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      Comparative evaluation of the stability of two different dental implant designs and surgical protocols—a pilot study

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          The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols.


          Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long.

          Group A received 10 tapered implants (OSPTX) (Astra Tech OsseoSpeed TX™) using the soft bone surgical protocol (TXSoft).

          Group B received 10 tapered implants (OSPTX) (AstraTech OsseoSpeedTX™) using the standard surgical protocol (TXStd).

          Group C received 10 parallel wall implants (OSP) (AstraTech OsseoSpeed™) using the standard surgical protocol (OStd).

          All implants were placed in the posterior maxilla in areas with a minimum of 8-mm crestal bone height.

          Resonance frequency measurements (implant stability quotient (ISQ)) and torque values were recorded to determine initial implant stability. All implants were uncovered 6 weeks after placement and restored with a functionally loaded resin provisional screw-retained crown. Resonance frequency measurements were recorded at the time of implant placement, at 6 weeks and 6 and 12 months. Twelve months after implant placement, the stability of the implants was recorded and the final restorations were placed using custom CAD/CAM fabricated abutments and cement-retained PFM DSIGN porcelain crowns. After implant restoration, bone levels were measured at 6 and 12 months with standardized radiographs.


          Radiographic mean bone loss was less than 0.5 mm in all groups, with no statistically significant differences between the groups. Implant survival rate at 1 year was 93.3%, with 2/30 implants failing to integrate prior to functional loading at 6 weeks. No statistically significant difference was found between ISQ measurements between the three groups at all time intervals measured. Strong positive correlations were found between overall bone loss at 6 months and insertion torque at time of placement. A very weak correlation was found between insertion torque and ISQ values at time of implant placement.


          Survival and stability of OSPTX and OSP implants is comparable. Osteotomy preparation by either standard or soft bone surgical protocol presented no significant effect on implant survival and stability for the specific implant designs.

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          Most cited references 24

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          The application of resonance frequency measurements to study the stability of titanium implants during healing in the rabbit tibia.

          The aim of this investigation was to measure the resonance frequency of a number of implants placed in the rabbit tibia at insertion and at predetermined periods thereafter and to correlate the results with histomorphometric measurements made when the animals were sacrificed. Ten mature New Zealand White rabbits were used in the study. Two c.p. threaded titanium implants were placed in the right tibia of each animal. Resonance frequency measurements were made by screwing a small transducer onto a standard abutment mounted on each fixture. Measurements were repeated with the transducer oriented perpendicular and parallel to the long axis of the tibia for all proximal implants 14 and 28 days after placement and in 6 implants additionally at 42, 56, 93, 122 and 168 days after which all animals were sacrificed. Histomorphometric analysis comprised 2 parts; measurement of bone-implant contact area and height. A significant increase in resonance frequency was observed after 14 (405 Hz, +/- 234 Hz) and 28 (658 Hz, +/- 332 Hz) days. The increase in resonance frequency levelled after approximately 40 days and little further change was observed. The variation in bone-implant contact area was relatively small (1.8-4.9 mm2) and the range of bone-implant contact heights was also narrow (-1.5 (-)+ 1.5 mm). Values for resonance frequencies plotted against contact area and height were grouped around 10 kHz. In conclusion, it was shown that resonance frequency measurements can be made at placement and during healing in vivo and changes may be related to the increase in stiffness of an implant in the surrounding tissues.
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            Contemporary Implant Dentistry

             CE MISCH,  C Misch,  C.E Misch (2008)
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              Influence of implant taper on the primary and secondary stability of osseointegrated titanium implants.

              The study presented was designed to analyse the mechanical performance and the primary and secondary stability characteristics of endosseous titanium implants with 1 degree (EXP1) and 2 degrees (EXP2) of taper when compared with the standard Brånemark design (Nobel Biocare AB, Gothenburg, Sweden). One pair of 10 mm EXP1 and control implants were placed in the femoral condyles of six rabbits. Paired 6 mm EXP1 and control implants and 6 mm EXP2 and control implants were placed in the tibial metaphysis. The control implants used were 4 mm diameter standard Brånemark implants, the same length as the test implants. At placement, insertion torque (IT) and resonance frequency analysis (RFA) measurements were performed. Six weeks postoperatively when the animals were killed, RFA and removal torque (RT) measurements were made. At placement, significantly higher IT was needed to insert the EXP implants compared with the controls. RFA values were significantly higher for EXP1 implants placed in the tibia but not in the femur. In pooling data from the femur and tibia there was a significant difference. The EXP2 implants failed to insert fully and demonstrated a lower RFA value than may have been expected due to the exposed threads, although this difference was not statistically significant. The results from the present study showed that 1 degrees of taper results in a better primary stability compared with the standard Brånemark design. There was no evidence that the tapered design caused negative bone tissue reactions. All the implants gained in stability during the healing period.

                Author and article information

                Int J Implant Dent
                Int J Implant Dent
                International Journal of Implant Dentistry
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                2 May 2017
                2 May 2017
                December 2017
                : 3
                [1 ]ISNI 0000 0000 8954 1233, GRID grid.279863.1, Department of Periodontics, , Louisiana State University Health Sciences Center School of Dentistry, ; 1100 Florida Avenue, New Orleans, LA 70119 USA
                [2 ]ISNI 0000 0001 2217 8588, GRID grid.265219.b, , Tulane University SPHTM, ; 1440 Canal St, Suite 2001, New Orleans, LA 70130 USA
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                Funded by: Dentsply Astra
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