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

Taek-Ka Kwon; In-Sung Yeo; Sung-Hun Kim; Jung-Suk Han; Jai-Bong Lee; Jae-Ho Yang

doi:10.4047/jkap.2011.49.2.128

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Kwon, Yeo, Kim, Han, Lee, and Yang: Implant stability evaluation according to the bone condition, fixture diameter and shape in the osseointegration simulated resin model

ORIGINAL ARTICLE

J Korean Acad Prosthodont 2011;49(2):128-137.

Published online: 18 December 2011

DOI: https://doi.org/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

Taek-Ka Kwon, DDS, MSD^1,², In-Sung Yeo, MSD, DDS, PhD², Sung-Hun Kim, DDS, PhD², Jung-Suk Han, MSD, DDS, PhD², Jai-Bong Lee, MSD, DDS, PhD², Jae-Ho Yang, DDS, MSD, PhD^2,^∗

^¹Department of Prosthodontics, School of Dentistry, Catholic University of Korea

^²Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Korea

∗Corresponding Author: Jae-Ho Yang Department of Prosthodontics, School of Dentistry, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-749, Korea +82 2 2072 3393: e-mail, jhoyang@snu.ac.kr

Received 5 October 201020 February 2011 Accepted 11 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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. (J Korean Acad Prosthodont 2011;49:128-37)

Keywords: Implant stability, Resonance frequency analysis, Periotest, Removal torque

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Fig. 1.

Aluminum mold for specimen.

Fig. 2.

Osseointegration simulated specimen.

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).

Fig. 4.

Evaluation of resonance frequency.

Fig. 5.

Evaluation of Periotest.

Fig. 6.

Removal torque test with motorized torque test stands, TSTM.

Fig. 7.

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

Fig. 8.

Mean PTV and static differences when engaged resin depth increased.

Fig. 9.

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

Fig. 10.

Mean PTV and static differences when cervical defect was increased.

Fig. 11.

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

Fig. 12.

Correlation between ISQ values and removal torque (Ncm).

Fig. 13.

Correlation between Periotest values and removal torque (Ncm).

Table 1.

Implant stability quotient (ISQ), periotest value (PTV), removal torque (RT, Ncm) in part 1 experiment (mean ± SD)

			Engaged acrylic resin depth			P value
		1 mm	3 mm	5 mm	10 mm	P value
Total	ISQ	48.37 ± 6.21	78.60 ± 1.85	85.20 ± 1.92	87.90 ± 1.70	<.001
	PTV	5.93 ± 3.19	-4.18 ± 0.74	-6.05 ± 0.65	-6.92 ± 0.42	<.001
	RT	26.41 ± 9.97	57.74 ± 31.33			<.001
Straight,	ISQ	45.20 ± 5.25	76.70 ± 1.30	83.60 ± 1.47	86.40 ± 0.82	<.001
Diameter 4 mm (S4)	PTV	7.45 ± 3.02	-3.49 ± 0.59	-5.51 ± 0.43	-6.60 ± 0.30	<.001
	RT	30.58 ± 7.60	40.96 ± 25.08			.28
Tapered,	ISQ	44.60 ± 3.59	78.50 ± 0.69	84.70 ± 1.19	87.40 ± 1.19	<.001
Diameter 4 mm (T4)	PTV	7.84 ± 1.83	-4.05 ± 0.22	-5.87 ± 0.47	-6.76 ± 0.22	<.001
	RT	31.08 ± 7.52	58.68 ± 31.82			.05
Tapered,	ISQ	55.30 ± 1.78	80.60 ± 0.68	87.30 ± 0.66	89.90 ± 0.31	<.001
Diameter 5 mm (T5)	PTV	2.52 ± 0.75	-5.01 ± 0.23	-6.77 ± 0.16	-7.41 ± 0.16	<.001
	RT	17.58 ± 8.43	73.58 ± 29.06			<.001

∗ ISQ and PTV were analyzed with Kruskal-Wallis test. RT was analyzed with Mann-Whitney U test. SD, standard deviation.

Table 2.

