• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.644-652
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• 2007

Statement of problem: Resonance frequency analysis is evaluated as the non-invasive and objective method for the evaluation of implant stability and has been increasingly used. It is necessary to evaluate the factors affect the ISQ measurement stability. Purpose: This study was performed to evaluate the effect of the autoclave sterilization and reuse of $Smartpeg^{TM}$ on ISQ measurement. Material and methods: $SmartPeg^{TM}$ (Integration Diagnostics Ltd., $G\ddot{o}teborg$, Sweden) of autoclave group (A) was autoclave sterilized 9 times and $Smartpeg^{TM}$ of reuse group (R) was reused 9 times. Ten $SmartPeg^{TM}s$ were allocated to each group and after each autoclave sterilization and reuse, implant stability quotient (ISQ) values were measured 3 times from the two directions a and b at a right angle. $Osstell^{TM}$ mentor (Integration Diagnostics Ltd. $G\ddot{o}teborg$, Sweden) was used and type 1 (article no. 100353) $Smartpeg^{TM}$ was selected according to $Smartpeg^{TM}$ reference list. Osstem Implant US II future (Osstem Co., Seoul, Korea) in $4.0mm{\times}11.5mm$ was embedded in the self-curing acrylic resin ($Orthojet^{(R)}$, Lang Dental, U.S.A.). Data was statistically analyzed by one-way ANOVA $({\alpha}=.05)$ and scheffe test was done where a significant difference exist. Correlation test was also done between ISQ value and the number of autoclave sterilization or reuse. Results: 1. In autoclave group, the means and sd. of ISQ value before autoclave sterilization were $84.97{\pm}0.41,\;84.93{\pm}0.74$ at direction a and b. There was significant differences between autoclave groups at direction a and b (P=.000). 2. In reuse group, the means and sd. of ISQ value before reuse were $85.40{\pm}0.62,\;85.50{\pm}0.57$ at direction a and b. There was no significant difference between reuse groups at direction a and b (P>.05). 3. There was a weak positive correlation between the number of reuse and ISQ value at direction a and b (${\gamma}=.207$ and .246, P<.01). Conclusion: Within the limitations of this study, the following conclusions were drawn. Till ninth reuse of $Smartpeg^{TM}$, the ISQ measurement stability did not be affected. After twice autoclave sterilization of $Smartpeg^{TM}$ the ISQ measurement stability was affected.

• The Journal of the Korean dental association
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• v.54 no.7
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• pp.529-540
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• 2016

Objective: The objective of this study was to evaluate the osseointegration of narrow-diameter implant with trapezoid-shape and to evaluate the effect of coronal microthreads on trapezoid-shape narrow-diameter implant. Materials and Methods: The experimental narrow-diameter implants were classified into two groups according to absence or presence of coronal microthreads: trapezoid-shape narrow diameter implant (TN group) and trapezoid-shape narrow-diameter implant with microthreads (TNM group). They were installed alternately in bilateral mandible in three dogs. After 8 weeks, the animals were sacrificed. Resonance frequency analysis, removal torque test, and histometric analysis were performed. Results: Statistically higher implant stability quotient (ISQ) values were observed in TNM group than in TN group at the time of implant installation. However, significant ISQ values difference was not observed between groups at 8 weeks. Both groups showed significantly increased ISQ values at 8 weeks, compared to the time of implant installation. There was no significant difference between groups in removal torque test. Bone-implant contact ratio also showed no significant difference between groups in total and coronal part. Conclusion: Within the limitation of this study, it could be concluded that the trapezoid-shape design on narrow-diameter implant showed successful ossointegration, and the microthreads on coronal part did not result in significant bone-implant contact and biomechanical stability at 8 weeks.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.3
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• pp.325-332
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• 2006

