Mechanical Versus Biological Stability of Immediate and Delayed Implant Placement Using Resonance Frequency Analysis

doi:10.1016/j.joms.2014.09.024

Journal of Oral and Maxillofacial Surgery

Volume 73, Issue 2, February 2015, Pages 253-257

https://doi.org/10.1016/j.joms.2014.09.024 Get rights and content

Purpose

The purpose was to objectively measure the stability of immediately placed implants compared with implants placed at healed sites using implant stability quotient (ISQ) values obtained by resonance frequency analysis.

Materials and Methods

Data were collected from 137 Nobel Replace Tapered Groovy Implants placed in 85 patients 19 to 93 years old. All implants were placed by the same surgeon from May 2007 to October 2011. Forty-one implants were placed immediately after extraction with MasterGraft bone grafting material and 96 were placed in healed sites with no grafting material. ISQ values obtained by the Osstell ISQ System were recorded at the time of implant placement and at a subsequent follow-up appointment (T2). T2 was split into 2- to 3-month and 4- to 6-month groups depending on when their follow-up ISQ values were obtained. Data were analyzed using simple linear regression.

Results

Implants placed in healed sites had higher average ISQ values at implant placement compared with immediately placed implants; however, mean ISQ values in the 2 immediate implant groups exceeded the ISQ threshold of 65. Immediately placed implants in the 2- to 3-month and 4- to 6-month groups had average ISQ values of 65.60 and 68.65, respectively, whereas implants placed in healed sites had averages of 76.73 (2- to 3-month group) and 71.23 (4- to 6-month group). These differences were statistically significant (P < .05). At subsequent follow-up appointments, implants placed in healed sites had higher mean ISQ values. Implants in healed sites had ISQ averages of 79.58 (2- to 3-month group) and 77.31 (4- to 6-month group), whereas immediately placed implants had averages of 73.88 and 70.14. These differences were statistically significant (P < .05). Moreover, these mean ISQ values in immediate implants exceeded the ISQ threshold of 65.

Conclusion

Although mean ISQ values of immediately placed implants are lower than those of delayed implants at implant placement and follow-up appointments, immediate implant mean ISQ values consistently remain higher than the clinically successful ISQ threshold of 65 throughout the osseointegration process. These results support the immediate placement of implants in extraction sockets under favorable conditions.

Section snippets

Materials and Methods

In this retrospective study, data were collected from 85 patients 19 to 93 years old. A total of 137 Nobel Replace Tapered Groovy Implants (Nobel Biocare, Yorba Linda, CA) were placed. All implants were placed by the same surgeon from May 2007 to October 2011. The implants were divided into 2 groups. Group 1 included 41 implants placed immediately after extraction. The resulting gaps were augmented with an alloplast (MasterGraft, Medtronic, Inc, Minneapolis, MN). Of those, 30 were placed in the

Results

The results are presented in Table 5. On average, group 2 showed higher ISQ values at T1 compared with group 1. For group 1, the average ISQ values were 65.60 (standard deviation [SD], 9.33; range, ±30.25) and 68.65 (SD, 6.47; range, ±25.5) in the 2- to 3-month and 4- to 6-month groups, respectively. Group 2 had ISQ averages of 76.73 (SD, 6.5; range, ±27.3) in the 2- to 3-month group and 71.23 (SD, 9.4; range, ±31.5) in the 4- to 6-month group. These differences were statistically significant (P

Discussion

The findings in this study support immediate implant placement in fresh extraction sockets under favorable conditions. It is well established that primary stability of dental implants is one of the most important factors in achieving successful osseointegration.⁵ Although mean ISQ values of immediately placed implants are lower than those of delayed implants at implant placement and follow-up appointments, mean ISQ values of immediate implants consistently remain higher than the suggested ISQ

Acknowledgments

The authors thank Dr Andy Lin of the UCLA Statistical Consulting Group for his time and expertise in the statistical analysis needed for this study.

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Implant stability is crucial for successful osseointegration. Marginal bone level is considered an important indicator of long-term implant success and stability. The purposes of this study were to investigate 1) the effect of age, gender, bone density, implant length, and implant diameter on insertion torque (IT), primary implant stability quotient (ISQ), and secondary ISQ, 2) the impact of age, gender, bone density, implant length, implant diameter, IT, and ISQ on marginal bone loss (MBL).
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Age had little effect on IT and primary ISQ (P > 0.05). Generally, males had higher IT and primary ISQ, but no significant differences between genders were detected. Bone density showed significant effects on IT and primary ISQ. Correlation analysis revealed high positive correlations between IT/bone density and primary ISQ/implant diameter. Significant impacts of bone density and IT on MBL were found.
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The implant site preparation with PE devices should be preferred to CDs whenever possible, because they seem to enhance implant stability and osseointegration, especially at the initial stages of healing.
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Dental implantsMechanical Versus Biological Stability of Immediate and Delayed Implant Placement Using Resonance Frequency Analysis

Purpose

Materials and Methods

Results

Conclusion

Section snippets

Materials and Methods

Results

Discussion

Acknowledgments

Biomaterials

Immediate implant placement into extraction sites: Surgical and restorative advantages

Int J Periodontics Restorative Dent

Immediate implantation in fresh extraction sockets. A controlled clinical and histological study in man

J Periodontol

Immediate placement of implants into extraction sockets: Implant survival

Int J Oral Maxillofac Implants

Immediate or early placement of implants following tooth extraction: Review of biologic basis, clinical procedures, and outcomes

Int J Oral Maxillofac Implants

Critical review of immediate implant loading

Clin Oral Implants Res

Timing of loading and effect of micromotion on bone-dental implant interface: Review of experimental literature

J Biomed Mater Res

[The Tubingen immediate implant in clinical studies]

Dtsch Zahnarztl Z

Stability measurements of osseointegrated implants using Osstell in partially edentulous jaws after 1 year of loading: A pilot study

Clin Implant Dent Relat Res

The relationship between implant stability quotient values and implant insertion variables: A clinical study

J Oral Rehabil

Quantitative determination of the stability of the implant-tissue interface using resonance frequency analysis

Clin Oral Implants Res

Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla

Clin Oral Implants Res

Resonance frequency analysis of implants subjected to immediate or early functional occlusal loading. Successful vs. failing implants

Clin Oral Implants Res

Dental implants
Mechanical Versus Biological Stability of Immediate and Delayed Implant Placement Using Resonance Frequency Analysis