The relationship between dental implant stability and trabecular bone structure using cone-beam computed tomography

Area of Science:

• Biomaterials Science
• Dental Implantology
• Bone Biology

Background:

• Primary implant stability is crucial for successful osseointegration.
• Trabecular bone microarchitecture significantly influences implant anchorage.
• Assessing bone quality non-invasively is essential for predicting implant success.

Purpose of the Study:

• To investigate the relationship between implant stability, measured by impact response frequency, and trabecular bone structural parameters.
• To evaluate the predictive capability of cone-beam computed tomography (CBCT) for assessing these relationships, excluding cortical bone effects.

Main Methods:

• Dental implants were placed in swine trabecular bone specimens (cortical bone excluded).
• Implant impact response frequency (peak frequency spectrum - SPF) was measured using an inductive sensor.
• 3D microstructural bone parameters were quantified from micro-CT and CBCT images.

Main Results:

• SPF showed significant positive correlations with bone volume per tissue volume (BV/TV), bone volume (BV), bone surface (BS), bone surface density (BSD), trabecular thickness (Tb.Th), trabecular number (Tb.N), fractal dimension (FD), and bone surface to bone volume (BS/BV).
• SPF demonstrated significant negative correlations with trabecular separation (Tb.Sp), trabecular pattern factor (Tb.Pf), and structure model index (SMI).
• Stepwise regression analysis indicated that combining BV/TV and SMI improved implant stability prediction.

Conclusions:

• Implant stability is positively associated with high bone volume and density, and thick, well-connected trabecular bone with reduced marrow spaces.
• CBCT-derived bone density and architectural parameters can more accurately predict implant stability than density alone.
• These findings support the use of CBCT for enhanced clinical diagnosis and treatment planning in dental implantology.