The Evaluation of the Reliability of Periotest for Implant Stability Measurements: An In Vitro Study

Correlation of two different devices for the evaluation of primary implant stability depending on dental implant length and bone density: An in vitro study

Non-invasive objective implant stability measurements are needed to determine the appropriate timing of prosthetic fitting after implant placement. We compared the early implant stability results obtained using resonance frequency analysis (RFA) and damping capacity analysis (DCA) depending on the implant length and bone density. Total 60, 4.0 mm diameter implants of various lengths (7.3 mm, 10 mm, and 13 mm) were used. In Group I, low-density bone was described using 15 PCF (0.24 g/cm3) polyurethane bone blocks, and in Group II, 30 PCF (0.48 g/cm3) polyurethane bone blocks were used to describe medium density bone. RFA was performed using an Osstell® Beacon+; DCA was performed using Anycheck®. Measurements were repeated five times for each implant. Statistical significance was set at P <0.05. In Group I, bone density and primary implant stability were positively correlated, while implant length and primary implant stability were positively correlated. In Group II, the implant stability quotient (ISQ) and implant stability test (IST) values in did not change significantly above a certain length. Primary implant stability was positively correlated with bone density and improved with increasing implant length at low bone densities. Compared with the Osstell® Beacon+, the simplicity of Anycheck® was easy to use and accessible.

The effect of surface roughening on the success of orthodontic mini-implants: A systematic review and meta-analysis

INTRODUCTION

Orthodontic mini-implants are a widely accepted treatment modality in orthodontics; however, the failure rate is moderately high. Surface roughening is the golden standard in conventional oral implantology, and this may prove beneficial for orthodontic mini-implants as well. The objective of this systematic review is to assess the effect of surface roughening on the success rate of orthodontic mini-implants in both adolescent and adult patients undergoing orthodontic treatment.

METHODS

Randomized studies comparing the success of surface-roughened and smooth, machined-surface orthodontic mini-implants were included. A literature search was conducted for 6 electronic databases (Pubmed/Medline, Embase, Cochrane, CINAHL, Web of Science, and Scopus), Clinical trial registry (https://www.

CLINICALTRIALS

gov), and grey literature (Google Scholar). A manual search of the reference lists of included studies was performed. Two authors independently performed the screening, data extraction, risk of bias, and quality assessments. The risk of bias was assessed with the Cochrane risk-of-bias 2.0 Tool. Data were synthesized using a random effect model meta-analysis presented as a forest plot. The certainty in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool.

RESULTS

A total of 4226 unique records were screened, and 6 of these were included in the quantitative analysis. Four additional articles were selected for a secondary outcome. A total of 364 orthodontic mini-implants were included in the primary outcome analysis. There was no statistically significant effect of surface roughening on the success of orthodontic mini-implants (odds ratio = 0.63 favoring roughened orthodontic mini-implants; 95% confidence interval, 0.35-1.14). The secondary outcome (ie, the overall failure rate of roughened orthodontic mini-implants) was 6% based on studies with high heterogeneity. Limitations of this study were the risk of bias, study imprecision, and possible publication bias, leading to a very low certainty in the body of evidence.

CONCLUSIONS

There is very low-quality evidence that there is no statistically significant effect of surface roughening on the success of orthodontic mini-implants in humans. The overall failure rate of surface-roughened orthodontic mini-implants was 6%.

FUNDING

No funding was received for this review.

REGISTRATION

This study was preregistered in the Prospective Register of Systematic Reviews (CRD42022371830).

Cortical bone microdamage affects primary stability of orthodontic miniscrew

BACKGROUND

The aim of this study was to investigate the effects of orthodontic miniscrew pitch and thread shape on microdamage in cortical bone. The relationship between the microdamage and primary stability was also examined.

