Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 5, August, p. 803–809
Publication type: original article
Assessment of the primary stability of root analog zirconia implants designed using cone beam computed tomography software by means of the Periotest® device: An ex vivo study. A preliminary report
1 Private Dental Practice, Wschowa, Poland
2 Private Dental Practice, Kościan, Poland
3 Dental Surgery Department, Wroclaw Medical University, Poland
Background. The implant primary stability is a fundamental prerequisite for a success of osseointegration process which determines the prosthetic reconstruction time.
Objectives. The aim of the present study was to assess the quality and precision of modern conical bone computer tomography (CBCT) software in preparing root analog zirconia implants (RAZIs) by measuring its primary stability by means of the Periotest device.
Material and Methods. Thirteen pig jaws with proper erupted first premolar (P1) teeth were used in the study. The CBCT examination was conducted in the area of the P1 tooth in each mandible. The 3-dimensional (3D) view of each tooth was designed from CBCT scan. The created 3D images were used to prepare root analog zirconia implants milled from a medical-grade zirconia block by means of laboratory milling. The RAZIs and titanium implants were placed into an alveolar socket after the tooth had been removed. The primary stability of the teeth before their extraction (G1), RAZIs (G2) and titanium implants (G3) were checked by Periotest devices.
Results. The mean results in PTV were: 15.9, 3.35, 12.7 for G1, G2 and G3 group, respectively. RAZIs during immediate loading achieved a significantly higher primary stability (lower Periotest value) as compared to the teeth and implants.
Conclusion. The modern CBCT device allows us to design a precise image of an extracted tooth for the purpose of manufacturing a root analog implant. The additional feature of the surgical protocol using RAZI is the possibility of avoiding the augmentation procedure, which reduces the whole cost of the treatment.
RAZI, primary stability, root analog zirconia implant, Periotest
- Natali AN, Carniel EL, Pavan PG. Investigation of viscoelastoplastic response of bone tissue in oral implant spress fit process. J Biomed Mater Res B Appl Biomater. 2009;91:868–875.
- Koh R, Rudek I, Wang HL. Immediate implant placement, positives and negatives. Implant Dent. 2010;19:98–108.
- Brunski JB, Puleo DA, Nanci A. Biomaterials and biomechanics of oral and maxillofacial implants: Current status and future developments. Int J Oral Maxillofac Implants. 2000;15:15–46.
- Binahmed A, Stoykewych A, Hussain A. Long-term follow-up of hydroxyapatite-coated dental implants: A clinical trial. Int J Oral Maxillofac Implants. 2007;22(6):963–968.
- Regish KM, Sharma D, Prithviraj DR. An overview of immediate root analogue zirconia implants. J Oral Implantol. 2013;39:225–233.
- Singh M, Kumar L, Anwar M, Chand P. Immediate dental implant placement with immediate loading following extraction of natural teeth. Nat J Maxillofac Surg. 2015;6(2):252.
- Kazor CE, Al Shamari K, Sarment DP, Misch CE, Wang HL. Implant plastic surgery, a review and rationale. J Oral Implantol. 2004;30:240–254.
- Moin DA, Hassan B, Mercelis P, Wismeijer D. Designing a novel dental root analogue implant using cone beam computed tomography and CAD/CAM technology. Clin Oral Implants Res. 2013;24:25–27.
- Kohal RJ, Hürzeler MB, Mota LF, Klaus G, Caffesse RG, Strub JR. Custom-made root analogue titanium implants placed into extraction sockets: An experimental study in monkeys. Clin Oral Implants Res. 1997;8:386–392.
- Kohal RJ, Klaus G, Strub JR. Clinical investigation of a new dental immediate implant sysytem. The Reimplant®-System. Deutsch Zahnarz Zeit. 2002;57:495–497.
