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The relationship between dental implant stability and trabecular bone structure using cone-beam computed tomography

  • Kang, Se-Ryong (Department of Biomedical Radiation Sciences, Seoul National University Graduate School of Convergence Science and Technology) ;
  • Bok, Sung-Chul (Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Choi, Soon-Chul (Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Lee, Sam-Sun (Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Heo, Min-Suk (Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Huh, Kyung-Hoe (Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Kim, Tae-Il (Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Yi, Won-Jin (Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry)
  • Received : 2016.01.13
  • Accepted : 2016.03.20
  • Published : 2016.04.30

Abstract

Purpose: The objective of this study was to investigate the relationships between primary implant stability as measured by impact response frequency and the structural parameters of trabecular bone using cone-beam computed tomography(CBCT), excluding the effect of cortical bone thickness. Methods: We measured the impact response of a dental implant placed into swine bone specimens composed of only trabecular bone without the cortical bone layer using an inductive sensor. The peak frequency of the impact response spectrum was determined as an implant stability criterion (SPF). The 3D microstructural parameters were calculated from CT images of the bone specimens obtained using both micro-CT and CBCT. Results: SPF had significant positive correlations with trabecular bone structural parameters (BV/TV, BV, BS, BSD, Tb.Th, Tb.N, FD, and BS/BV) (P<0.01) while SPF demonstrated significant negative correlations with other microstructural parameters (Tb.Sp, Tb.Pf, and SMI) using micro-CT and CBCT (P<0.01). Conclusions: There was an increase in implant stability prediction by combining BV/TV and SMI in the stepwise forward regression analysis. Bone with high volume density and low surface density shows high implant stability. Well-connected thick bone with small marrow spaces also shows high implant stability. The combination of bone density and architectural parameters measured using CBCT can predict the implant stability more accurately than the density alone in clinical diagnoses.

