Outcomes of flapless immediate implants with low primary stability

Area of Science:

• Dentistry
• Oral Implantology
• Biomaterials

Background:

• Assessing the prognosis of dental implants with compromised primary stability is crucial for predictable treatment outcomes.
• Low primary stability, defined by insertion torque and Implant Stability Quotient (ISQ), presents a challenge in immediate implant placement.
• Sandblasted, large-grit, acid-etched (SLAA) implant surfaces are commonly used in modern implantology.

Purpose of the Study:

• To evaluate the long-term prognosis and survival rate of immediately placed dental implants exhibiting low or no primary stability.
• To determine if implants with initial low stability can achieve successful osseointegration.
• To analyze the changes in Implant Stability Quotient (ISQ) values from placement to prosthetic loading.

Main Methods:

• A retrospective study involving 16 patients who received 16 SLAA-surfaced implants with low primary stability (insertion torque < 10 Ncm, initial ISQ < 55).
• Implants were placed using a flapless surgical technique.
• Implant stability was measured using the ISQ system (Osstell) immediately after placement and at impression taking (average 13 weeks post-placement).

Main Results:

• Excluding six cases with unmeasurable initial ISQ, the average initial ISQ was 42.2±7.5, increasing to 68.7±7.6 at impression taking (P<0.01).
• A 100% implant survival rate was observed after an average follow-up of 65.18 months.
• Significant improvement in ISQ values indicates successful osseointegration despite low initial stability.

Conclusions:

• Immediately placed dental implants with low or no primary stability can achieve successful osseointegration.
• Long-term implant survival is not compromised by initially low primary stability.
• Clinical protocols may be adapted to accommodate immediate implant placement even in situations with suboptimal primary stability.