- Singh A, Gupta A, Yadav A, Chaturvedi TP, Bhatnagar A, Singh BP. Immediate placement of implant in fresh extraction socket with early loading. Contemp Clin Dent. 2012;3(Suppl 2):219–222.
- Mall N, Dhanasekar B, Aparna IN. Validation of implant stability: A measure of implant permanence. Indian J Dent Res. 2011;22:462–67.
- O’Sullivan D, Sennerby L, Jagger D, Meredith N. A comparison of two methods of enhancing implant primary stability. Clin Implant Dent Relat Res. 2004;6:48–57.
- Friberg B, Sennerby L, Meredith N, Lekholm U. A comparison between cutting torque and resonance frequency measurements of maxillary implants: A 20-month clinical study. Int J Oral Maxillofac Surg. 1999;28:297–303.
- Friberg B, Sennerby L, Grondahl K, Bergstrom C, Back T, Lekholm U. On cutting torque measurements during implant placement: A 3-year clinical prospective study. Clin Implant Dent Relat Res. 1999;1:75–83.
- Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the implant-tissue interface using resonance frequency analysis. Clin Oral Implants Res. 1996;7:261–267.
- Zix J, Hug S, Kessler-Liechti G, Mericske-Stern R. Measurement of dental implant stability by resonance frequency nalysis and damping capacity assessment, comparison of both techniques in a clinical trial. Int J Oral Maxillofac Implants. 2008;23:525–530.
- Sjöström M, Lundgren S, Nilson H, Sennerby L. Monitoring of implant stability in grafted bone using resonance frequency analysis: A clinical study from implant placement to 6 months of loading. Int J Oral Maxillofac Surg. 2005;34:45–51.
- Ersanli S, Karabuda C, Beck F, Leblebicioglu B. Resonance frequency analysis of one-stage dental implant stability during the osseointegration period. J Periodontol. 2005;76:1066–1071.
- Roberts WE, Smith RK, Zilberman Y, Mozsary PG, Smith RS. Osseous adaptation to continuous loading of rigid endosseous implants. Am J Orthod. 1984;86:95–111.
- Atsumi M, Park SH, Wang HL. Methods used to assess implant stability: Current status. Int J Oral Maxillofac Implants. 2007;22:743–754.
- Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont. 1998;11:491–501.
- Schulte W, Lukas D. The periotest method. Int Dent J. 1992;42:433–440.
- Dilek O, Tezulas E, Dincel M. Required minimum primarystability and torque values for immediate loading of mini dental implants: An experimental study in nonviable bovine femoral bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:20–27.
- Al-Rawi B, Hassan B, Vandenberge B, Jacobs R. Accuracy assessment of three-dimensional surface reconstructions of teeth from cone beam computed tomography scans. J Oral Rehab. 2010;37:352–358.
- Chahine G, Smith P, Kovacevic R, Ajlouni R, Ajlouni K. Digital engineering of bio-adaptable dental implants. In: Turkyilmaz I, ed. Implant dentistry: A rapidly evolving practise. InTech. 2011:251–266.
- Moin DA, Hassan B, Parsa A, Mercelis P, Wismeijer D. Accuracy of preemptively constructed, cone beam CT‐, and CAD/CAM technology‐based, individual root analogue implant technique: An in vitro pilot investigation. Clin Oral Implants Res. 2014;25(5):598–602.
- Pirker W, Wiedemann D, Lidauer A, Kocher AA. Immediate, single stage, truly anatomic zirconia implant in lower molar replacement: A case report with 2.5 years follow-up. Int J Oral Maxillofac Surg. 2011;40:212–216.
- Chen J, Zhang Z, Chen X, Zhang C, Zhang G, Xu Z. Design and manufacture of customized dental implants by using reverse engineering and selective laser melting technology. J Prosthet Dent. 2014;112(5):1088–1095.
- Depprich R, Zipprich H, Ommerborn M, et al. Osseointegration of zirconia implants compared with titanium: An in vivo study. Head Face Med. 2008;4:30.