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Influence of Skeletal and Local Bone Density on Dental Implant Stability in Patients with Osteoporosis

Journal article
Authors J. Merheb
A. Temmerman
Lars Rasmusson
A. Kubler
A. Thor
M. Quirynen
Published in Clinical Implant Dentistry and Related Research
Volume 18
Issue 2
Pages 253-260
ISSN 1523-0899
Publication year 2016
Published at Institute of Odontology, Section 1
Pages 253-260
Language en
Keywords density, dual-energy X-ray absorptiometry, implant, ISQ, Osstell, osteoporosis, resonance, resonance frequency analysis, stability, resonance frequency-analysis, insertion torque, maxilla, survival, outcomes, surface, system, device
Subject categories Dentistry


Background and PurposeOsteoporosis is a major skeletal disease affecting millions of people worldwide. Recent studies claim that patients with osteoporosis do not have a higher risk of early implant failure compared to non-osteoporotic patients. The aim of this study was to assess the effect of skeletal osteoporosis and local bone density on initial dental implant stability. Materials and MethodsSeventy-three patients were recruited and were assigned (based on a Dual-energy X-ray Absorptiometry scan) to either the osteoporosis (Opr), osteopenia (Opn), or control (C) group. Forty nine of the 73 patients received dental implants and had implant stability measured by means of resonance frequency analysis (RFA) at implant placement and at prosthetic abutment placement. On the computerized tomography scans, the cortical thickness and the bone density (Hounsfield Units) at the sites of implant placement were measured. ResultsAt implant placement, primary stability was on average lower in group Opr (63.310.3 ISQ) than in group Opn (65.3 +/- 7.5 implant stability qutient (ISQ)), and group C (66.7 +/- 8.7 ISQ). At abutment placement, a similar trend was observed: group Opr (66.4 +/- 9.5 ISQ) scored lower than group Opn (70.7 +/- 7.8 ISQ), while the highest average was for group C (72.2 +/- 7.2 ISQ). The difference between groups Opr and C was significant. Implant length and diameter did not have a significant effect on implant stability as measured with RFA. A significant correlation was found between local bone density and implant stability for all regions of interest. ConclusionsImplant stability seems to be influenced by both local and skeletal bone densities. The lower stability scores in patient with skeletal osteoporosis reinforce the recommendations that safe protocols and longer healing times could be recommended when treating those patients with dental implants.

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