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

Full-text

Available from: Alan G.T. Payne
  • 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.
    Full-text · Article · Oct 2012 · Clinical Oral Implants Research
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the ability of baseline resonance frequency analysis (RFA) measurements to predict early implant failure in the posterior maxilla and to evaluate potential correlations between this measurement with Hounsfield units, bone quality variables, and implant dimension. This prospective randomized study involved 46 SLActive Straumann implants placed in the posterior maxillae of 21 subjects. Each patient received at least one control (delayed loading) and one experimental (immediate nonfunctional loading) implant. Each site was evaluated with presurgical computer-assisted tomography (CT) scans, histomorphometric analysis of bone cores, and subjective determination of bone quality. Baseline implant stability quotients (ISQ) were determined by RFA measurements made at the time of fixture placement. Pearson's correlation analysis and Spearman's test were used to identify statistically significant correlations within the resultant data. Receiver operating characteristic (ROC) analysis was used to determine whether baseline ISQ values can accurately predict early implant failure. The mean baseline ISQ values for the two groups were 66.8 (experimental) and 66.2 (control). The 12-month survival rates were 86.4% (experimental) and 100% (control). There were no statistically significant correlations between baseline ISQ values and early implant failure, bone quality variables, or implant dimension. ROC analysis showed that baseline ISQ values cannot predict early implant failure. Baseline RFA measurements were not able to predict early failure of immediately loaded implants placed in the posterior maxilla and therefore should not be used to determine whether an implant is a candidate for immediate nonfunctional loading in this region of the mouth.
    No preview · Article · Dec 2013 · Clinical Oral Implants Research
  • 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.
    Full-text · Article · Apr 2014 · Clinical Oral Implants Research
Show more