Keywords

References

  1. Javed F, Romanos GE. Impact of diabetes mellitus and glycemic control on the osseointegration of dental implants: a systematic literature review. J Periodontol 2009;80:1719-30. https://doi.org/10.1902/jop.2009.090283
  2. Javed F, Romanos GE. The role of primary stability for successful immediate loading of dental implants. A literature review. J Dent 2010;38:612-20. https://doi.org/10.1016/j.jdent.2010.05.013
  3. Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont 1998;11:491-501.
  4. Sakka S, Coulthard P. Bone quality: a reality for the process of osseointegration. Implant Dent 2009;18:480-5. https://doi.org/10.1097/ID.0b013e3181bb840d
  5. Song YD, Jun SH, Kwon JJ. Correlation between bone quality evaluated by cone-beam computerized tomography and implant primary stability. Int J Oral Maxillofac Implants 2009;24:59-64.
  6. Felsenberg D, Boonen S. The bone quality framework: determinants of bone strength and their interrelationships, and implications for osteoporosis management. Clin Ther 2005;27:1-11. https://doi.org/10.1016/j.clinthera.2004.12.020
  7. Bouxsein ML. Bone quality: where do we go from here? Osteoporos Int 2003;14 Suppl 5:S118-27. https://doi.org/10.1007/s00198-003-1489-x
  8. Friberg B, Sennerby L, Linden B, Grondahl K, Lekholm U. Stability measurements of one-stage Branemark implants during healing in mandibles. A clinical resonance frequency analysis study. Int J Oral Maxillofac Surg 1999;28:266-72. https://doi.org/10.1016/S0901-5027(99)80156-8
  9. van Steenberghe D, Quirynen M, Molly L, Jacobs R. Impact of systemic diseases and medication on osseointegration. Periodontol 2000 2003;33:163-71. https://doi.org/10.1046/j.0906-6713.2003.03313.x
  10. Kaneko T. Pulsed oscillation technique for assessing the mechanical state of the dental implant-bone interface. Biomaterials 1991;12:555-60. https://doi.org/10.1016/0142-9612(91)90050-K
  11. Kaneko T, Nagai Y, Ogino M, Futami T, Ichimura T. Acoustoelectric technique for assessing the mechanical state of the dental implant-bone interface. J Biomed Mater Res 1986;20:169-76. https://doi.org/10.1002/jbm.820200206
  12. Noyes DH, Solt CW. Measurement of mechanical mobility of human incisors with sinusoidal forces. J Biomech 1973;6:439-42. https://doi.org/10.1016/0021-9290(73)90002-X
  13. Turkyilmaz I, McGlumphy EA. Influence of bone density on implant stability parameters and implant success: a retrospective clinical study. BMC Oral Health 2008;8:32. https://doi.org/10.1186/1472-6831-8-32
  14. Isoda K, Ayukawa Y, Tsukiyama Y, Sogo M, Matsushita Y, Koyano K. Relationship between the bone density estimated by cone-beam computed tomography and the primary stability of dental implants. Clin Oral Implants Res 2012;23:832-6. https://doi.org/10.1111/j.1600-0501.2011.02203.x
  15. Roze J, Babu S, Saffarzadeh A, Gayet-Delacroix M, Hoornaert A, Layrolle P. Correlating implant stability to bone structure. Clin Oral Implants Res 2009;20:1140-5. https://doi.org/10.1111/j.1600-0501.2009.01745.x
  16. Hsu JT, Huang HL, Tsai MT, Wu AY, Tu MG, Fuh LJ. Effects of the 3D bone-to-implant contact and bone stiffness on the initial stability of a dental implant: micro-CT and resonance frequency analyses. Int J Oral Maxillofac Surg 2013;42:276-80. https://doi.org/10.1016/j.ijom.2012.07.002
  17. Kabel J, Odgaard A, van Rietbergen B, Huiskes R. Connectivity and the elastic properties of cancellous bone. Bone 1999;24:115-20. https://doi.org/10.1016/S8756-3282(98)00164-1
  18. Pothuaud L, Van Rietbergen B, Mosekilde L, Beuf O, Levitz P, Benhamou CL, et al. Combination of topological parameters and bone volume fraction better predicts the mechanical properties of trabecular bone. J Biomech 2002;35:1091-9. https://doi.org/10.1016/S0021-9290(02)00060-X
  19. Ruegsegger P, Koller B, Muller R. A microtomographic system for the nondestructive evaluation of bone architecture. Calcif Tissue Int 1996;58:24-9. https://doi.org/10.1007/BF02509542
  20. Uchiyama T, Tanizawa T, Muramatsu H, Endo N, Takahashi HE, Hara T. A morphometric comparison of trabecular structure of human ilium between microcomputed tomography and conventional histomorphometry. Calcif Tissue Int 1997;61:493-8. https://doi.org/10.1007/s002239900373
  21. Ho JT, Wu J, Huang HL, Chen MY, Fuh LJ, Hsu JT. Trabecular bone structural parameters evaluated using dental cone-beam computed tomography: cellular synthetic bones. Biomed Eng Online 2013;12:115. https://doi.org/10.1186/1475-925X-12-115