METHODS

Ti6Al4V orthodontic miniscrews and 1.0-mm-thick cortical bone pieces from fresh porcine tibia were prepared. The orthodontic miniscrews had custom-made thread height (H) and pitch (P) size geometries, and were classified into three groups: control geometry; HCPC (HC; thread height = 0.12 mm, PC; pitch size = 0.60 mm), geometry with a narrower pitch; HCPN (HC; thread height = 0.12 mm, PN; pitch size = 0.30 mm), and geometry with a taller thread height; HTPC (HT; thread height = 0.36 mm, PC; pitch size = 0.60 mm). The orthodontic miniscrews were inserted into a pilot hole in the cortical bone, and maximum insertion torque and Periotest value were measured. After insertion, the samples were stained with basic fuchsin. Histological thin sections were obtained and the bone microdamage parameters, i.e., total crack length and total damage area, and insertion state parameters, i.e., orthodontic miniscrew surface length and bone compression area were calculated.

RESULTS

The orthodontic miniscrews with the taller thread height resulted in lower primary stability with minimal bone compression and microdamage; however, the narrower thread pitch led to maximum bone compression and extensive bone microdamage.

CONCLUSIONS

A wider thread pitch reduced microdamage, and decreased thread height resulted in increased bone compression, ultimately resulting in increased primary stability.

Efficacy of laser in re-osseointegration of dental implants-a systematic review

Despite their high success rates, peri-implantitis can affect the stability and function of dental implants. Various treatment modalities have been investigated for the treatment of peri-implantitis to achieve re-osseointegration. An electronic literature search was performed supplemented by a manual search to identify studies published until January 2022. Articles that evaluated re-osseointegration in peri-implantitis sites in animal models following laser therapy or antimicrobial photodynamic therapy (aPDT) were included. Case reports, case series, systematic reviews, and letters to the editor were excluded. Risk of bias and GRADE assessment were followed to evaluate the quality of the evidence. Six studies out of 26 articles identified on electronic search were included in this review. The studies included animal studies conducted on canine models. Four out of six studies reported a higher degree of re-osseointegration following treatment of implants with laser therapy. The findings suggest that laser decontamination shows potential in enhancing re-osseointegration, particularly with the Er: YAG laser, which effectively decontaminated implant surfaces. However, conflicting outcomes and limitations in the evidence quality warrant caution in drawing definitive conclusions. Based on the limited available evidence, laser therapy may show a higher degree of re-osseointegration of implants than mechanical debridement.

Evaluation of Implant Stability According to Implant Placement Site and Duration in Elderly Patients: A Prospective Multi-Center Cohort Study

The aim of this prospective study is to investigate implant stability and the reliability of different measuring devices according to implant placement site and duration in patients aged over 65 years. The study evaluated 60 implants (diameter: 3.5/4.0/4.5/5.0 mm and length: 8.5/10.0/11.5 mm) in 60 patients aged ≥ 65 years. The implant placement sites were divided into six evenly distributed sections (n = 10), i.e., maxillary right-posterior, A; maxillary anterior, B; maxillary left-posterior, C; mandibular right-posterior, D; mandibular anterior, E; mandibular left-posterior, F. Participants visited the hospital six times: implant surgery, 1V; stitch removal, 2V; 1-month follow-up, 3V; 2-month follow-up, 4V; before final restoration delivery, 5V; and after final restoration delivery, 6V. The implant stability was evaluated with the Osstell Mentor (ISQ), Periotest M (PTV), and Anycheck (IST). The mean values of ISQ, PTV, and IST were analyzed (α = 0.05). ISQ, PTV, and IST results of 4V and 5V were significantly higher than those of 1V (p < 0.05). The lowest ISQ results occurred in the E location at 4V and 5V (p < 0.05). In all mandibular locations, IST results of 6V were significantly higher than those of 1V, 2V, 3V, and 4V (p < 0.05). ISQ results were negatively correlated with PTV and positively correlated with IST, and PTV was negatively correlated with IST. By considering various factors affecting the stability of the implant, it is necessary to determine the appropriate implant load application time. This could help increase the implant success rate in elderly patients. And as a diagnostic device for implant stability and the evaluation of osseointegration in elderly patients, Anycheck was also able to prove its relative reliability compared to Osstell ISQ Mentor and Periotest M.

