• Journal of Periodontal and Implant Science
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• v.48 no.6
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• pp.360-372
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• 2018

Purpose: It has been suggested that resonance frequency analysis (RFA) can measure changes in the stability of dental implants during osseointegration. This retrospective study aimed to evaluate dental implant stability at the time of surgery (primary stability; PS) and secondary stability (SS) after ossseointegration using RFA, and to investigate the relationship between implant stability and cortical bone thickness. Methods: In total, 113 patients who attended the Tohoku University Hospital Dental Implant Center were included in this study. A total of 229 implants were placed in either the mandibular region (n=118) or the maxilla region (n=111), with bone augmentation procedures used in some cases. RFA was performed in 3 directions, and the lowest value was recorded. The preoperative thickness of cortical bone at the site of implant insertion was measured digitally using computed tomography, excluding cases of bone grafts and immediate implant placements. Results: The mean implant stability quotient (ISQ) was $69.34{\pm}9.43$ for PS and $75.99{\pm}6.23$ for SS. The mandibular group had significantly higher mean ISQ values than the maxillary group for both PS and SS (P<0.01). A significant difference was found in the mean ISQ values for PS between 1-stage and 2-stage surgery (P<0.5). The mean ISQ values in the non-augmentation group were higher than in the augmentation group for both PS and SS (P<0.01). A weak positive correlation was observed between cortical bone thickness and implant stability for both PS and SS in all cases (P<0.01). Conclusions: Based on the present study, the ISQ may be affected by implant position site, the use of a bone graft, and cortical bone thickness before implant therapy.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.391-401
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• 2009

The successful outcome of dental implants is mainly the result of intial implant stability following placement. The aim of this study was to investigate the effect of a self-tapping blades and implant design on initial stability of two tapered implant systems in poor bone quality. The two different implant systems included one with self-tapping blades and one without self-tapping blades. D4 bone model using Solid Rigid Polyurethane Form was used to simulate poor bone densities. The insertion torque during implant placement was recorded. Resonance frequency Analysis (RFA), measured as the implant stability quotient (ISQ), was assessed immediately after insertion. Finally, the implant-bone specimen was transferred to an Universal Testing Machine to measure the axial pull-out force. Insertion torque values and maximum pull-out torque value of the non self-tapping implants were significantly higher than those in the self-tapping group (P = 0.008). No statistically differences were noted between the two implant designs in RFA. Within the each implant system, no correlation among insertion torque, maximum pull-out torque and RFA value could be determined. Higher insertion torque of the non-self-tapping implants appeared to confirm higher clinical initial stability. In conclusion, implants without self-tapping blades have higher initial stability than implants with self-tapping blades in poor bone quality.

• The Journal of Advanced Prosthodontics
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• v.1 no.1
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• pp.19-25
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• 2009

STATEMENT OF PROBLEM. Primary stability at the time of implant placement is related to the level of primary bone contact. The level of bone contact with implant is affected by thread design, surgical procedure and bone quality, etc. PURPOSE. The aim of this study was to compare the initial stability of the various taper implants according to the thread designs, half of which were engaged to inferior cortical wall of type IV bone(Group 1) and the rest of which were not engaged to inferior cortical wall(Group 2) by measuring the implant stability quotient(ISQ) and the removal torque value(RTV). MATERIAL AND METHODS. In this study, 6 different implant fixtures with 10 mm length were installed. In order to simulate the sinus inferior wall of type IV bone, one side cortical bone of swine rib was removed. 6 different implants were installed in the same bone block following manufacturer s recommended procedures. Total 10 bone blocks were made for each group. The height of Group 1 bone block was 10 mm for engagement and that of group 2 was 13 mm. The initial stability was measured with ISQ value using Osstell $mentor^{(R)}$ and with removal torque using MGT50 torque gauge. RESULTS. In this study, we found the following results. 1. In Group 1 with fixtures engaged to the inferior cortical wall, there was no significant difference in RTV and ISQ value among the 6 types of implants. 2. In Group 2 with fixtures not engaged to the inferior cortical wall, there was significant difference in RTV and ISQ value among the 6 types of implants(P < .05). 3. There was significant difference in RTV and ISQ value according to whether fixtures were engaged to the inferior cortical wall or not(P < .05). 4. Under-drilling made RTV and ISQ value increase significantly in the NT implants which had lower RTV and ISQ value in Group 2(P < .05). CONCLUSIONS. Without being engaged to the inferior cortical wall fixtures had initial stability affected by implant types. Also in poor quality bone, under-drilling improved initial stability.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.2.1-2.6
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• 2017

Background: All clinicians are aware of the difficulty of installing a dental implant in posterior maxilla because of proximate position of maxillary sinus, insufficient bone width, and lower bone density. This study is to examine which factors will make the implantation in the posterior maxilla more difficult, and which factors will affect the postoperative implant stability in this region. Methods: Five hundred seventy-three fixtures on the maxilla posterior were included for this study from all the patients who underwent an installation of the dental implant fixture from January 2010 to December 2014 at the Department of Oral and Maxillofacial Surgery in Pusan National University Dental Hospital (Yangsan, Korea). The postoperative implant stability quotient (ISQ) value, fixture diameter and length, presence of either bone graft or sinus lift, and graft material were included in the reviewed factors. The width and height of the bone bed was assessed via preoperative cone beam CT image analysis. The postoperative ISQ value was taken just before loading by using the OsstellTM $mentor^{(R)}$ (Integration Diagnostics AB, Gothenburg, Sweden). The t test and ANOVA methods were used in the statistical analysis of the data. Results: Mean ISQ of all the included data was 79.22. Higher initial bone height, larger fixture diameter, and longer fixture length were factors that influence the implant stability on the posterior edentulous maxilla. On the other hand, the initial bone width, bone graft and sinus elevation procedure, graft material, and approach method for sinus elevation showed no significant impact associated with the implant stability on the posterior edentulous maxilla. Conclusions: It is recommended to install the fixtures accurately in a larger diameter and longer length by performing bone graft and sinus elevation.

