Associations between cortical bone-to-implant contact and microstructure derived from CBCT and implant primary stability

Abstract

Objectives: To evaluate the associations between the cortical bone-to-implant contact (CBIC), bone microstructure derived from cone-beam computed tomography (CBCT), and the primary stability of the implant.

Materials and methods: Twenty-two patients with 65 implants were enrolled in this study. The peak insertion torque values (ITVs) were measured during implant insertion, and the implant stability quotient (ISQ) values were measured immediately after implant placement and 3 months after surgery. The profiles of the peri-implant bone structure were outlined using the volumetric reconstruction of the CBCTs and superimposition of the virtual models, and the features of CBIC and bone microstructure parameters were measured. The linear mixed effects model and generalized estimating equation were used to explore the predictors for implant primary stability.

Results: The average ITV, baseline, and secondary ISQ values were 31.44 ± 6.54 N·cm, 73.34 ± 7.39, and 80.32 ± 4.58, respectively. Statistically significant correlations were found between ITV and surface area of CBIC (r = .340, p = .006), bone volume fraction (r = .294, p = .017), and bone surface fraction (r = -.278, p = .039). Implants with buccolingual CBIC had a higher ITV than implants without CBIC (p = .016). None of the parameters were associated with baseline and secondary ISQ values in generalized estimating equation analysis (all p > .05).

Conclusions: Within the limitations of the study, preoperative CBCT measurements might enable the prediction of ITV and therefore of implant primary stability values.

Keywords: bone-to-implant contact; cone-beam computed tomography; dental implants; implant stability; microarchitecture; resonance frequency analysis; trabecular bone.