The primary stability of implants is an important factor to predict the osseointegration. Recently, the resonance frequency analysis has been used to measure the primary stability. It is an objective method to monitor the stability of implants during healing phase. This study is to validate the differences in the effect of the osteotome method according to the bone quality as well the thickness of cortical bone. Two hundred seventy implants of 3.75mm in diameter(Neoplant, Neobiotech, Korea) were placed in 135 bovine ribs. The bone quality is classified into 3 classes according to the number of bone marrow spaces which implants would be placed, and then classified into 9 subclasses after the ribs were trimmed. Two implants were placed in 15 specimens of each class. The conclusion were as follows: 1. In case of less dense cancellous bone, the oseotome method is more effective in primary stability rather than the drilling method(p <0.05). 2. If there was cortical bone, it is more advantagous to get stronger primary stability. 3. If cancellous bone is more dense or if cortical bone exists, there is no statistical significance between drilling and osteotome method(p <0.05).
Di Stefano, Danilo Alessio;Perrotti, Vittoria;Greco, Gian Battista;Cappucci, Claudia;Arosio, Paolo;Piattelli, Adriano;Iezzi, Giovanna
The Journal of Advanced Prosthodontics
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제10권3호
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pp.227-235
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2018
PURPOSE. Implant site preparation may be adjusted to achieve the maximum possible primary stability. The aim of this investigation was to study the relation among bone-to-implant contact at insertion, bone density, and implant primary stability intra-operatively measured by a torque-measuring implant motor, when implant sites were undersized or tapped. MATERIALS AND METHODS. Undersized (n=14), standard (n=13), and tapped (n=13) implant sites were prepared on 9 segments of bovine ribs. After measuring bone density using the implant motor, 40 implants were placed, and their primary stability assessed by measuring the integral of the torque-depth insertion curve. Bovine ribs were then processed histologically, the bone-to-implant contact measured and statistically correlated to bone density and the integral. RESULTS. Bone-to-implant contact and the integral of the torque-depth curve were significantly greater for undersized sites than tapped sites. Moreover, a correlation between bone to implant contact, the integral and bone density was found under all preparation conditions. The slope of the bone-to-implant/density and integral/density lines was significantly greater for undersized sites, while those corresponding to standard prepared and tapped sites did not differ significantly. CONCLUSION. The integral of the torque-depth curve provided reliable information about bone-to-implant contact and primary implant stability even in tapped or undersized sites. The linear relations found among the parameters suggests a connection between extent and modality of undersizing and the corresponding increase of the integral and, consequently, of primary stability. These results might help the physician determine the extent of undersizing needed to achieve the proper implant primary stability, according to the planned loading protocol.
Statement of problem: Current tendencies of the implant macrodesign are tapered shapes for improved primary stability, but there are lack of studies regarding the relationship between the implant macrodesign and primary stability. Purpose: The purpose is to investigate the effect of implant macrodesign on the implant primary stability by way of resonance frequency analysis in the bovine rib bones with different kinds of quality. Material and method: Fifty implants of 6 different kinds from two Korean implant systems were used for the test. Bovine rib bones were cut into one hundred pieces with the length of 5 cm. Among them forty pieces of rib bones with similar qualities were again selected. For the experimental group 1, the thickness of cortical part was measured and 20 pieces of rib bones with the mean thickness of 1.0mm were selected for implant placement. For the experimental group 2, the cortical parts of the remaining 20 pieces of rib bones were totally removed and then implants were placed on the pure cancellous bone according to the surgical manual. After placement of all implants, the implant stability quotient(ISQ) was measured by three times, and its statistical analysis was done. Results: There are statistically significant differences in ISQ values among 4 different kinds of Avana system implants in the experimental group 2. For the experimental group 1, Avana system implants showed significantly different ISQ values, but when differences in the thickness of cortical parts were statistically considered, did not show any significant differences in ISQ values. Among Oneplant system implants, there are no significant differences in ISQ values for the experimental group 2 as well as for the experimental group 1. Conclusion: Within the limits of this study, bone quality and implant design have some influences on the primary stability of implants. Especially in the bone of poor quality, tapered shape of implants are more favorable for the primary stability of implants.
