An exploratory survey of diagnostic methods for bone quality assessment used by Brazilian dental implant specialists

Bone quality (BQ) has been described as an important predictor for the outcome of dental implant treatment. It is, however, unclear how this factor is assessed in the dental practice routine. The aim of this study was to investigate what Brazilian dental implant specialists know and understand about BQ, if they include BQ assessments in their treatment planning and which methods they use to assess BQ. A questionnaire was posted to Brazilian dental implant specialists, containing open and closed questions about their knowledge and understanding of BQ assessment, and 221 answered the questionnaire. Data were gathered and methods for BQ assessment were grouped using hierarchical cluster analysis. Answers about BQ knowledge and understanding were categorized into quantity of cortical and marrow bone (n = 72), density (n = 55), type of bone (n = 35), bone height (n = 30), bone thickness (n = 27), primary stability (n = 24) and other less common categories. BQ assessment was judged relevant to be considered a selection criterion for implant treatment. Overall frequency analysis showed that methods were roughly divided into usual (n > 170) and unusual methods (n < 9). Cluster analysis grouped BQ assessment methods into four clusters: unusual methods (DEXA, resonance frequency, Periotest and occlusal radiography), perioperative methods (peak insertion torque and tactile perception), sectional imaging (computed tomography) and plain films (periapical and panoramic radiographs). No consensus on BQ understanding or the clinical application of methods to assess BQ was found in this survey. The selection of methods shows a clear natural grouping from basic to advanced strategies for BQ assessment by Brazilian specialists in dental implants.