  22. Panmekiate S, Ngonphloy N, Charoenkarn T, Faruangsaeng T, Pauwels R. Comparison of mandibular bone microarchitecture between micro-CT and CBCT images. Dentomaxillofac Radiol 2015;44:20140322. https://doi.org/10.1259/dmfr.20140322
  23. Kim DS, Lee WJ, Choi SC, Lee SS, Heo MS, Huh KH, et al. A new method for the evaluation of dental implant stability using an inductive sensor. Med Eng Phys 2012;34:1247-52. https://doi.org/10.1016/j.medengphy.2011.12.012
  24. Kim DS, Lee WJ, Choi SC, Lee SS, Heo MS, Huh KH, et al. Comparison of dental implant stabilities by impact response and resonance frequencies using artificial bone. Med Eng Phys 2014;36:715-20. https://doi.org/10.1016/j.medengphy.2013.12.004
  25. Greenstein G, Cavallaro J, Romanos G, Tarnow D. Clinical recommendations for avoiding and managing surgical complications associated with implant dentistry: a review. J Periodontol 2008;79:1317-29. https://doi.org/10.1902/jop.2008.070067
  26. Natali AN, Carniel EL, Pavan PG. Investigation of viscoelastoplastic response of bone tissue in oral implants press fit process. J Biomed Mater Res B Appl Biomater 2009;91:868-75.
  27. Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing. Clin Oral Implants Res 2004;15:529-39. https://doi.org/10.1111/j.1600-0501.2004.01042.x
  28. Miyamoto I, Tsuboi Y, Wada E, Suwa H, Iizuka T. Influence of cortical bone thickness and implant length on implant stability at the time of surgery--clinical, prospective, biomechanical, and imaging study. Bone 2005;37:776-80. https://doi.org/10.1016/j.bone.2005.06.019
  29. Johns RB, Jemt T, Heath MR, Hutton JE, McKenna S, McNamara DC, et al. A multicenter study of overdentures supported by Branemark implants. Int J Oral Maxillofac Implants 1992;7:513-22.
  30. Saadoun AP, LeGall ML. Clinical results and guidelines on Steri-Oss endosseous implants. Int J Periodontics Restorative Dent 1992;12:486-95.
  31. Atsumi M, Park SH, Wang HL. Methods used to assess implant stability: current status. Int J Oral Maxillofac Implants 2007;22:743-54.
  32. Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res 2007;18:275-80. https://doi.org/10.1111/j.1600-0501.2007.01336.x
  33. Ito Y, Sato D, Yoneda S, Ito D, Kondo H, Kasugai S. Relevance of resonance frequency analysis to evaluate dental implant stability: simulation and histomorphometrical animal experiments. Clin Oral Implants Res 2008;19:9-14.
  34. Nkenke E, Hahn M, Weinzierl K, Radespiel-Troger M, Neukam FW, Engelke K. Implant stability and histomorphometry: a correlation study in human cadavers using stepped cylinder implants. Clin Oral Implants Res 2003;14:601-9. https://doi.org/10.1034/j.1600-0501.2003.00937.x
  35. de Oliveira RC, Leles CR, Lindh C, Ribeiro-Rotta RF. Bone tissue microarchitectural characteristics at dental implant sites. Part 1: identification of clinical-related parameters. Clin Oral Implants Res 2012;23:981-6. https://doi.org/10.1111/j.1600-0501.2011.02243.x
  36. Ab-Lazid R, Perilli E, Ryan MK, Costi JJ, Reynolds KJ. Pullout strength of cancellous screws in human femoral heads depends on applied insertion torque, trabecular bone microarchitecture and areal bone mineral density. J Mech Behav Biomed Mater 2014;40:354-61. https://doi.org/10.1016/j.jmbbm.2014.09.009
  37. Ab-Lazid R, Perilli E, Ryan MK, Costi JJ, Reynolds KJ. Does cancellous screw insertion torque depend on bone mineral density and/or microarchitecture? J Biomech 2014;47:347-53. https://doi.org/10.1016/j.jbiomech.2013.11.030
  38. Baum T, Carballido-Gamio J, Huber MB, Muller D, Monetti R, Rath C, et al. Automated 3D trabecular bone structure analysis of the proximal femur--prediction of biomechanical strength by CT and DXA. Osteoporos Int 2010;21:1553-64. https://doi.org/10.1007/s00198-009-1090-z
  39. Huh KH, Yi WJ, Jeon IS, Heo MS, Lee SS, Choi SC, et al. Relationship between two-dimensional and three-dimensional bone architecture in predicting the mechanical strength of the pig mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:363-73. https://doi.org/10.1016/j.tripleo.2005.06.024
  40. Syahrom A, Abdul Kadir MR, Abdullah J, Ochsner A. Mechanical and microarchitectural analyses of cancellous bone through experiment and computer simulation. Med Biol Eng Comput 2011;49:1393-403. https://doi.org/10.1007/s11517-011-0833-0

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