By Scott D. Ganz, DMD
Prosthetics & Implant Dentistry
It has been clinically demonstrated that implant stability plays a significant role in determining treatment outcomes (Sennerby & Meredith 1998, Esposito et al. 1998). Implants show high success rates if certain preconditions are fulfilled (Sennerby & Meredith 2000, 2008).
Clinicians from all over the world participated to Osstell Scientific Symposium at EAO Congress 2018 in Vienna, on October 11th.
Have you ever placed an implant in an augmented bone site and added another few months of healing time just to be on the safe side?
It has long been recognized in the dental implant literature that implant stability is a critical factor in predictable treatment outcomes. Both primary stability (mechanical stability) and stability prior to provisionalization or restoration of the implant should be considered in the individual treatment plan. The secondary (aka biological stability) will indicate the level of osseointegration when compared to the initial primary stability (mechanical stability) at placement of the implant. There are other factors, of course, to be considered but there is little disagreement in the literature that implant stability is key.
Physiologic healing after implant placement varies from patient to patient and site to site. Surgeons must find balance between mechanical stability and avoiding excessive trauma to alveolar bone, especially the cortical bone found at the alveolar crest. The two measures of quantifying primary stability are insertion torque volume (ITV) and resonance frequency analysis (RFA). Implant stability quotient or ISQ is a value used to determine stability via RFA.
Primary and secondary stability is a much discussed topic. Which one should a clinician aim for to achieve successful implant treatments? We met with Dr. Stephen Jacobs after his lecture at the AO Annual Meeting about primary and secondary implant stability to clarify things.
Could you explain the difference between primary and secondary stability?
During the twenty-two years of my clinical and scientific work with dental implants I have been a witness to huge development in the implant dentistry. Changes to implants' macro and micro design, surfaces, and surgical and prosthetic procedures that expand today's treatment with dental implants. But for me, the most impressive improvement was an implementation of resonance frequency analysis (RFA) from scientific to clinical work in implant dentistry.