Implant stability and histomorphometry: a correlation study in human cadavers using stepped cylinder implants

Authors: Nkenke E.1; Hahn M.2; Weinzierl K.1; Radespiel-Tröger M.3; Neukam F.W.1; Engelke K.4

Source: Clinical Oral Implants Research, Volume 14, Number 5, October 2003 , pp. 601-609(9)

Publisher: Blackwell Publishing

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Abstract:

The aim of the present study was to determine the correlation between the primary stability of dental implants placed in edentulous maxillae and mandibles, the bone mineral density and different histomorphometric parameters. After assessing the bone mineral density of the implant sites by computed tomography, 48 stepped cylinder screw implants were installed in four unfixed human maxillae and mandibles of recently deceased people who had bequeathed their bodies to the Anatomic Institute I of the University of Erlangen-Nuremberg for medical–scientific research. Peak insertion torque, Periotest values and resonance frequency analysis were assessed. Subsequently, histologic specimens were prepared, and bone-to-implant contact, the trabecular bone pattern factor (TBPf), the density of trabecular bone (BV/TV) and the height of the cortical passage of the implants were determined. The correlation between the different parameters was calculated statistically. The mean resonance frequency analysis values (maxilla 6130.4±363.2 Hz, mandible 6424.5±236.2 Hz) did not correlate with the Periotest measurements (maxilla 13.1±7.2, mandible –7.9±2.1) and peak insertion torque values (maxilla 23.8±2.2 N cm, mandible 45.0±7.9 N cm) (P=0.280 and 0.193, respectively). Again, no correlations could be found between the resonance frequency analysis, the bone mineral density (maxilla 259.2±124.8 mg/cm3, mandible 349.8±113.3 mg/cm3), BV/TV (maxilla 19.7±8.8%, mandible 34.3±6.0%) and the TBPf (maxilla 2.39±1.46 mm-1, mandible –0.84±3.27 mm-1) (P=0.140 and 0.602, respectively). However, the resonance frequency analysis values did correlate with bone-to-implant contact of the oral aspect of the specimens (maxilla 12.6±6.0%, mandible 35.1±5.1%) and with the height of the crestal cortical bone penetrated by the implants in the oral aspect of the implant sites (maxilla 2.1±0.7 mm, mandible 5.1±3.7 mm) (P=0.024 and 0.002, respectively). The Periotest values showed a correlation with the height of the crestal cortical bone penetrated by the implants in the buccal aspect of the implant sites (maxilla 2.5±1.2 mm, mandible 5.4±1.2 mm) (P=0.015). The resonance frequency analysis revealed more correlations to the histomorphometric parameters than the Periotest measurements. However, it seems that the noninvasive determination of implant stability has to be improved in order to give a more comprehensive prediction of the bone characteristics of the implant site.

To cite this article:

Nkenke E, Hahn M, Weinzierl K, Radespiel-Tröger M, Neukam FW, Engelke K. Dental implant stability and histomorphometry: a correlation study in human cadavers.

Clin. Oral Impl. Res14, 2003; 601–609

Keywords: bone mineral density; histomorphometry; peak insertion torque; Periotest; resonance frequency analysis

Document Type: Research article

DOI: 10.1034/j.1600-0501.2003.00937.x

Affiliations: 1: Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Germany 2: Department of Bone Pathology/Center Biomechanics, University of Hamburg, Germany 3: Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nuremberg, Germany 4: Institute of Medical Physics, University of Erlangen-Nuremberg, Germany

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