Statement of problem. Primary implant stability has long been identified as a prerequisite to achieve osseointegration. So the application of a simple, clinically applicable noninvasive test to assess implant stability and osseiointegratation are considered highly desirable. Purpose. The purpose of this study was to evaluate the ISQ value and the insertion torque of the 3 different implant system, then to evaluate whether there was a correlation between ISQ value and insertion torque; and to determine whether implant design has an influence on either insertion torque or ISQ value. Material and method. The experiment was composed of 3 groups: depending on the implant fixture design. Group1 was Branemark type parallel implant in $3.75{\times}7mm$. Group2 was Oneplant type straight implant in $4.3{\times}8.5mm$. Group3 was Oneplant type tapered implant in $4.3{\times}8.5mm$. Depending on the density of the bone, 2 types of bone were used in this experiment. Type I bone represented for cortical bone, type II bone represented for cancellous bone. With the insertion of the implant in type I and type II bone, the insertion torque was measured, then the ISQ value was evaluated, and then the correlation between insertion torque and ISQ value was analyzed Result and conclusion. Within the limitations of this study, the following conclusions were drawn. 1. Within the 3 different implants, the insertion torque value and ISQ value were higher in type I bone, when compared with type II bone.(p<0.05) 2. In type I and type II bone, Oneplant type tapered implant has the highest value in insertion torque.(p<0.05) 3. In type I and type II bone, there was no difference in ISQ values among the 3 types of implant. (p>0.05) 4. Significant linear correlation was found in $Br{\aa}nemark$ type parallel implant: $3.75{\times}7mm$ in type II bone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.417-422
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• 2010

Introduction: Bone density is one of the important factors for the long term success of endosseous implants. The bone density varies from site to site and from patient to patient. A preoperative evaluation of the bone density is quite useful to oral surgeons for planning dental implantation. More accurate information on the bone density will help surgeons identify suitable implant sites, thereby increase the success rate of dental implantation. This study examined the correlation between the bone density measured preoperatively by computed tomography (CT) and the implant primary stability measured by resonance frequency analysis. Furthermore, the effects of the implant sites, gender, age and generalized systemic disorder patients on the bone density and primary implant stability were examined. Materials and Methods: One hundred and fourteen patients were selected. None of the patients had undergone a tooth extraction or bone graft history in the previous year. Preoperatively, the patients underwent CT scanning to evaluate the Hounsfield unit (HU), and resonance frequency analysis (RFA) was used to evaluate the implant primary stability at the time of implant installation. All implants were 4.0 mm diameter and 11.5 mm length US II. All patients were recorded and the HU and implant stability quotient (ISQ) value were evaluated according to the sites, gender and age. Results: The highest HU values were found in the mandibular anterior site ($827.6{\pm}151.4$), followed by the mandibular molar site ($797{\pm}135.1$), mandibular premolar site ($753.8{\pm}171.2$), maxillary anterior site ($726.3{\pm}154.4$), maxillary premolar site ($656.7{\pm}173.8$) and maxillary molar site ($621.5{\pm}164.9$). The ISQ value was the highest in the mandibular premolar site ($81.5{\pm}2.4$) followed by the mandibular molar site ($80.0{\pm}5.7$), maxillary anterior site ($77.4{\pm}4.1$), mandibular anterior site ($76.4{\pm}11.9$), maxillary premolar site ($74.2{\pm}14.3$) and maxillary molar site ($73.7{\pm}7.4$). The mean HU and ISQ value were similar in females and males. (HU: P=0.331, ISQ: P=0.595) No significant difference was also found in the age group respectively. However, the correlation coefficients between the variables showed a closed correlation between the HU and ISQ value. Conclusion: These results showed close correlation between the bone density (HU) and primary stability value (ISQ) at the time of implant installation (Correlation coefficients=0.497, P<0.01). These results strengthen the hypothesis that it might be possible to predict and quantify the initial implant stability and bone density from a presurgical CT diagnosis.

• The Journal of Advanced Prosthodontics
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• v.1 no.1
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• pp.47-55
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• 2009

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 $TiO_2$ coating surface, heat-treated 80 nm $TiO_2$ 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. $Periotest^{(R)}$ & 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.

