Can resonance frequency analysis predict failure risk of immediately loaded implants?

Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin, New Zealand.
The International journal of prosthodontics (Impact Factor: 1.46). 07/2012; 25(4):326-39.
Source: PubMed

ABSTRACT Resonance frequency analysis (RFA) is used to measure oral implant stability. There is controversy with regard to its accuracy in predicting both implant stability and osseointegration. This systematic review and meta-analysis determined the prognostic accuracy of RFA in predicting implant failure following immediate loading protocols.
MEDLINE, EMBASE, the Cochrane Oral Health Group's Trials Register, the United Kingdom National Research Register, the Australian New Zealand Clinical Trials Registry, the Database of Abstracts of Reviews of Effectiveness, and the Conference Proceedings Citations Index were searched to select studies that used RFA in assessing implant stability prior to immediate loading. The sensitivity, specificity, and accuracy of RFA in the selected studies were evaluated using a random effects model. The summary receiver operating characteristic was constructed to summarize the overall test performance.
Fifteen studies with 2,236 immediately loaded implants were identified. The sensitivity of RFA in predicting failure of immediately loaded implants was 0.38 (95% confidence interval [CI]: 0.22 to 0.56), the specificity was 0.73 (95% CI: 0.71 to 0.75), and the diagnostic odds ratio was 2.10 (95% CI: 0.79 to 5.57). The area under the curve was 0.54, suggesting a poor predictive and discriminative ability.
RFA measurement at the time of implant placement is not sufficiently accurate to determine implant stability and osseointegration during immediate loading protocols.

Download full-text


Available from: Alan G.T. Payne, Sep 28, 2015
147 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: It is of imperative clinical significance to define a safe threshold for planned immediate implant restoration. The aim of this report was to evaluate the prognostic accuracy of resonance frequency analysis (RFA) measurements recorded at two different times (implant placement and 8-week post-implant placement) and to determine the optimal threshold value for predicting failure risk of immediately restored/loaded implants. Material and methods: Twenty-eight 8- or 9-mm-diameter implants were placed in either a fresh molar extraction socket or a healed site. An electronic RFA device was used to record the implant stability quotients (ISQs) at implant placement surgery, 8 weeks and 1 year. Receiver operating characteristic (ROC) analysis was used to identify the optimal cut-off level. Sensitivity and specificity were also determined at the selected cut-off value. Results: The area under the ROC curve for RFA at 8 weeks was 0.93 with a significant P-value (P = 0.001). The optimum cut-off value for detecting implant stability was 60.5 ISQ measured at 8 weeks, with sensitivity and specificity of 95.2% and 71.4%, respectively. Conclusions: The implant stability measurements after 8 weeks showed a better accuracy in predicting implants that were at risk of failure than those taken at the time of implant placement.
    Clinical Oral Implants Research 10/2012; 25(1). DOI:10.1111/clr.12057 · 3.89 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Short implants are increasingly used, but there is doubt about their performance being similar to that of regular implants. The aim of this study was to compare the mechanical stability of short implants vs. regular implants placed in the edentulous posterior mandible.Material and methodsTwenty-three patients received a total of 48 short implants (5 × 5.5 mm and 5 × 7 mm) and 42 regular implants (4 × 10 mm and 4 × 11.5 mm) in the posterior mandible. Patients who received short implants had <10 mm of bone height measured from the bone crest to the outer wall of the mandibular canal. Resonance frequency analysis (RFA) was performed at time intervals T0 (immediately after implant placement), T1 (after 15 days), T2 (after 30 days), T3 (after 60 days), and T4 (after 90 days).ResultsThe survival rate after 90 days was 87.5% for the short implants and 100% for regular implants (P < 0.05). There was no significant difference between the implants in time intervals T1, T2, T3, and T4. In T0, the RFA values of 5 × 5.5 implants were higher than values of 5 × 7 and 4 × 11.5 implants (P < 0.05). A total of six short implants that were placed in four patients were lost (three of 5 × 5.5 mm and three of 5 × 7 mm). Three lost implants started with high ISQ values, which progressively decreased. The other three lost implants started with a slightly lower ISQ value, which rose and then began to fall.Conclusions Survival rate of short implants after 90 days was lower than that of regular implants. However, short implants may be considered a reasonable alternative for rehabilitation of severely resorbed mandibles with reduced height, to avoid performing bone reconstruction before implant placement. Patients need to be aware of the reduced survival rate compared with regular implants before implant placement to avoid disappointments.
    Clinical Oral Implants Research 04/2014; 26(9). DOI:10.1111/clr.12394 · 3.89 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated the effect of implant design and bone quality on insertion torque (IT), implant stability quotient (ISQ), and insertion energy (IE) by monitoring the continuous change in IT and ISQ while implants were inserted in artificial bone blocks that simulate bone of poor or poor-to-medium quality. Polyurethane foam blocks (Sawbones) of 0.16 g/cm³ and 0.32 g/cm³ were respectively used to simulate low density and low- to medium-density cancellous bone. In addition, some test blocks were laminated with a 1-mm 0.80 g/cm³ polyurethane layer to simulate cancellous bone with a thin cortical layer. Four different implants (Nobel Biocare Mk III-3.75, Mk III-4.0, Mk IV-4.0, and NobelActive-4.3) were placed into the different test blocks in accordance with the manufacturer's instructions. The IT and ISQ were recorded at every 0.5-mm of inserted length during implant insertion, and IE was calculated from the torque curve. The peak IT (PIT), final IT (FIT), IE, and final ISQ values were statistically analyzed. All implants showed increasing ISQ values when the implant was inserted more deeply. In contrast to the ISQ, implants with different designs showed dissimilar IT curve patterns during the insertion. All implants showed a significant increase in the PIT, FIT, IE, and ISQ when the test-block density increased or when the 1-mm laminated layer was present. Tapered implants showed FIT or PIT values of more than 40 Ncm for all of the laminated test blocks and for the nonlaminated test blocks of low to medium density. Parallel-wall implants did not exhibit PIT or FIT values of more than 40 Ncm for all of the test blocks. NobelActive-4.3 showed a significantly higher FIT, but a significantly lower IE, than Mk IV-4.0. While the existence of cortical bone or implant designs significantly affects the dynamic IT profiles during implant insertion, it does not affect the ISQ to a similar extent. Certain implant designs are more suitable than others if high IT is required in bone of poor quality. The manner in which IT, IE, and ISQ represent the implant primary stability requires further study.
    The International journal of prosthodontics 01/2015; 28(1):40-7. DOI:10.11607/ijp.4063 · 1.46 Impact Factor