• Journal of Periodontal and Implant Science
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• v.39 no.3
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• pp.339-348
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• 2009

Purpose: The purpose of the present study was to analyze the implant stability quotient(ISQ) values for Korean non-submerged type implant and determine the factors that affect implant stability. Methods: A total of 49 Korean non-submerged type implants were installed in 24 patients, and their stability was measured by resonance frequency analysis(RFA) at the time of surgery, and 1, 2, 3, 4, 8, 12 weeks postoperatively. The data for implant site, age, sex, implant length and diameter, graft performing, bone type, and insertion torque were analyzed. Results: The lowest mean stability measurement was at 3 weeks. There was significant difference between implant placement and 12 weeks. There was significant difference between implant placement and 12 weeks in diameters of 4.1 mm and 4.8 mm. Also, there were significant differences between diameters of 4.1 mm and 4.8 mm at implant placement and 12 weeks after surgery. This result suggests that the factor related to implant diameter may affect the level of implant stability. No statistically significant relationship was found between the resonance frequency analysis and the variables of maxilla/mandible, sex, anterior/posterior, implant length, age of patient, graft performing, bone type, insertion torque during initial healing period. Conclusions: These findings suggest that the factor related to implant diameter may affect the variance of implant stability, and ISQ value of implant was stable enough for proved stability level during initial healing period.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.4
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• pp.291-296
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• 2003

The use of resonance frequency analysis (RFA) provides a possibility to clinically measure implant stability and osseointegration. The implant stability quotient (ISQ) value of RFA is well known that influenced by effective abutment length and stiffness of the implant in the surrounding tissues. Among these factors stiffness is not accurately defined histologically yet. And the purpose of this study was to find the histolgical relationship of RFA. 17 implants in 3 beagle dogs were used for this study. Among these implants 10 were survived for 7 months, 4 were survived for 3 months and 3 were immediate status after placement. Resonance frequency analyses were conducted and the dogs were sacrificed. Percentage of the bone to implant contact (BIC) in the interface, percentage of the mineralized bone (bone area) within the threads of the implant, and marginal bone level were measured under light microscopy. The correlation between resonance frequency and histomorphometric measurements were analysed and following results were obtained. 1. There was statistically significant correlation between ISQ value and BIC on healed implants. But ISQ value and BIC of all implants were not significantly correlated. (P<0.01) 2. Significant correlation between ISQ value and bone area was not found in this study. 3. There was statistically significant correlation between ISQ value and marginal bone level on all implants as well as on healed implants. (P<0.01).

• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.1
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• pp.32-38
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• 2018

Purpose: The purpose of present study was to retrospectively analyze the survival rate of narrow diameter implant less than 3.6 mm by initial stability and radiographic measurements. Materials and Methods: In total, 24 patients who received 38 narrow diameter implants (${\leq}3.6mm$ in diameter, ${\geq}7mm$ in length) were enrolled in this retrospective study. The cumulative survival rate was calculated and various factors were investigated according to the implant platform diameter, body diameter, length, position, concomitant use of guided bone regeneration in implant placement and final prosthesis type. Initial stability was investigated with implant stability quotient (ISQ) value. The mesial and distal marginal bone level (MBL) change was calculated with radiography. Results: The overall survival rate was 92.11%. Mean ISQ value and MBL change of survival implants was 66.26 and $0.14{\pm}0.31mm$, respectively. None of the implants with platform diameters larger than the body diameter failed. Conclusion: In conclusion, the findings of present study suggest that narrow diameter implant could be predictable treatment in narrow alveolar ridge.

• Journal of Korean Dental Science
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• v.4 no.2
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• pp.67-72
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• 2011

Purpose: This study sought to evaluate the effects of bone graft wedging on the initial stability of implants in bone sites of unfavorable quality. Materials and Methods: Three male beagle dogs were used in this study. Osteotomies were performed with parallel drills (${\O}4.1{\times}10mm$), and fixtures (${\O}3.3{\times}8mm$) were placed. The control group was given implants without bone graft. Experiment group A was given implants with minimal initial stability using autobone grafts, whereas experiment group B was given xenografts. Groups were also divided by healing times at 4, 8, and 12 weeks. Results: All implants in the control group failed to osseointegrate. On the other hand, all implants in the experiment groups were clinically well-maintained during the entire experiment period. After 4, 8, and 12 weeks, bone-to-implant contact (BIC) ratio and implant stability quotient (ISQ) increased in the experiment groups. The differences between experiment groups A and B were not statistically significant, however. Conclusion: In unfavorable bone regions for dental implants, bone graft packing into the osteotomy prior to implant placement secured minimal initial stability and showed reasonable BIC ratios and ISQ values throughout the study period.