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A correlation between bone (B), insertion torque (IT), and implant stability (S): BITS score.

Manisha Herekar1, Megha Sethi2, Tousif Ahmad3

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A new scoring index correlates bone density, insertion torque, and implant stability, aiding treatment adjustments. This score helps optimize implant success by considering bone quality and stability throughout the treatment process.

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Area of Science:

  • Dental Implantology
  • Biomaterials Science
  • Orthopedic Surgery

Background:

  • Existing criteria for assessing bone quality lack a comprehensive score correlating it with implant primary and secondary stability.
  • A unified scoring system is needed to integrate bone density, insertion torque, and resonance frequency analysis for dental implants.

Purpose of the Study:

  • To propose a novel scoring index linking computed tomography (CT) bone density, maximum insertion torque, and resonance frequency analysis (RFA) values.
  • To establish a correlation between these parameters across different phases of dental implant treatment.

Main Methods:

  • Evaluated 60 implant sites for bone density (Hounsfield units), insertion torque (Ncm), and implant stability quotient (ISQ) via RFA for primary and secondary stability.
  • Classified bone density (D1-D4), insertion torque (A-B), and ISQ values (5 groups).
  • Calculated primary and secondary scores based on measurements at implant placement and follow-up intervals.

Main Results:

  • Observed bone densities D2, D3, and D4. Maximum torque recorded was 40 Ncm; no significant difference between torque and bone types.
  • Higher mean ISQ values for primary and secondary stability were found in D2 bone compared to D3 and D4.
  • Mean ISQ values increased significantly (P<.001) at second-stage surgery across all bone types; no significant difference between primary and secondary ISQ (P=.780).

Conclusions:

  • The developed score emphasizes the importance of integrating bone quality, insertion torque, and implant stability (ISQ) throughout implant treatment.
  • Score variations at recall visits allow for timely adjustments in treatment plans, including healing periods and prosthetic design.