• Journal of Periodontal and Implant Science
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• v.45 no.1
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• pp.30-35
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• 2015

Purpose: Implant beds with an insufficient amount of cortical bone or a loss of cortical bone can result in the initial instability of a dental implant. Thus, the objective of this study was to evaluate the effect of bone cement grafting on implant initial stability in areas with insufficient cortical bone. Methods: Two different circumferential defect depths (2.5 mm and 5 mm) and a control (no defect) were prepared in six bovine rib bones. Fourteen implants of the same type and size ($4mm{\pm}10mm$) were placed in each group. The thickness of the cortical bone was measured for each defect. After the implant stability quotient (ISQ) values were measured three times in four different directions, bone cement was grafted to increase the primary stability of the otherwise unstable implant. After grafting, the ISQ values were measured again. Results: As defect depth increased, the ISQ value decreased. In the controls, the ISQ value was $85.45{\pm}3.36$ ($mean{\pm}standard$ deviation). In circumferential 2.5-mm and 5-mm defect groups, the ISQ values were $69.42{\pm}7.06$ and $57.43{\pm}6.87$, respectively, before grafting. These three values were significantly different (P<0.001). After grafting the bone cement, the ISQ values significantly increased to $73.72{\pm}8.00$ and $67.88{\pm}10.09$ in the 2.5-mm and 5.0-mm defect groups, respectively (P<0.05 and P<0.001). The ISQ value increased to more than double that before grafting in the circumferential 5-mm defect group. The ISQ values did not significantly differ when measured in any of the four directions. Conclusions: The use of bone cement remarkably increased the stability of the implant that otherwise had an insufficient level of stability at placement, which was caused by insufficient cortical bone volume.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.25-39
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• 2011

In animal studies, Magnesium (Mg) - incorporated oxidized implants showed significant enhancement of the bone response. This prospective clinical trial was performed to investigate the success rate, implant stability and marginal bone loss of Mg oxidized clinical implant. The experimental protocol was approved by Institutional Review Board of the Gangneung-Wonju National University Dental Hospital. Fifty healthy patients had partial edentulism were included in this study. Mg oxidized clinical implants (Implant M, Shinhung, Korea) were installed and restored with conventional protocol. The patients were recalled at 1, 3, 6 months after functional loading. Implant stability quotient (ISQ) was measured and periapical radiographic images were obtained. Amount of marginal bone loss was calculated with calibrated images from periapical radiographs. Repeated measured analysis of variance and post hoc Tukey test were used to compare the mean ISQ and bone level. A total of 101 implants were analyzed. The mean ISQ values increased continuously with time lapse from 68.4 at fixture installation to 71.5 at 6 months after loading. Implant stability was correlated with gender, fixture diameter, bone quality and implant sites. The mean marginal bone loss during 6 months after loading was 0.26 mm. There was no failed implant and six-month success rate was 100%. Within the limitations of this study, the six-month success rate of Mg oxidized implant was satisfactory. The implant stability and marginal bone level were excellent. However, further longer clinical studies will be needed to confirm the success of Mg oxidized clinical implant.

• The Journal of Advanced Prosthodontics
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• v.1 no.2
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• pp.107-112
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• 2009

