Resonance Frequency Analysis and Clinical Outcomes in Implant Dentistry: A Systematic Review and Meta-Analysis

Given the growing use of resonance frequency analysis in clinical implantology and the inconsistent evidence regarding its prognostic value, this systematic review aimed to clarify the association between implant stability quotient (ISQ) with insertion torque (IT), marginal bone loss (MBL), and implant survival/success rate.

Following PRISMA guidelines, a comprehensive literature search was conducted across MEDLINE, Scopus, and Web of Science to answer the PIO question: "In systemically healthy patients undergoing implant placement, are ISQ values associated with intraoperative and postoperative surrogate parameters (IT and MBL) and clinical outcomes such as implant survival and success?" Risk of bias was assessed using design-specific methodological tools.

Forty-eight studies were included, and 20 were eligible for quantitative analysis of ISQ-IT correlation. A moderate and statistically significant association was observed (pooled r = 0.44; 95% CI: 0.32-0.55, p < 0.001), with substantial heterogeneity (I² > 90%). Three studies assessed baseline ISQ values and implant survival. Although surviving implants showed higher ISQ values (mean difference = 10.22), the pooled estimate was not statistically significant and remained highly heterogeneous. Quantitative synthesis for MBL and implant success was not feasible due to inconsistent reporting and methodological variability.

ISQ shows a moderate correlation with IT, supporting its role as a complementary indicator of primary implant stability. However, high heterogeneity and limited certainty of evidence restrict its clinical interpretability. Current evidence does not support baseline ISQ values as independent predictors of MBL or implant survival.