Influence of bone density on implant stability parameters and implant success: a retrospective clinical study

BackgroundThe aim of the present clinical study was to determine the local bone density in dental implant recipient sites using computerized tomography (CT) and to investigate the influence of local bone density on implant stability parameters and implant success.MethodsA total of 300 implants were placed in 111 patients between 2003 and 2005. The bone density in each implant recipient site was determined using CT. Insertion torque and resonance frequency analysis were used as implant stability parameters. The peak insertion torque values were recorded with OsseoCare machine. The resonance frequency analysis measurements were performed with Osstell instrument immediately after implant placement, 6, and 12 months later.ResultsOf 300 implants placed, 20 were lost, meaning a survival rate of %. 93.3 after three years (average 3.7 ± 0.7 years). The mean bone density, insertion torque and RFA recordings of all 300 implants were 620 ± 251 HU, 36.1 ± 8 Ncm, and 65.7 ± 9 ISQ at implant placement respectively; which indicated statistically significant correlations between bone density and insertion torque values (p < 0.001), bone density and ISQ values (p < 0.001), and insertion torque and ISQ values (p < 0.001). The mean bone density, insertion torque and RFA values were 645 ± 240 HU, 37.2 ± 7 Ncm, and 67.1 ± 7 ISQ for 280 successful implants at implant placement, while corresponding values were 267 ± 47 HU, 21.8 ± 4 Ncm, and 46.5 ± 4 ISQ for 20 failed implants; which indicated statistically significant differences for each parameter (p < 0.001).ConclusionCT is a useful tool to determine the bone density in the implant recipient sites, and the local bone density has a prevailing influence on primary implant stability, which is an important determinant for implant success.

[1]  L Sennerby,et al.  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. , 1997, Clinical oral implants research.

[2]  P. Trisi,et al.  Bone classification: clinical-histomorphometric comparison. , 1999, Clinical oral implants research.

[3]  I. Turkyilmaz,et al.  Assessment of correlation between computerized tomography values of the bone, and maximum torque and resonance frequency values at dental implant placement. , 2006, Journal of oral rehabilitation.

[4]  B. Gantes,et al.  Bone density assessments of dental implant sites: 3. Bone quality evaluation during osteotomy and implant placement. , 2007, The International journal of oral & maxillofacial implants.

[5]  T Jemt,et al.  Early failures in 4,641 consecutively placed Brånemark dental implants: a study from stage 1 surgery to the connection of completed prostheses. , 1991, The International journal of oral & maxillofacial implants.

[6]  George A Zarb,et al.  Long-term treatment outcomes in edentulous patients with implant overdentures: the Toronto study. , 2005, The International journal of prosthodontics.

[7]  Lars Sennerby,et al.  Reconstruction of the atrophic edentulous maxilla with free iliac crest grafts and implants: a 3-year report of a prospective clinical study. , 2007, Clinical implant dentistry and related research.

[8]  D. Buser,et al.  Immediate loading of implants with 3-unit fixed partial dentures: a 12-month clinical study. , 2006, The International journal of oral & maxillofacial implants.

[9]  U. Lekholm,et al.  Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption. , 1995, The International journal of oral & maxillofacial implants.

[10]  C. Watson,et al.  A survey of U.K. centres on implant failures. , 1999, Journal of oral rehabilitation.

[11]  N Meredith,et al.  Assessment of implant stability as a prognostic determinant. , 1998, The International journal of prosthodontics.

[12]  Hugo Nary Filho,et al.  A comparison between cutting torque and resonance frequency in the assessment of primary stability and final torque capacity of standard and TiUnite single-tooth implants under immediate loading. , 2004, The International journal of oral & maxillofacial implants.

[13]  George A. Zarb,et al.  Tissue-Integrated Prostheses: Osseointegration in Clinical Dentistry , 1985 .

[14]  I. Turkyilmaz.  Clinical and radiological results of patients treated with two loading protocols for mandibular overdentures on Brånemark implants. , 2006, Journal of clinical periodontology.