STATEMENT OF PROBLEM. Macroscopic and especially microscopic properties of implant surfaces play a major role in the osseous healing of dental implants. Dental implants with modified surfaces have shown stronger osseointegration than implants which are only turned (machined). Advanced surface modification techniques such as anodic oxidation and Ca-P application have been developed to achieve faster and stronger bonding between the host bone and the implant. PURPOSE. The purpose of this study was to investigate the effect of surface treatment of titanium dental implant on implant stability after insertion using the rabbit tibia model. MATERIAL AND METHODS. Three test groups were prepared: sandblasted, large-grit and acid-etched (SLA) implants, anodic oxidized implants, and anodized implants with Ca-P immersion. The turned implants served as control. Twenty rabbits received 80 implants in the tibia. Resonance frequencies were measured at the time of implant insertion, 2 weeks and 4 weeks of healing. Removal torque values (RTV) were measured 2 and 4 weeks after insertion. RESULTS. The implant stability quotient (ISQ) values of implants for resonance frequency analysis (RFA) increased significantly (P <. 05) during 2 weeks of healing period although there were no significant differences among the test and control groups (P >. 05). The test and control implants also showed significantly higher ISQ values during 4 weeks of healing period (P < .05). No significant differences, however, were found among all the groups. All the groups showed no significant differences in ISQ values between 2 and 4 weeks after implant insertion (P >. 05). The SLA, anodized and Ca-P immersed implants showed higher RTVs at 2 and 4 weeks of healing than the machined one (P < .05). However, there was no significant difference among the experimental groups. CONCLUSION. The surface-modified implants appear to provide superior implant stability to the turned one. Under the limitation of this study, however, we suggest that neither anodic oxidation nor Ca-P immersion techniques have any advantage over the conventional SLA technique with respect to implant stability.

• Journal of Periodontal and Implant Science
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• v.43 no.1
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• pp.30-36
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• 2013

Purpose: Implant stability at the time of surgery is crucial for the long-term success of dental implants. Primary stability is considered of paramount importance to achieve osseointegration. The purpose of the present study was to investigate the correlation between the insertion torque and primary stability of dental implants using artificial bone blocks with different bone densities and compositions to mimic different circumstances that are encountered in routine daily clinical settings. Methods: In order to validate the objectives, various sized holes were made in bone blocks with different bone densities (#10, #20, #30, #40, and #50) using a surgical drill and insertion torque together with implant stability quotient (ISQ) values that were measured using the Osstell Mentor. The experimental groups under evaluation were subdivided into 5 subgroups according to the circumstances. Results: In group 1, the mean insertion torque and ISQ values increased as the density of the bone blocks increased. For group 2, the mean insertion torque values decreased as the final drill size expanded, but this was not the case for the ISQ values. The mean insertion torque values in group 3 increased with the thickness of the cortical bone, and the same was true for the ISQ values. For group 4, the mean insertion torque values increased as the cancellous bone density increased, but the correlation with the ISQ values was weak. Finally, in group 5, the mean insertion torque decreased as the final drill size increased, but the correlation with the ISQ value was weak. Conclusions: Within the limitations of the study, it was concluded that primary stability does not simply depend on the insertion torque, but also on the bone quality.

• The Journal of the Korean dental association
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• v.50 no.1
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• pp.31-37
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• 2012

Objective : This research compared stabilities between two types of dental implant ($SLA^{TM}$, Institut Straumann AG, Waldenburg, Switzerland and $SSII^{TM}$, Osstem co, Busan, Korea) using Osstell Mentor (Integration Diagnostics AB, Goteborg, Sweden) considering surgery methods, surgery area, diameter of implant, systemic disease, and smoking for obtaining prognosis information when installing fixture of dental implant. Materials & Methods : 206 implants of 131 patients taken by resonance frequency analysis (RFA) were determined as a final sample. Dental implants were installed as protocol of supplier by a excellent dentist who had 10 years experience about dental implants. Before connecting abutments (3 months after installation of fixture), RFA were measured twice for buccal and lingual direction to obtain average value. Results : Dental implants at mandible showed significantly higher stabilities significantly than at maxilla (p<0.001). Diameter 4.8 implants had also higher stabilities than diameter 4.1 in case of $SLA^{TM}$ implants (p<0.001). $SLA^{TM}$ implants showed more excellent stabilities than $SSII^{TM}$ implants, especially at posterior area of mandible (p=0.045) and premolar area of maxilla (p=0.032). Conclusions : This research revealed higher stabilities of $SLA^{TM}$ implants than $SSII^{TM}$ implant, especially at posterior area of mandible (p=0.045) and premolar area of maxilla (p=0.032).