The following conclusions can be made: (1) the implant design was effective under all clinical conditions; (2) no significant and unexpected complications or risk factors were evident; (3) survival was found to be excellent; and (4) this implant is well suited for use in the restoration of masticatory function and esthetics in patients with missing natural teeth.
Primary implant stability and bone density are variables that have long been considered to be essential to achieving predictable osseointegration and long-term clinical survival. Although the dentist can control most factors associated with implant survival, bone density is the one factor that cannot be controlled. Measuring implant stability would assist in determining if an implant has integrated and is ready for the fabrication of the final prosthesis. Changes in implant stability in each type of Bone Quality (BQ-1, -2, -3, and -4), which may occur with time, have not been studied. Such information could help identify well-integrated implants and identify changes associated with impending implant failure. Several studies have used the Periotest instrument to study implant stability. Use of the Periotest implant stability will be studied during each phase of implant treatment for each bone density, and a range for clinically satisfactory integration will be suggested. Implant stability changes over time, and the changes are different for each bone density as the bone surrounding the nonhydroxyapatite implant becomes denser. This is clearly demonstrated in a postmortem histological specimen. The changes in implant stability (Periotest Values [PTVs]) are more apparent in BQ-1 and BQ-2 bone and less apparent in BQ-3 and BQ-4 bone. The Periotest is capable of providing valuable information concerning favorable or unfavorable changes in the bone-implant interface after uncovering. In addition, it can help identify when an implant is ready to be loaded. A new range of PTVs (-5 to -2) is suggested for monitoring the status of implants. Implants with PTVs more positive than -2 would indicate a bone-implant complex that may be marginal.
This in vitro study evaluated agreement among 10 trained evaluators when assessing implant stability with the Wired/Classic and Wireless/Periotest "M." A difference of 1 Periotest value (PTV) between the wired (-7) and wireless (-8) instruments was observed for the pretest calibration ring. No significant differences were found between the instruments and for all evaluators for all tests (analysis of variance, P < .05). Each instrument can provide meaningful and reproducible recordings of stability measurements.
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