Clinical Validation of Dental Implant Stability by Newly Designed Damping Capacity Assessment Device during the Healing Period

Background and Objectives: To evaluate the stability of a dental implant and the effectiveness of a newly designed damping capacity assessment device by improving the number of blows and strength evaluated by a prospective clinical study. Materials and Method: The stability of dental implants was measured in 50 implants in a total of 38 patients. Measurements were performed using Anycheck and Periotest M devices, twice in total, divided into buccal and lingual directions. In addition, measurements were performed on the day of surgery, two weeks, one month, two months, and three months after surgery for a total of five times. After the standardization of the measured values, the differences and changes over time for each device were observed. Result: No difference in standardized values between the two devices was observed at any time point. In both devices, stability decreased at two weeks postoperatively but gradually increased thereafter. No differences were observed in the values according to the measurement direction. Conclusions: The damping capacity of Anycheck was similar to that of Periotest M. After a slight decrease in stability two weeks after implant placement, implant stability increased over time.

Intra- and inter-operator concordance of the resonance frequency analysis. A cross-sectional and prospective clinical study

OBJECTIVE

Resonance frequency analysis (RFA) provides an evaluation of implant stability over time. This analysis is a non-invasive, precise, and objective method. Several studies compare the RFA system with other devices. However, few investigations analyze repeatability and reproducibility between different operators. The aim of this study was to evaluate the intra- and inter-operator concordance of the Osstell® ISQ.

MATERIAL AND METHODS

RFA measurements were performed with Osstell® ISQ in a total of 37 implants placed in 21 patients. At the time of implant placement, 6 measurements per implant were taken by three different experienced operators. Three measurements were carried out consecutively and three by removing and placing the SmartPeg-Osstell® to assess intra-operator and inter-operator agreement.

RESULTS

Intra-operator concordance according to the intraclass correlation coefficient (ICC) showed high concordance. The ICC values were higher than 0.9 (p < 0.0001) for consecutive measures and alternative measures, being almost perfect of Landis & Koch classification. For inter-operator concordance The ICC was 0.709 (p < 0.0001) and 0.670 (p < 0.0001) for consecutive and alternative measures, respectively, both estimates being in the substantial category. In torque and ISQ values, no statistically significant differences were observed when operators and measurements were compared.

CONCLUSIONS

Osstell® ISQ system was stable both in intra-operator and inter-operator measurements. This device has excellent repeatability and reproducibility, demonstrating reliability to measure the stability of dental implants.

CLINICAL RELEVANCE

Resonance frequency analysis (RFA) is a non-invasive, objective, and reliable diagnostic method to determine the ideal moment to load the implant, as well as to predict possible failures.

Photobiomodulation stimulates surrounding bone formation and increases stability of titanium alloy miniscrews in ovariectomized rats

The number of older individuals (> 60 years) treated in orthodontic dental practice is constantly growing, and osteoporosis is a common disease within this age range. Orthodontic treatment for this group tends to be challenging, often requiring the use of mini-implants. Mini-implants are important accessories in orthodontic treatment that provide solutions to complex cases. Despite the high level of success, these devices are prone to failure if insufficient bone stability is achieved. This study aimed to evaluate the effects of photobiomodulation on bone neoformation around mini-implants using fluorescence analysis in ovariectomized rats. A total of 12 female rats (Wistar) were ovariectomized and divided into three groups: two groups of low-level laser therapy irradiation in two different protocols, as follows: in the PBM1 group, applications were performed using 2 J, for 20 s each for 48 h, 6 irradiations in total, and in the PBM2 group, a single application of 4 J was performed for 40 s, and the third group represented the control group, and no laser therapy was applied. Each rat received two mini-implants placed immediately behind the upper incisors, and 0 g of force was applied using a NiTi spring. All rats received two bone markers, tetracycline (days 0-4) and alizarin (days 7-10), for 5 days each. Both markers were bound to calcium, allowing visualization of bone neoformation through fluorescence microscopy. After 12 days, euthanasia was performed; the results revealed that both irradiated groups showed significantly greater bone neoformation compared to the control group (p < 0.05). Mini-implant stability was measured in all animals using the Periotest device on day 0 and on the day of euthanasia. A significant increase in stability was observed in the group that received more laser application (p < 0.05). Photobiomodulation had a positive effect on bone neoformation around mini-implants in ovariectomized rats, with an increase in stability when more irradiation was performed.

