J Korean Acad Prosthodont.  2011 Apr;49(2):128-137. 10.4047/jkap.2011.49.2.128.

Implant stability evaluation according to the bone condition, fixture diameter and shape in the osseointegration simulated resin model

• Kwon TK
• Yeo IS
• Kim SH
• Han JS
• Lee JB
• Yang JH

• KMID: 2196119
• DOI: http://doi.org/10.4047/jkap.2011.49.2.128

Abstract

PURPOSE
Resonance frequency analysis, Periotest, and removal torque (RT) test were known as the methods to assess implant stability. The results of these methods are affected by the bone condition, implant diameter and shape. The purpose of this study is to access the meaning and the correlationship of the resonance frequency analysis, Periotest and RT test in osseointegration simulated acrylic resin when the engaged bone thickness and peri-implant bone defect are changed.
MATERIALS AND METHODS
To simulate osseointegration, the fixture was fixed to an aluminum mold with a screw. Acrylic resin powder and liquid were poured into the mold for polymerization. The engaged resin thickness with implant was controlled. Simulated cortical bone thicknesses were 1, 3, 5 and 10 mm. Additional 1, 3 and 5 mm peri-implant bone defects were simulated. Three types of implants were used; 4 mm diameter implants of straight shape, 4 mm diameter implants of tapered shape and 5 mm diameter implants of tapered shape. Five fixtures per each type were tested in respective bone condition. Resonance frequency analysis and Periotest were evaluated in all bone conditions. Peak removal torque was measured at simulated cortical bone thicknesses of 1 and 3 mm. The statistical analysis was performed with the Kruskal-Wallis test, Mann-Whitney U test, and Spearman test using a 95% level of confidence.
RESULTS
With increasing engaged bone depth, the Implant Stability Quotient (ISQ) values increased and the Periotest values (PTVs) decreased (P<.001, P<.001). With increasing peri-implant bone defect, ISQ values decreased and PTVs increased (P<.001). When the diameter of implant increased, ISQ values increased and Periotest values (PTV) decreased (P<.001). There was a strong correlation between ISQ values and PTVs (r = -0.99, P<.001). Furthermore, the peak removal torque values had weak correlations with both ISQ values and PTVs (r = 0.52, P<.001 ; r = -0.52, P<.001).
CONCLUSION
This study confirmed favorable implant stability with increasing engaged bone depth and implant diameter and decreasing peri-implant bone defect. ISQ values and PTVs showed strong correlation with each other and not with the peak removal torque values.

Keyword

Implant stability; Resonance frequency analysis; Periotest; Removal torque

MeSH Terms

Aluminum
Fungi
Osseointegration
Polymerization
Polymers
Torque
Aluminum
Polymers

Figure

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  Fig. 1. Aluminum mold for specimen.

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  Fig. 2. Osseointegration simulated specimen.

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  Fig. 3. Schematic view of simulated bone condition with acrylic resin (1M0 : integration with 1 mm thick resin, 3M0 : integration with 3 mm thick resin, 5M0 : integration with 5 mm thick resin, 10M0 : integration with over 10 mm thick resin, 10M1 : integration with over 10 mm thick resin and simulation of 1 mm cervical bone loss, 10M3 : integration with over 10 mm thick resin and simulation of 3 mm cervical bone loss, 10M5 : integration with over 10 mm thick resin and simulation of 5 mm cervical bone loss).

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  Fig. 4. Evaluation of resonance frequency.

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  Fig. 5. Evaluation of Periotest.

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  Fig. 6. Removal torque test with motorized torque test stands, TSTM.

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  Fig. 7. Mean ISQ values and static differences when engaged resin depth increased.

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  Fig. 8. Mean PTV and static differences when engaged resin depth increased.

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  Fig. 9. Mean ISQ values and static differences when cervical defect was increased.

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  Fig. 10. Mean PTV and static differences when cervical defect was increased.

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  Fig. 11. Scatterplot from 420 implant stability quotient (ISQ) values and Periotest values of all 45 implants, correlation between ISQ and PTVs.

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  Fig. 12. Correlation between ISQ values and removal torque (Ncm).

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  Fig. 13. Correlation between Periotest values and removal torque (Ncm).

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