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Reliability of clinical techniques for evaluating alveolar bone quality and implant stability
EAO Online Library. Karl M. Oct 9, 2018; 232567
Matthias Karl
Matthias Karl
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Abstract
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Background- While various classification methods for alveolar bone quality have been introduced, an objective clinical assessment method is still missing.Aim- To evaluate the reliability of various methods used for determining alveolar bone quality and primary implant stability.Material and Methods- Implant surgery in human cadaver bone was performed by two implantologists differing in experience. Bone quality was rated radiographically, based on tactile sensation during drilling and using intraoperative compressive tests. Implant stability was evaluated using insertion torque measurements and resonance frequency analysis (RFA). Statistical analysis was based on two way ANOVA followed by Tukey multiple comparisons and Pearson’s product moment correlation. The level of significance was set at α+=0.05.Results- Human cadaver bone was ranked according to implant insertion torque. Radiographic assessment, tactile sensation during implant site preparation and implant stability measurements did not allow differentiating bone classes in all instances. Cortical BoneProbe measurements showed a significant trend towards higher measurement values in greater bone classes (p<0.01) and were independent from the implantologist’s level of expertise (p=0.12). In trabecular bone, a significant difference existed between both surgeons (p<0.01) while a non-significant trend towards higher BoneProbe values in better classes of bone quality existed. With only two exceptions, significant correlations existed between BoneProbe measurements and all other parameters evaluated.Conclusion and Clinical implications- Despite a limited number of measurement performed, intraoperative compressive testing of bone may be an option for objectively classifying alveolar bone quality.
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