Local application of the osteogenic inducer sustained-release system promotes early bone remodeling around titanium implants

Enhanced osseointegration and a shortened healing time are required for dental implant treatment. The aim of this study was to evaluate whether topical application of the osteogenic inducer (OI) sustained-release system over the implant promotes early bone remodeling around the implant. The mandibular canines of 15 New Zealand White rabbits were extracted. After 3 months of healing, implants coated with poly(lactic-co-glycolic acid) (PLGA)+OI, PLGA alone, or no material (control) were inserted into the canine sites. After 4 weeks, specimens were harvested from the three groups and evaluated. Implant stability recorded by Periotest revealed significantly higher values for the PLGA + OI group (-2.61 ± 0.43) than for the PLGA (-1.47 ± 0.45) and control groups (-1.08 ± 0.19) (P < 0.001). Moreover, the PLGA+OI group had improved bone volume and structural parameters around the implants at 4 weeks, as shown by significantly increased BV/TV, BSA/BV, Tb.Th, and BIC (P < 0.05), as well as decreased Tb.Sp (P = 0.010) compared with the other groups. The histological results showed more trabecular bone and bone matrix around the implants in the PLGA+OI group. Therefore, local application of the OI sustained-release system might be able to promote early bone remodeling around titanium implants and facilitate faster and better osseointegration.

Effects of low-level laser therapy on the orthodontic mini-implants stability: a systematic review and meta-analysis

Objectives

The aim of this systematic review and meta-analysis was to assess the effects of low-level laser therapy (LLLT) on the orthodontic mini-implants (OMI) stability.

Materials and methods

An unrestricted electronic database search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, Google Scholar, and ClinicalTrials.gov and a hand search were performed up to December 2020. Randomized clinical trials (RCTs) or non-randomized clinical trials (Non-RCTs) that assessed the effects of LLLT on the OMI stability were included. Data regarding the general information, LLLT characteristics, and outcomes were extracted. The authors performed risk of bias assessment with Cochrane Collaboration’s or ROBINS-I tool. Meta-analysis was also conducted.

Results

Five RCTs and one Non-RCT were included and 108 patients were evaluated. The LLLT characteristics presented different wavelength, power, energy density, irradiation time, and protocol duration. Five RCTs had a low risk of selection bias. Two RCTs had a low risk of performance and detection bias. All RCTs had a low risk of attrition bias, reporting bias and other bias. The Non-RCT presented a low risk of bias for all criteria, except for the bias in selection of participants. The meta-analysis revealed that LLLT significantly increased the OMI stability (p < 0.001, Cohen’s d = 0.67) and the highest clinical benefit was showed after 1 (p < 0.001, Cohen’s d = 0.75), 2 (p < 0.001, Cohen’s d = 1.21), and 3 (p < 0.001, Cohen’s d = 1.51) months of OMI placement.

Conclusions

LLLT shows positive effects on the OMI stability.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40510-021-00350-y.