Implant stability quotient (ISQ), periotest value (PTV) in part 2 experiment (mean ± SD)

			Cervical defect depth			P value
		0 mm	1 mm	3 mm	5 mm	P value
Total	ISQ	87.90 ± 1.70	85.82 ± 2.84	80.37 ± 3.68	72.08 ± 4.75	<.001
	PTV	-6.92 ± 0.42	-6.33 ± 0.79	-4.08 ± 1.29	-0.30 ± 2.39	<.001
S4	ISQ	86.40 ± 0.82	83.25 ± 1.80	77.35 ± 0.81	69.70 ± 3.34	<.001
	PTV	-6.60 ± 0.30	-5.64 ± 0.59	-3.21 ± 0.38	0.76 ± 1.87	<.001
T4	ISQ	87.40 ± 1.19	84.90 ± 0.97	78.55 ± 1.88	68.80 ± 1.99	<.001
	PTV	-6.76 ± 0.22	-6.13 ± 0.40	-3.33 ± 0.91	1.29 ± 1.58	<.001
T5	ISQ	89.90 ± 0.31	89.30 ± 0.47	85.20 ± 0.41	77.75 ± 1.94	<.001
	PTV	-7.41 ± 0.16	-7.23 ± 0.15	-5.71 ± 0.12	-2.93 ± 0.76	<.001

∗ SD, standard deviation; S4, straight and 4 mm diameter; T4, tapered and 4 mm diameter; T5, tapered and 5 mm diameter.

∗ ISQ and PTV were analyzed with Kruskal-Wallis test. RT was analyzed with Mann-Whitney U test.

Table 3.

Influence of diameter and shape on ISQ, Periotest Value (PTV), Removal Torque (RT) (mean ± SD)

Resin depth	Cervical defect		Different diameter		P value	Different shape		P value
Resin depth	Cervical defect		T4	T5	P value	S4	T4	P value
1 mm		ISQ	44.60 ± 3.59	55.30 ± 1.78	<.001	45.20 ± 5.25	44.60 ± 3.59	.74
		PTV	7.84 ± 1.83	2.52 ± 0.75	<.001	7.45 ± 3.02	7.84 ± 1.83	.11
		RT	31.08 ± 7.52	17.58 ± 8.43	<.001	30.58 ± 7.60	31.08 ± 7.52	.51
3 mm		ISQ	78.50 ± 0.69	80.60 ± 0.68	<.001	76.70 ± 1.30	78.50 ± 0.69	<.001
		PTV	-4.05 ± 0.22	-5.01 ± 0.23	<.001	-3.49 ± 0.59	-4.05 ± 0.22	<.01
		RT	58.68 ± 31.82	73.58 ± 29.06	.05	40.96 ± 25.08	58.68 ± 31.82	.05
5 mm		ISQ	84.70 ± 1.19	87.30 ± 0.66	<.001	83.60 ± 1.47	84.70 ± 1.19	<.05
		RT	-5.87 ± 0.47	-6.77 ± 0.16	<.001	-5.51 ± 0.43	-5.87 ± 0.47	<.01
10 mm	0 mm	ISQ	87.40 ± 1.19	89.90 ± 0.31	<.001	86.40 ± 0.82	87.40 ± 1.19	<.01
		PTV	-6.76 ± 0.22	-7.41 ± 0.16	<.001	-6.60 ± 0.30	-6.76 ± 0.22	.132
	1 mm	ISQ	84.90 ± 0.97	89.30 ± 0.47	<.001	83.25 ± 1.80	84.90 ± 0.97	<.01
		PTV	-6.13 ± 0.40	-7.23 ± 0.15	<.001	-5.64 ± 0.59	-6.13 ± 0.40	<.05
	3 mm	ISQ	78.55 ± 1.88	85.20 ± 0.41	<.001	77.35 ± 0.81	78.55 ± 1.88	<.01
		PTV	-3.33 ± 0.91	-5.71 ± 0.12	<.001	-3.21 ± 0.38	-3.33 ± 0.91	<.05
	5 mm	ISQ	68.80 ± 1.99	77.75 ± 1.94	<.001	69.70 ± 3.34	68.80 ± 1.99	<.01
		PTV	1.29 ± 1.58	-2.93 ± 0.76	<.001	0.76 ± 1.87	1.29 ± 1.58	<.01

∗ ISQ, PTV and RT were analyzed with Mann-Whitney U test. SD, standard deviation

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