• The Journal of Advanced Prosthodontics
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• v.2 no.4
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• pp.148-153
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• 2010

PURPOSE. The aim of this study was to investigate a comparison of implant bone bed preparation with Er,Cr:YSGG laser and conventional drills on the relationship between implant stability quotient (ISQ) values and implant insertion variables. MATERIALS AND METHODS. Forty implants were inserted into two different types of pig rib bone. One group was prepared with conventional drills and a total of 20 implants were inserted into type I and type II bone. The other group was prepared with a Er,Cr:YSGG laser and a total of 20 implants were inserted into type I and type II bone. ISQ, maximum insertion torque, angular momentum, and insertion torque energy values were measured. RESULTS. The mean values for variables were significantly higher in type I bone than in type II bone (P < .01). In type I bone, the ISQ values in the drill group were significantly higher than in the laser group (P < .05). In type II bone, the ISQ values in the laser group were significantly higher than in the drill group (P < .01). In both type I and type II bone, the maximum insertion torque, total energy, and total angular momentum values between the drill and laser groups did not differ significantly (P ${\geq}$ .05). The ISQ values were correlated with maximum insertion torque (P < .01, r = .731), total energy (P < .01, r = .696), and angular momentum (P < .01, r = .696). CONCLUSION. Within the limitations of this study, the effects of bone bed preparation with Er,Cr:YSGG laser on the relationship between implant stability quotient (ISQ) values and implant insertion variables were comparable to those of drilling.

• Journal of Periodontal and Implant Science
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• v.47 no.2
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• pp.106-115
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• 2017

Purpose: The possibility of immediate or early loading has become popular in implant dentistry. A prerequisite for the immediate or early loading of an implant prosthesis is the achievement of initial stability in the implant. Moreover, in response to clinicians' interest in verifying clinical stability to determine the optimal time point for functional loading, a non-invasive method to assess implant stability has been developed on the basis of resonance frequency analysis (RFA). The primary objective of this study was to monitor the stability of sandblasted, large-grit, and acid-etched (SLA) implants with different diameters during the early phases of healing by RFA. The secondary objective was to evaluate how the initial stability of implants varied depending on different surface modifications and other contributing factors. Methods: Thirty-five implants (25 SLA implants and 10 resorbable blasting media [RBM] implants) placed in 20 subjects were included. To measure implant stability, RFA was performed at baseline and at 1, 2, 3, 4, 6, and 10 weeks after surgery. Results: The longitudinal changes in the implant stability quotient (ISQ) values were similar for the SLA implants with different diameters and for the RBM implants. During the initial healing period, the ISQ decreased after installation and reached its lowest values at 1 week and 2 weeks, respectively. The mean ISQ values in the SLA implants were significantly higher in ${\varnothing}5.0mm$ implants than in ${\varnothing}4.0mm$ implants. Men showed a higher ISQ than women. Mandibular sites showed a higher ISQ than maxillary sites. Conclusions: All implants used in this study are suitable for immediate or early loading under appropriate indications. A wider diameter and SLA surface treatment of implants could improve the stability, if the implant is fixed with at least 30 Ncm of insertion torque.

• 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 Korean Academy of Prosthodontics
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• v.44 no.3
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• pp.314-324
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• 2006

Statement of problem. Osseointegration is important mechanism of dental implant but it is not easy to evaluate. Indirect measurement is non-invasive and clinically applicable but they need more study about correlation between indirect values and degree of osseointegration. Purpose. The aims of this study were to evaluate the coefficient of correlation between indirect measurement and direct measurement under different healing time, and assessment of effect of initial insertion torque to the implant stability. Material and Methods. 20 rabbits received 3 implants on each side of tibia. Three kinds of implants (machined surface implant, Sandblasted with Large grit and Acid etched implant, Resorbable Blast Media treated implant) were used. During the surgery implant insertion torque were measured with $Osseocare^{TM}$. After the 1, 4, 8, 12 weeks of healing time, animals were sacrificed and stability values (Implant Stability Quotient with $Osstell^{TM}$, removal torque with torque gauge) were measured. Results. The Bone quality of rabbit tibia was classified into 2 groups according to the insertion torque. Resonance frequency analysis (ISQ) and removal torque showed positive correlation until $4^{th}$ week (r=0.555, p=0.040). After $8^{th}$ week (r=0.011, p=0.970) the correlation became weak and it turned negative at $12^{th}$ week (r=-0.074, p=0.801). Insertion torque and ISQ showed changing correlation upon the healing time ($1^{st}$ week: r=0.301, p=0.033, $4^{th}$ week: r=-0.429, p=0.018, $8^{th}$ week: r=0.032, p=0.865, $12^{th}$ week: r=-0.398, p=0.029). Insertion torque and removal torque has positive correlation but it was not statistically significant ($1^{st}$ week: r=0.410, p=0.129, $4^{th}$ week: r=0.156, p=0.578, $8^{th}$ week: r=0.236, p=0.398, $12^{th}$ week: r=0.260, p=0.350). Conclusion. In this study, bone quality may affect the degree of osseointegration positively during healing time and correlation between ISQ and degree of osseointegration can be different according to the healing time and bone quality.