Correlation of Implant Stability Between Two Noninvasive Methods Using Submerged and Nonsubmerged Healing Protocols: A Randomized Clinical Trial

Various invasive and noninvasive methods have been used for measuring primary implant stability. Periotest damping device and resonance frequency analysis with the Osstell device have been classified as noninvasive methods. Primary and secondary implant stability measurements using both devices have given reproducible quantitative values. In this clinical randomized trial, a general correlation was evaluated between the implant stability recorded using both Osstell and Periotest devices on the day of implant installation and 3 months after healing for the submerged and nonsubmerged loading protocols. The present study also investigated whether the difference in gender of the included patients would have an effect on the correlation between the two devices. Eighty completely edentulous patients were recruited, and all patients ranged from 50 to 69 years of age. Overall, 56 men and 24 women were included, with a mean age of 62.5 years for men and 59.6 years for women. A single implant was installed in the midline of the completely edentulous mandible to improve retention of the patient's lower denture. After implant installation, one implant stability quotient (ISQ) value at the buccal surface was recorded, and then the Periotest M device was used to measure the damping effect (Periotest value [PTV]) of the installed implant using the smart peg screwed to the implant. Patients were then randomized into 2 groups using sealed envelopes: the submerged and nonsubmerged groups. For both groups, all ISQ and Periotest readings were recorded in the patient's case report file on the day of implant installation and 3 months after healing. When the ISQ of the buccal surface was correlated to the PTV, there was a moderate negative statistically significant correlation between the 2 readings (correlation coefficient = -.466, P = .000). There tended to be a weak negative correlation between the 2 devices in the male group (correlation coefficient = .395, P = .046) during implant installation, although there tended to be no correlation between the 2 devices in the female group (correlation coefficient = -.367, P = .342). After 3 months of healing, when correlating the readings of the buccal surface of the Osstell with that of the Periotest within each group (submerged and nonsubmerged), there was no statistically significant correlation between the readings within each group (correlation coefficient = -.014, -.430, P = .942, P = .052, respectively). However, there was a strong negative statistically significant correlation between the 2 devices for the female group for both the nonsubmerged group (correlation coefficient = -.823, P = .003) and submerged group (correlation coefficient = -.857, P = .014), whereas there was no statistically significant correlation within the male group for both the nonsubmerged group (correlation coefficient = -.377, P = .123) and submerged group (correlation coefficient = -.022, P = .940). The correlation between the Osstel and Periotest device remains controversial. The present study concluded that there is a significant negative correlation between the 2 devices when recording primary implant stability, although this significance is lost after 3 months of loading when recording secondary implant stability. Gender also affects the implant stability recording, which is mainly due to the difference in bone density between men and women.

Effects of supporting conditions and anchor microscrew on the stabilization of the implant guide template during the drilling process: An in vitro study

STATEMENT OF PROBLEM

Implant placement errors have been reported in guided surgeries because of movement of the guide template during implant placement. With a completely limiting guide design with high restrictions, guide template stabilization is essential to minimize mobility during the drilling process.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of supporting conditions and the use of an anchor microscrew on the seating and functional stabilization of a computer-aided design and computer-aided manufacturing (CAD-CAM) implant surgical guide with a completely limiting design.

MATERIAL AND METHODS

Twelve implant surgical guide templates were fabricated under different supporting conditions: tooth-mucosa, tooth-tooth, tooth-screw, and screw-screw (n=3 per group). In the tooth-screw and screw-screw groups, anchor microscrews and anchor caps were used to fix the guide templates. The seating stability of the templates was evaluated by using a micromovement assessment. The functional stability of the templates was analyzed during the drilling process by using a motion tracking method. One-way analysis of variance and the Tukey HSD post hoc test were conducted to compare the differences among the groups (α=.05).

RESULTS

The tooth-tooth, tooth-screw, and screw-screw groups exhibited similar seating stability, which was significantly more stable than that of the tooth-mucosa group (P<.001). In terms of functional stability, the tooth-mucosa group reported the highest positional deviation and motion magnitude, whereas low values were found in the tooth-screw and screw-screw groups (P<.001).

