared mean ISQ values using a repeated-measures analysis of variance test. Results: The mean ISQ values at surgery and 16 weeks in implants treated only with sandblasting and acid etching were 77.8 ± 6.7 and 83.2 ± 2.5, respectively, while in those treated with further photoactivation were 78.9 ± 5.3 and 84.1 ± 3.3, respectively. The photoactivated implants showed higher ISQ values than those without photoactivated surface treatment. However, there were no significant differences between the two implant groups. Conclusion: Both implant groups showed high implant stability in clinical practice. The photoactivated implant surface appears to have higher implant stability than that without photoactivation by increasing the hydrophilic surface.

Resonance frequency measurements <i>in vivo</i> and related surface properties of magnesium-incorporated, micropatterned and magnesium-incorporated TiUnite^®, Osseotite^®, SLA^® and TiOblast^® implants

Sul, Young-Taeg,Jö,nsson, Jö,rgen,Yoon, Goui-Seong,Johansson, Carina Blackwell Publishing Ltd 2009 Clinical oral implants research Vol.20 No.10

<P>Abstract</P><P>Objective</P><P>To investigate implant stability using resonance frequency measurements of topographically changed and/or surface chemistry-modified implants in rabbit bone.</P><P>Material and methods</P><P>Six groups of microstructured, screw-shaped titanium implants: two oxidized, cation-incorporated experimental implants [Mg implants and MgMp implants with micropatterned thread flanges (80–150 μm wide and 60–70 μm deep)] and four commercially available clinical implants (TiUnite<SUP>®</SUP>, Osseotite<SUP>®</SUP>, SLA<SUP>®</SUP>, and TiOblast<SUP>®</SUP>) were installed in 10 rabbit tibia for 6 weeks. The surface properties of the implants were characterized in detail using several analytical techniques. Implant stability was measured using a resonance frequency analyzer (Osstell<SUP>™</SUP>).</P><P>Results</P><P>Surface characterization of the implants revealed microstructured, moderately rough implant surfaces varying 0.7–1.4 μm in <I>S</I><SUB>a</SUB> (mean height deviation), but with clear differences in surface chemistry. After 6 weeks, all implants showed statistically significantly higher increases in implant stability. When compared with one another, MgMp implants showed the most significant mean implant stability quotient (ISQ) value relative to the others (<I>P</I>≤0.016). In terms of increment (ΔISQ) in implant stability, MgMp implants showed a significantly greater value as compared with Osseotite<SUP>®</SUP> (<I>P</I>≤0.005), TiOblast<SUP>®</SUP> (<I>P</I>≤0.005), TiUnite<SUP>®</SUP> (<I>P</I>≤0.005), SLA<SUP>®</SUP> (<I>P</I>≤0.007), and Mg implants (<I>P</I>≤0.012). In addition, transducer direction dependence of resonance frequency analysis (RFA) measurements was observed such that the differences in the mean ISQ values between longitudinal and perpendicular measurements were significant at implant placement (<I>P</I>≤0.004) and after 6 weeks (<I>P</I>≤0).</P><P>Conclusion</P><P>The present study found that implant surface properties influence RFA measurements of implant stability. Surface chemistry-modified titanium implants showed higher mean ISQ values than did topographically changed implants. In particular, cation (magnesium)-incorporated micropatterns in MgMp implants may play a primary role in ΔISQ.</P>

A comparative study on the initial stability of different implants placed above the bone level using resonance frequency analysis

In-Ho Kang,Chang-Whe Kim,Young-Jun Lim,Myung-Joo Kim 대한치과보철학회 2011 The Journal of Advanced Prosthodontics Vol.3 No.4

PURPOSE This study evaluated the initial stability of different implants placed above the bone level in different types of bone. MATERIALS AND METHODS As described by Lekholm and Zarb, cortical layers of bovine bone specimens were trimmed to a thickness of 2 mm, 1 mm or totally removed to reproduce bone types II, III, and IV respectively. Three Implant system (Brånemark System® Mk III TiUnite™, Straumann Standard Implant SLA®, and Astra Tech Microthread™-OsseoSpeed™) were tested. Control group implants were placed in level with the bone, while test group implants were placed 1, 2, 3, and 4 mm above the bone level. Initial stability was evaluated by resonance frequency analysis. Data was statistically analyzed by one-way analysis of variance in confidence level of 95%. The effective implant length and the Implant Stability Quotient (ISQ) were compared using simple linear regression analysis. RESULTS In the control group, there was a significant difference in the ISQ values of the 3 implants in bone types III and IV (P<.05). The ISQ values of each implant decreased with increased effective implant length in all types of bone. In type II bone, the decrease in ISQ value per 1-mm increase in effective implant length of the Brånemark and Astra implants was less than that of the Straumann implant. In bone types III and IV, this value in the Astra implant was less than that in the other 2 implants. CONCLUSION The initial stability was much affected by the implant design in bone types III, IV and the implant design such as the short pitch interval was beneficial to the initial stability of implants placed above the bone level.