Jun, Sang Ho;Park, Chang-Joo;Hwang, Suk-Hyun;Lee, Youn Ki;Zhou, Cong;Jang, Hyon-Seok;Ryu, Jae-Jun
Maxillofacial Plastic and Reconstructive Surgery
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제40권
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pp.8.1-8.6
/
2018
Background: This study was to evaluate the effect of bone graft procedure on the primary stability of implants installed in fresh sockets and assess the vertical alteration of peri-implant bone radiographically. Methods: Twenty-three implants were inserted in 18 patients immediately after tooth extraction. The horizontal gap between the implant and bony walls of the extraction socket was grafted with xenografts. The implant stability before and after graft procedure was measured by Osstell Mentor as implant stability quotient before bone graft (ISQ bbg) and implant stability quotient after bone graft (ISQ abg). Peri-apical radiographs were taken to measure peri-implant bone change immediately after implant surgery and 12 months after implant placement. Data were analyzed by independent t test; the relationships between stability parameters (insertion torque value (ITV), ISQ abg, and ISQ bbg) and peri-implant bone changes were analyzed according to Pearson correlation coefficients. Results: The increase of ISQ in low primary stability group (LPSG) was 6.87 ± 3.62, which was significantly higher than the increase in high primary stability group (HPSG). A significant correlation between ITV and ISQ bbg (R = 0.606, P = 0.002) was found; however, age and peri-implant bone change were not found significantly related to implant stability parameters. It was presented that there were no significant peri-implant bone changes at 1 year after bone graft surgery. Conclusions: Bone graft procedure is beneficial for increasing the primary stability of immediately placed implants, especially when the ISQ of implants is below 65 and that bone grafts have some effects on peri-implant bone maintenance.
Primary stability is a fundamental criteria of implant success. There has been various trials to increase initial stability and bone to implant contact. The objective of osteotome technique is to preserve all the existing bone by minimizing or even eliminating the drilling sequence of the surgical protocol. The bone layer adjacent to the osteotomy site is progressively compacted with various bone condensers(osteotomes) this will result in a denser bone to implant contact. This improved bone density helps to optimize primary implant stability in low density bone. The use of wide implant is one of methods to increse primary stability. They can be used in special situations in which they can increase the surface area available for implant anchorage and improve their primary stability The aim of this study was to evaluate the influence of the osteotome technique and implant width on primary stability. Osteotome technique was compared with conventional drilling method by resonance frequency measurments according to the implant fixtures diameter. The results were as follows: 1. The average of ISQ value was sightly higher in osteotome technique, but there was not statistically significant in regular and narrow implant(p <0.05). 2. Either osteotome technique or conventional technique. ISQ value was significantly higer as increasing of implant diameter(p <0.05). 3. ISQ value of drilling technique was higer than those of osteotome technique in wide implant. It was assumed to be caused by difference in final preparation diameter.
Purpose: The alveolar ridge preservation (ARP) is widely conducted for implant placement. However, experimental results using deproteinized porcine bone mineral (DPBM) have been scarce. This retrospective study evaluated factors affecting the primary stability of implants in an area where ARP was performed using DPBM. Materials and Methods: Thirty-eight patients were divided into two groups based on the primary stability, with torque value of 30 Ncm as borderline. To determine the factors that affect the primary stability of implants, we collected data from patients' medical records including age, sex, reentry time, socket location, remaining bone wall at the time of extraction, and type of collagen membrane, as well as from radiographs and histomorphometric analysis. Result: The results showed statistically significant difference for the remaining extraction socket wall (P=0.014), residual graft (P=0.029), and fibrovascular tissue (P=0.02) between the two groups. There was an insignificant tendency toward the time of reentry surgery (P=0.052) and location (P=0.077). All implants placed in sites using DPBM functioned well up to 3 years. Conclusion: Within the limitations of the present study, extraction socket wall, residual graft, and fibrovascular tissue can affect the primary stability at the time of implant placement on grafted sites using DPBM and collagen membranes. In addition, reentry time and locations can be considered. In future studies, comparative experiments in quantified models will be required to supporting the findings.