CONCLUSIONS

The use of anchor microscrews can increase the seating and functional stability of CAD-CAM guide templates during the drilling process for implant placement.

Comparison of implant stability measurements between a resonance frequency analysis device and a modified damping capacity analysis device: an in vitro study

Purpose

A stability-measuring device that utilizes damping capacity analysis (DCA) has recently been introduced in the field of dental implantology. This study aimed to evaluate the sensitivity and reliability of this device by measuring the implant stability of ex vivo samples in comparison with a resonance frequency analysis (RFA) device.

Methods

Six implant beds were prepared in porcine ribs using 3 different drilling protocols to simulate various implant stability conditions. Thirty-six pork ribs and 216 bone-level implants measuring 10 mm in height were used. The implant beds were prepared using 1 of the following 3 drilling protocols: 10-mm drilling depth with a 3.5-mm-diameter twist drill, 5-mm drilling depth with a 4.0-mm-diameter twist drill, and 10-mm drilling depth with a 4.0-mm-diameter twist drill. The first 108 implants were external-connection implants 4.0 mm in diameter, while the other 108 implants were internal-connection implants 4.3 mm in diameter. The peak insertion torque (PIT) during implant placement, the stability values obtained with DCA and RFA devices after implant placement, and the peak removal torque (PRT) during implant removal were measured.

Results

The intraclass correlation coefficients (ICCs) of the implant stability quotient (ISQ) results obtained using the RFA device at the medial, distal, ventral, and dorsal points were 0.997, 0.994, 0.994, and 0.998, respectively. The ICCs of the implant stability test (IST) results obtained using the DCA device at the corresponding locations were 0.972, 0.975, 0.974, and 0.976, respectively. Logarithmic relationships between PIT and IST, PIT and ISQ, PRT and IST, and PRT and ISQ were observed. The mean absolute difference between the ISQ and IST values on a Bland-Altman plot was −6.76 (−25.05 to 11.53, P<0.05).

Conclusions

Within the limits of ex vivo studies, measurements made using the RFA and DCA devices were found to be correlated under a variety of stability conditions.

New Dental Implant with 3D Shock Absorbers and Tooth-Like Mobility-Prototype Development, Finite Element Analysis (FEA), and Mechanical Testing

Background: Once inserted and osseointegrated, dental implants become ankylosed, which makes them immobile with respect to the alveolar bone. The present paper describes the development of a new and original implant design which replicates the 3D physiological mobility of natural teeth. The first phase of the test followed the resistance of the implant to mechanical stress as well as the behavior of the surrounding bone. Modifications to the design were made after the first set of results. In the second stage, mechanical tests in conjunction with finite element analysis were performed to test the improved implant design. Methods: In order to test the new concept, 6 titanium alloy (Ti6Al4V) implants were produced (milling). The implants were fitted into the dynamic testing device. The initial mobility was measured for each implant as well as their mobility after several test cycles. In the second stage, 10 implants with the modified design were produced. The testing protocol included mechanical testing and finite element analysis. Results: The initial testing protocol was applied almost entirely successfully. Premature fracturing of some implants and fitting blocks occurred and the testing protocol was readjusted. The issues in the initial test helped design the final testing protocol and the new implants with improved mechanical performance. Conclusion: The new prototype proved the efficiency of the concept. The initial tests pointed out the need for design improvement and the following tests validated the concept.

The behavior of polyetheretherketone healing abutments when measuring implant stability with electronic percussive testing

BACKGROUND

It is unknown whether it is possible to measure implant stability with polyetheretherketone (PEEK) healing abutments using electronic percussive testing (EPT).

PURPOSE

To investigate the reliability of the percussive test values (PTVs) measured with PEEK healing abutments and to compare them with the PTVs measured with titanium healing abutments.

