A possible novel objective intraoperative measurement of maxillary bone density

Implant survival and success rates are strictly related to the density of the bone they are placed in. Bone density, in fact, affects both implant primary stability and implant micromovements after implant positioning. Current bone density classifications rely on subjective, scarcely reproducible evaluations. A novel implant micro motor featuring a bone density measurement probe has been recently introduced. The objective of this study was to test such bone density measurement system for its capability of distinguishing different bone density areas in the upper and in the lower jaw.

1254 implant placement sites had their bone density measured during standard implant placement at a single clinical facility. After data collection bone density distribution was statistically analyzed in order to test the hypothesis of a non-homogeneous distribution in four different predefined anatomical maxillary zones, namely pre-antral (between teeth from 14 to 24) and sub-antral (more distally) in the upper maxilla and interforaminal (between and including teeth from 34 to 44) and retroforaminal (more distally) zone.

Measured bone density values, organized according the named four anatomical zones, produced a statistically significant inhomogeneous pattern (P<0.001). Density distribution was consistent with data from literature, but not always corresponding with the one achieved by applying the well known Misch classification.

The measuring system we tested allowed to distinguish different and clinically significant anatomical zones according to their different bone density, and can represent a fundamental diagnostic tool to plan the proper implant placement steps.