Alveolar Bone Density and Width Affect Primary Implant Stability.

Area of Science:

• Dental Implantology
• Biomaterials Science
• Radiology

Background:

• Primary implant stability (PIS) is crucial for successful osseointegration.
• Predicting PIS preoperatively can optimize treatment planning and outcomes.
• Bone density (BD) and alveolar ridge width (ARW) are key recipient bone characteristics influencing PIS.

Purpose of the Study:

• To assess the association between PIS and preoperative measurements of BD and ARW using cone beam computerized tomography (CBCT).
• To determine the predictive value of CBCT-derived bone characteristics for PIS measures like implant stability quotient (ISQ) and insertion torque (IT).

Main Methods:

• A convenience sample of 160 implants in 48 patients was analyzed.
• Preoperative CBCT was used to measure ARW and BD in Hounsfield units (HUs).
• PIS was assessed using ISQ (resonance frequency analysis) and IT.

Main Results:

• PIS (ISQ and IT) positively correlated with edentulous alveolar ridge BD.
• The HU value at 0.5 mm outside the implant placement area was the most significant predictor for both lateral and rotational PIS.
• ISQ values were significantly related to ARW in all thirds of the ridge and were higher with larger-diameter implants.

Conclusions:

• Preoperative CBCT assessment of BD and ARW can reliably predict PIS.
• Bone density, particularly adjacent to the implant site, is a critical factor for achieving adequate implant stability.
• Wider alveolar ridges positively influenced lateral PIS but not rotational PIS.