A Clinical Study of the Implant Stability Quotient and the Insertion Torque at Implant Placement

Shigehiro Ono DDS, PhD, Department of Oral and Maxillofacial Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Yoshiaki Ninomiya DDS, PhD, Department of Oral and Maxillofacial Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Kouji Ohta DDS, PhD, Department of Oral and Maxillofacial Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Takayuki Nakagawa DDS, PhD, Department of Oral and Maxillofacial Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Magumi Takamoto PhD, Department of Oral and Maxillofacial Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Masaaki Takechi DDS, PhD, Department of Oral and Maxillofacial Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Statement and problem

For objective based evaluation of implant stability, we use a resonance frequency analyzing device (Osstell ISQ®). This device determines the implant stability quotient (ISQ) by analyzing the resonance frequency emitted by a transducer attached to the implant, which is then used for evaluating the initial fixation. In the present report, we determined ISQ values, insertion torque values, implant length and width, and bone quality as part of a clinical statistics investigation.

Patients and methods

The subjects were 85 patients whose ISQ and torque values were determined at the time of implant insertion performed from January 2009 to December 2013 at the Department of Oral and Maxillofacial Reconstructive Surgery, Hiroshima University Hospital. They consisted of 37 male and 48 female, with ages ranging from 17 to 86 years old (mean 52.25 years old). A total of 208 implants were inserted; 106 in the upper jaw and 102 in the lower jaw. The correlations of ISQ (measured value, percentage of increase) and insertion torque values with sex, age, insertion site, bone quality (Lechholn & Zarb classification), and implant length and width were examined by statistical analysis.

Data analysis

Student’s t-test was used for continuous variables. All statistical analysis were performed using EZR (Saitama Medical Center, Jichi Medical University), a graphical user interface for R (The R Foundation for Statistical Computing, version 2.13.0). More precisely, this is a modified version of R commander (version 1.6-3) that includes statistical functions frequently used in biostatistics.

Results

ISQ values at the time of implant placement showed significant correlations with age, insertion site, implant length and width, and bone quality. In addition, those at the time of secondary surgery showed significant correlations with age, site, and bone quality. Insertion torque values showed significant correlations with site and bone quality. Moreover, our findings suggested that ISQ at the time of secondary surgery had a significantly greater increase in implants with an ISQ value of ≤73 as compared to those with an ISQ value of >73.

Conclusion

The present results indicate that evaluation of ISQ and insertion torque values during implant surgery may be effective for providing parameters to determine the advisability of immediate or early loading, or for predicting early osseointegration. In addition, in regard to implant selection, the choice of implant with as great a width as possible might be an important factor for treatment success, though that is also dependent on the state of the alveolar bone.

Oh JS, Kim SG.

Clinical study of the relationship between implant stability measurements using Periotest and Osstell mentor and bone quality assessment.

Oral Surg Oral Med Oral Pathol Oral Radiol. 113(3):e35-40. (2012)

Turkyilmaz I, Tumer C, Ozbek EN, Tözüm TF.

Relations between the bone density values from computerized tomography, and implant stability parameters: a clinical study of 230 regular platform implants.

J Clin Periodontol. 34(8):716-722.(2007)

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