Purpose: This study was performed to compare and evaluate the effect of recipient site depths and diameters of the drills on the primary stability of implant in pig's ribs. Materials and methods: An intact pig's rib larger than 8 mm in width and 20 mm in height; RBM(resorbable blasting media) surface blasted ${\phi}3.75mm$ and 8.0 mm long USII Osstem Implants (Osstem Co., Korea) were used. To measure the primary stability, $Periotest^{(R)}$ (Simens AG, Germany) and $Osstell^{TM}$ (Model 6 Resonance Frequency Analyser: Integration Diagnostics Ltd., Sweden) were used. They were divided into 6 groups according to its recipient site formation method: D3H3, D3H5, D3H7, D3.3H3, D3.3H5, D3.3H7. Each group had, as indicated, 10 implants placed, and total 60 implants were used. The mean value was obtained by 4-time measurements each on mesial, distal, buccal, and lingual side perpendicular to the long axis of the implant using $Periotest^{(R)}$ and $Osstell^{TM}$. For statistical analysis one-way ANOVA was used to compare the mean value of each group, and the correlation between placement depths and the primary stability, and that of measuring instruments was analyzed using SPSS 12.0. Results: The primary stability of the implants increased as the placement depths increased (p<0.05), and showed a proportional relationship (p<0.01). The primary stability increased when the diameter of the recipient site was smaller than that of the implant but with no statistical significance. There was a strong correlation between $Osstell^{TM}$ and $Periotest^{(R)}$ (p<0.01). Conclusion: These results suggest that increasing the placement depth of implants enhances the primary stability of implant.
Purpose: To find out the priority of which procedure has had a better outcome both clinically and radiographically between the two groups, one is treated by primary repair and the other by modified Brostr$\ddot{o}$m's procedure, by comparing the postoperative ankle joint stability and the patient's degree of satisfaction. Material and methods: 16 cases were taken into consideration whose number of severed ligaments were at least two or more of the lateral collateral ligaments of the ankle, and also were confirmed intraoperatively. Among them, 8 cases were treated with primary repair and the other 8 cases were treated with primary repair and the other 8 cases by modified Brostr$\ddot{o}$m's procedure. Results: There was no distinguishable difference for the patient's degree of satisfaction between the two procedures above mentioned. In 3 cases treated with primary repair, functional instability was observed. In case of postoperative ankle joint stability, 7 of 8 cases treated by modified Brostr$\ddot{o}$m's procedure has revealed increased joint stability. And 3 of 8 cases which were treated by primary repair have showed postoperative residual instability. Conclusion: Actually, the severed ligament can not maintain its normal strength though several months has elapsed, and possible residual instability could be remained. Therefore, it can be expected that modified Brostr$\ddot{o}$m's procedure also would be a .good method in obtaining suitable ankle joint stability as well as subtalar joint stability because of its reinforcement using extensor retinaculum.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제45권1호
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pp.29-33
/
2019
Objectives: Bone density seems to be an important factor affecting implant stability. The relationship between bone density and primary and secondary stability remains under debate. The aim of this study was to compare primary and secondary stability measured by resonance frequency analysis (RFA) between different bone types and to compare implant stability at different time points during 3 months of follow-up. Materials and Methods: Our study included 65 implants (BioHorizons Implant Systems) with 3.8 or 4.6 mm diameter and 9 or 10.5 mm length in 59 patients. Bone quality was assessed by Lekholm-Zarb classification. After implant insertion, stability was measured by an Osstell device using RFA at three follow-up visits (immediately, 1 month, and 3 months after implant insertion). ANOVA test was used to compare primary and secondary stability between different bone types and between the three time points for each density type. Results: There were 9 patients in type I, 18 patients in type II, 20 patients in type III, and 12 patients in type IV. Three implants failed, 1 in type I and 2 in type IV. Stability values decreased in the first month but increased during the following two months in all bone types. Statistical analysis showed no significant difference between RFA values of different bone types at each follow-up or between stability values of each bone type at different time points. Conclusion: According to our results, implant stability was not affected by bone density. It is difficult to reach a certain conclusion about the effect of bone density on implant stability as stability is affected by numerous factors.
This paper describes the variation of the critical speed of an urban railway vehicle according to the change of suspension characteristics. Suspensions of a railway vehicle are composed of primary and secondary suspensions. Generally, main focus of the stability analysis has been the primary suspension. However, secondary suspension has large effects on the stability as well as the ride quality of a vehicle. In this paper, stability of an urban railway vehicle is discussed in relation to the variation of characteristics of both primary and secondary suspension. For this, modal analysis is carried out using a linear dynamic model of a half vehicle and a polynomial fit for Kalker's creep coefficients. Stability along with change of the effective conicity of a wheel is also investigated.
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