Assessment of implant stability with resonance frequency analysis and changes in the thickness of keratinized tissue and crestal bone level using cone-beam computed tomography in two-stage implants: A three-dimensional clinicoradiographic study.

BACKGROUND

The present study aims to evaluate a three-dimensional (3D) changes in the crestal bone levels (buccally, lingually/palatally, mesially, and distally) and in the thickness of keratinized tissue around single or multiple implants using cone-beam computed tomography (CBCT) after 1 year.

MATERIALS AND METHODS

Twenty-eight implants were placed in the posterior load-bearing areas in 10 patients. The crestal bone levels and the thickness of keratinized tissue surrounding the edentulous area were assessed preoperatively, immediately after implant placement, and 1 year after implant placement using CBCT (3D imaging technique with DICOM software (Carestream Health, Rochester, NY)). Implant stability quotient (ISQ) was measured immediately after implant placement using resonance frequency analysis (RFA) (Penguin RFA Monitor Osseointegration, Integration Diagnostics Sweden AB, Furstenbergsgatan 4 416 64 Göteborg, Sweden).

RESULTS

The average crestal bone loss around the implants after 1 year was 0.78 ± 0.26 mm on the buccal side, 0.63 ± 0.27 mm on the lingual side, 0.57 ± 0.18 mm on the mesial side, and 0.53 ± 0.28 mm on the distal side. The average amount of bone loss including all sites was 0.63 ± 0.17 mm and the mean change in keratinized tissue thickness after 1 year was 0.3 ± 0.19 mm. The RFA ranged from 75 to 82 Nm for all the implants immediately after placement.

CONCLUSION

CBCT can be used as a reliable source, as it is compararively more superior and precise than intraoral periapical radiographs in measuring the changes in the bone and thickness of the keratinized tissue before and after implant placement. A thick biotype of the keratinized tissue is as important as the bone topography for the success of the implant. ISQ measurements immediately after implant placement can also act as a major factor in depicting the success of the implant in the future.