• Journal of Periodontal and Implant Science
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• v.40 no.1
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• pp.19-24
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• 2010

Purpose: It has been suggested that primary implant stability plays an essential role in successful osseointegration. Resonance frequency analysis (RFA) is widely used to measure the initial stability of implants because it provides superior reproducibility and non-invasiveness. The purpose of this study is to investigate whether the fractal dimension from the panoramic radiograph is related to the primary stability of the implant as represented by RFA. Methods: This study included 22 patients who underwent dental implant installation at the Department of Periodontology of Seoul National University Dental Hospital. Morphometric analysis and fractal analysis of the bone trabecular pattern were performed using panoramic radiographs, and the implant stability quotient (ISQ) values were measured after implant installation using RFA. The radiographs of 52 implant sites were analyzed, and the ISQ values were compared with the results from the morphometric analysis and fractal analysis. Results: The Pearson correlation showed a linear correlation between the ISQ values of RFA and the parameters of morphometric analysis but not of statistical significance. The fractal dimension had a linear correlation that was statistically significant. The correlation was more pronounced in the mandible. Conclusions: In conclusion, we suggest that the fractal dimension acquired from the panoramic radiograph may be a useful predictor of the initial stability of dental implants.

• The Journal of Advanced Prosthodontics
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• v.3 no.4
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• pp.190-195
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• 2011

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 (Br${\aa}$nemark System$^{(R)}$ Mk III TiUnite$^{TM}$, Straumann Standard Implant SLA$^{(R)}$, and Astra Tech Microthread$^{TM}$-OsseoSpeed$^{TM}$) 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 Br${\aa}$nemark 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.

• Journal of Periodontal and Implant Science
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• v.40 no.5
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• pp.239-243
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• 2010

Purpose: The purpose of this study was to evaluate the effects of implant shape and bone preparation on the primary stability of the implants using resonance frequency analysis. Methods: Sixty bovine rib blocks were used for soft and hard bone models. Each rib block received two types of dental implant fixtures; a straight-screw type and tapered-screw type. Final drilling was done at three different depths for each implant type; 1 mm under-preparation, standard preparation, and 1 mm over-preparation. Immediately after fixture insertion, the implant stability quotient (ISQ) was measured for each implant. Results: Regardless of the bone type, the ISQ values of the straight-screw type and tapered-screw type implants were not significantly different (P>0.05). Depth of bone preparation had no significant effect on the ISQ value of straight-screw type implants (P>0.05). For the tapered-screw type implants, under-preparation significantly increased the ISQ value (P<0.05), whereas overpreparation significantly decreased the ISQ value (P<0.05). Conclusions: Within the limitations of this study, it is concluded that bone density seemed to have a prevailing effect over implant shape on primary stability. The primary stability of the tapered-screw type implants might be enhanced by delicate surgical techniques.

• The Journal of Advanced Prosthodontics
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• v.1 no.1
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• pp.31-36
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• 2009

PURPOSE. To determine the change in stability of single-stage, three different design of implant systems in humans utilizing resonance frequency analysis for early healing period(24 weeks), without loading. MATERIAL AND METHODS. Twenty-five patients were included into this study. A total of 45 implants, three different design of implant systems(group A,C,R) were placed in the posterior maxilla or mandible. The specific transducer for each implant system was used. ISQ(implant stability quotient) reading were obtained for each implant at the time of surgery, 3, 6, 8, 10, 12, 24 weeks postoperatively. Data were analyzed for different implant type, bone type, healing time, anatomical locations. RESULTS. For each implant system, a two-factor mixed-model ANOVA demonstrated that a significant effect on ISQ values(group A=0.0022, C=0.017, R=0.0018). For each implant system, in a two-factor mixed model ANOVA, and two-sample t-test, the main effect of jaw position(P > .005) on ISQ values were not significant. CONCLUSIONS. All the implant groups A, C and R, the change patterns of ISQ over time differed by bone type. Implant stability increased greatly between week 0 and week six and showed slow increase between week six and six months(plateau effect).

• 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 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.