MATERIAL AND METHODS

Thirty dental implants were inserted into the fresh pelvis belonging to a cow. Titanium healing abutments (2 and 5 mm), PEEK healing abutments (5 mm), and prepable standard titanium abutments (5 mm) were screwed to the implants, respectively, and PTVs were measured by two examiners using a wireless EPT device. Differences in PTVs between different dental implant components were evaluated using Friedman's test with post hoc Wilcoxon signed-rank test and Bonferroni correction. Inter and intra-observer reliabilities were detected using interclass correlation coefficients (ICCs) RESULTS: The mean PTVs obtained using the PEEK healing abutments were significantly higher than the mean PTVs obtained using the other abutments for both examiners (P < .01). The ICCs for intra-observer reliability were detected as poor for PEEK healing abutments; and excellent for the other abutment types for both examiners. The ICCs for the inter-observer reliability between the two examiners were poor (0.25) for PEEK healing abutments, and excellent for the 2 and 5 mm titanium healing abutments and for standard abutments (0.82, 0.84 and 0.93, respectively).

CONCLUSION

Within the limitations of this in vitro study, it may be concluded that EPT measurements should be avoided using PEEK healing abutments because of the poor reliability.

Influence of the Localization of Frontal Bone Defects on Primary Stability Values of 2 Different Implant Designs: An In Vitro Study

OBJECTIVES

The aim of this study was to determine the influence of different frontal bone defect localizations on primary stability values of 2 different implant designs.

MATERIALS AND METHODS

Eight cow rib segments were prepared before implant installation, as 2 segments with coronal, 2 with middle, and 2 with apical defects and 2 with control. Thirty-two cylindrical and 32 tapered implants were placed in the remaining 4 segments. Implant stability measurements were performed using electronic percussive testing and resonance frequency analysis.

RESULTS

No significance was detected between the stability values of the 2 implant designs except the implant stability quotient (ISQ) of control groups. The tapered implants control group showed significantly higher lateral ISQs compared with cylindrical implants (P = 0.033). For both implant types, stability values were significantly lower in coronal defects (P < 0.01). No significant differences were detected in other defect types.

CONCLUSION

Within the limitations of this study, it may be concluded that coronal defects may influence primary stability negatively, compared with middle and apical defects. Although statistically not significant, coronal defects caused lower primary stability values with the tapered design compared with parallel design.

Early loading of delayed versus immediately placed implants in the anterior mandible: A pilot comparative clinical study

STATEMENT OF PROBLEM

Numerous studies of the efficacy of immediately placed implants have been published but only a few of the comparative analyses of the early loading of delayed versus immediately placed dental implants.

PURPOSE

The purpose of this pilot prospective clinical study was to evaluate and compare the outcomes of early loaded delayed versus immediately placed implants.

MATERIAL AND METHODS

Eighty-eight participants satisfying predefined inclusion and exclusion criteria were selected for this pilot prospective study of 3 years' duration after obtaining institutional review board approval and informed consent. The immediate and the delayed implant placement group each consisted of 44 participants. The anterior mandible canine region was the implant placement site for all participants, and all implants were of the same size and manufacture. Participants were evaluated for hard (crestal bone loss and stability) and soft (periimplant probing depth) tissue implant success parameters at 6 and 12 months after implant placement. Data were analyzed, and results were computed.

RESULTS

Intergroup comparisons for mean mesial, mean distal, and mean crestal bone loss at 6 and 12 months after immediate and delayed implant placement showed statistically insignificant differences (P≥.05). Intergroup comparisons of mean mesial, mean distal, mean labial, and mean lingual and mean pocket depth at 6 and 12 months also showed statistically insignificant differences (P≥.05). Comparative mean values using the Periotest also demonstrated statistically insignificant differences (P≥.05).

CONCLUSIONS

The short-term outcomes of early loaded delayed and immediately placed implants were comparable. Therefore, early loaded immediately placed implants may be a promising option for the mandibular anterior region.