Influence of cortical bone and implant design in the primary stability of dental implants measured by two different devices of resonance frequency analysis: An in vitro study

Abstract

Background: This study aimed to evaluate the effect of the implant design and the presence of cortical bone in the primary stability, as well as analyze the differences between the stability measurements obtained by two different resonance frequency analysis (RFA) devices. Material and Methods: A total of 80 Klockner implants of two different models [40 Essential Cone implants (group A) and 40 Vega implants (group B)] were used. The implants were placed in two polyurethane blocks that simulated the mechanical properties of the maxillary bone. One block featured a layer of cortical bone that was absent from the other block. The primary stability of all implants was measured by insertion torque and RFA using two different devices: Penguin RFA and Osstell IDX. Results: Primary stability was superior in the cortical bone in both torque and RFA. In the block containing cortical bone, group A implants obtained a greater insertion torque than did group B. The insertion torque was lesser in the bone lacking cortex. Regarding the ISQ of the implants, group A presented higher values in the block with cortical bone, but the values were lower in the block without cortical bone. There were no significant differences between the values obtained from the Osstell IDX and Penguin RFA. Conclusions: The presence of cortical bone positively influences the primary stability of dental implants. The design of the implant also has a statistically significant influence on implant primary stability, although the impact depends on whether there is coronal cerclage or not. There were no statistically significant differences in the implant stability measurements obtained by two different devices.

Osseodensification Drilling vs. Standard Protocol of Implant Site Preparation: An In Vitro Study on Polyurethane Foam Sheets

“…Chávarri-Prado et al reported in a polyurethane study that the presence of the cortical layer represents a positive influence for the implant primary stability [43].…”

Evaluation of the primary stability in dental implants placed in low density bone with a new drilling technique, Osseodensification: an in vitro study

“…Currently, primary implant stability is considered a prerequisite for osseointegration. Primary stability is a static and purely mechanical parameter, which is determined at the time of implant placement and is associated with resistance or friction between the bone and the implant upon insertion ( 1 - 4 ). Primary stability can be affected by multiple factors, including recipient bone density, implant design, surgical technique, or operator experience ( 5 - 8 ).…”

Does the Modification of the Apical Geometry of a Dental Implant Affect Its Primary Stability? A Comparative Ex Vivo Study

“…The insertion torque, for example, can only be recorded at the time of implant insertion and thus stability monitoring over time is not possible. In contrast, RFA can also be applied for long-term monitoring of dental implant stability [ 7 , 10 ]. However, measurement of insertion torque is believed to be more sensitive for determining primary stability than both RFA and Periotest ® values [ 16 , 31 , 48 ].…”

“…Here, sufficient primary stability might be difficult to achieve. Therefore, modifications of the drilling technique or the macrodesign of the implant are recommended [ 7 , 8 , 9 ]. In regard to drilling techniques, undersized preparation creates an implant bed with a diameter that is significantly smaller than the implant diameter, resulting in an increase in primary stability [ 8 , 10 , 11 ].…”

“…Currently, implant insertion torque measurements and the use of resonance frequency analysis (RFA) are the most widely accepted biomechanical parameters for measuring primary stability [ 7 , 10 , 21 ]. However, the two indicators differ in terms of their approach: while insertion torque measures the resistance arising when the implant is inserted in the apical direction, the RFA measurement records the natural oscillation frequency of the implant in the bone, which depends on the stiffness of the implant-bone connection.…”