[15]  P. Trisi,et al.  Bone mineral density and bone histomorphometry are statistically related. , 2005, The International journal of oral & maxillofacial implants.

[16]  U. Grunder.  Immediate functional loading of immediate implants in edentulous arches: two-year results. , 2001, The International journal of periodontics & restorative dentistry.

[17]  Sadami Tsutsumi,et al.  Assessment of correlation between computerized tomography values of the bone and cutting torque values at implant placement: a clinical study. , 2005, The International journal of oral & maxillofacial implants.

[18]  C Aparicio,et al.  Periotest method as a measure of osseointegrated oral implant stability. , 1990, The International journal of oral & maxillofacial implants.

[19]  I. Turkyilmaz,et al.  Bone density assessments of oral implant sites using computerized tomography. , 2007, Journal of oral rehabilitation.

[20]  L. Levin,et al.  The Effect of Cigarette Smoking on Dental Implants and Related Surgery , 2005, Implant dentistry.

[21]  C. Gamble,et al.  Bone classification: an objective scale of bone density using the computerized tomography scan. , 2001, Clinical oral implants research.

[22]  P. Reichart,et al.  Smoking interferes with the prognosis of dental implant treatment: a systematic review and meta-analysis. , 2007, Journal of clinical periodontology.

[23]  N Meredith,et al.  Quantitative determination of the stability of the implant-tissue interface using resonance frequency analysis. , 1996, Clinical oral implants research.

[24]  D. Riediger,et al.  Implant stability during osseointegration in irradiated and non-irradiated minipig alveolar bone: an experimental study. , 2008, Clinical oral implants research.

[25]  George A Zarb,et al.  Long-term treatment outcomes in edentulous patients with implant-fixed prostheses: the Toronto study. , 2004, The International journal of prosthodontics.

[26]  W. Rand,et al.  Quantitative evaluation of bone density using the Hounsfield index. , 2006, The International journal of oral & maxillofacial implants.

[27]  T. Albrektsson,et al.  Determinants of correct clinical reporting. , 1998, The International journal of prosthodontics.

[28]  P. Branemark,et al.  Introduction to osseointegration , 1985 .

[29]  Lars Sennerby,et al.  Resonance frequency analysis of implants subjected to immediate or early functional occlusal loading. Successful vs. failing implants. , 2004, Clinical oral implants research.

[30]  I. Turkyilmaz,et al.  Stability and marginal bone level measurements of unsplinted implants used for mandibular overdentures: a 1-year randomized prospective clinical study comparing early and conventional loading protocols. , 2006, Clinical oral implants research.

[31]  U. Lekholm,et al.  Patient selection and preparation , 1985 .

[32]  L Sennerby,et al.  Identification of bone quality in conjunction with insertion of titanium implants. A pilot study in jaw autopsy specimens. , 1995, Clinical oral implants research.

[33]  A. Ekfeldt,et al.  A retrospective analysis of factors associated with multiple implant failures in maxillae. , 2001, Clinical oral implants research.

[34]  C. Misch.  Contemporary Implant Dentistry , 1993 .

[35]  da Cunha Ha,et al.  A comparison between cutting torque and resonance frequency in the assessment of primary stability and final torque capacity of standard and TiUnite single-tooth implants under immediate loading. , 2004 .

[36]  F. Carinci,et al.  Clinical outcome of 802 immediately loaded 2-stage submerged implants with a new grit-blasted and acid-etched surface: 12-month follow-up. , 2006, The International journal of oral & maxillofacial implants.

[37]  L Sennerby,et al.  A comparison between cutting torque and resonance frequency measurements of maxillary implants. A 20-month clinical study. , 1999, International journal of oral and maxillofacial surgery.

[38]  M. Tschabitscher,et al.  Correlation of insertion torques with bone mineral density from dental quantitative CT in the mandible. , 2003, Clinical oral implants research.