Osstell cihazı kullanılarak yerleştirme torku ve implant stabilitesinin değerlendirilmesi: bağlantı yöntemi ve uygulayıcı değişkenliğinin etkileri
Abstract
Amaç: Bu çalışma, SmartPeg bağlantı yöntemlerinin ve uygulayıcıya bağlı değişkenliğin, Osstell cihazı kullanılarak yapılan yerleştirme torku ve implant stabilitesi ölçümleri üzerindeki etkilerini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Dört ağız, diş ve çene cerrahı, D1 kemik kalitesine sahip sığır femur kemik bloklarına, her biri 40 implant yerleştirmiştir. Çalışma, Hatay Mustafa Kemal Üniversitesi Diş Hekimliği Fakültesi, Ağız Diş ve Çene Cerrahisi Anabilim Dalı’nda yürütülmüştür. SmartPeg yerleştirme torku dijital tork anahtarıyla ölçülmüştür. SmartPeg bağlantısından hemen sonra rezonans frekans analizi (RFA) gerçekleştirilmiştir. Veriler, ANOVA ve iç sınıf korelasyon katsayısı (ICC) ile analiz edilmiştir.
Bulgular: Ortalama yerleştirme torku, düşük tork uygulayan grupta 69.88 ± 2.11 Ncm, yüksek tork uygulayan grupta 81.66 ± 1.43 Ncm, standart açı adaptörlü grupta ise 80.88 ± 1.55 Ncm olarak bulunmuştur. Gruplar arasında istatistiksel olarak anlamlı fark saptanmıştır. En yüksek grup içi tutarlılık, yüksek manuel tork grubu ile açı adaptörlü grup arasında kaydedilmiştir (ICC = 0.655, %95 GA: 0.045–0.955, p = 0.026). Ayrıca, ISQ değerlerinin tork tutarlılığı ile pozitif korelasyon gösterdiği gözlemlenmiştir; bu durum, standart bağlantı yöntemlerinin ölçüm güvenilirliğini artırabileceğini göstermektedir.
Sonuç: Uygulayıcı kaynaklı değişkenlik, SmartPeg yerleştirme torkunu ve buna bağlı olarak ISQ ölçümlerini etkileyebilmektedir. Sabit tork uygulayan açı adaptörü gibi standart bağlantı yöntemlerinin kullanımı, RFA temelli implant stabilite değerlendirmelerinde tekrarlanabilirlik ve güvenilirliği artırabilir.
Keywords
İmplant stabilitesi yerleştirme torku rezonans frekansı analizi uygulayıcı farklılığı SmartPeg
References
- Bafijari D, Pirayesh R, Memari Y, Nezafati S, Jafari M. Influence of resonance frequency analysis (RFA) measurements for successful osseointegration of dental implants during the healing period and its impact on implant assessed by Osstell Mentor device. Open Access Maced J Med Sci. 2019;7:4110–5.
- Herrero-Climent M, Falcao A, Tondela J. Relevant aspects of the dental implant design on the insertion torque, resonance frequency analysis (RFA) and micromobility: an in vitro study. J Clin Med. 2023;12:1–12.
- Dos Santos MV, Elias CN, Cavalcanti Lima JH. The effects of superficial roughness and design on the primary stability of dental implants. Clin Implant Dent Relat Res. 2011;13:215–23.
- Petersson A, Sennerby L. On standard calibration of ISQ transducer pegs: prerequisites for accurate and comparable RFA measurements. Integr Diagn Updat. 2016;1:1–3.
- Monje A, Ortega-Oller I, Galindo-Moreno P, Catena A, Monje F, O'Valle F et al. Sensitivity of resonance frequency analysis for detecting early implant failure: a case-control study. Int J Oral Maxillofac Implants. 2014;29:456–61.
- 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;7:261–7.
- Kästel I, Hüttig F, Wegner B, Kirchner E, Heinemann F. Does the manual insertion torque of smartpegs affect the outcome of implant stability quotients (ISQ) during resonance frequency analysis (RFA)? Int J Implant Dent. 2019;5:1–7.
- Geckili O, Bilhan H, Cilingir A, Mumcu E, Bural C. A comparative in vitro evaluation of two different magnetic devices detecting the stability of osseointegrated implants. J Periodontal Res. 2012;47:508–13.
- Salatti DB, Pelegrine AA, Gehrke S, Teixeira ML, Moshaverinia A, Moy PK. Is there a need for standardization of tightening force used to connect the transducer for resonance frequency analysis in determining implant stability? Int J Oral Maxillofac Implants. 2019. doi:10.11607/jomi.7361
- Al-Otaibi HN, Almutairi A, Alfarraj J, Algesadi W. The effect of torque application technique on screw preload of implant-supported prostheses. Int J Oral Maxillofac Implants. 2017;32:259–63.
- Leyk D, Gorges W, Ridder D, Wunderlich M, Rüther T, Sievert A et al. Hand-grip strength of young men, women and highly trained female athletes. Eur J Appl Physiol. 2007;99:415–21.
- Petersson A, Sennerby L. On standard calibration of ISQ transducer pegs: prerequisites for accurate and comparable RFA measurements. Integr Diagn Updat. 2016;1:1–3.
- Balleri P, Cozzolino A, Ghelli L, Momicchioli G, Varriale A. Stability measurements of osseointegrated implants using Osstell in partially edentulous jaws after 1 year of loading: a pilot study. Clin Implant Dent Relat Res. 2002;4:128–32.
- Scarano A, Inchingolo F, Quaranta M, Piattelli A. A 5-year follow-up of osseointegrated implants inserted without flap surgery. Clin Implant Dent Relat Res. 2010;12:1–6.
- Huang HM, Pan YH, Lin DJ, Lee SY. Effects of various tightening torques of the smartpeg on resonance frequency measurements. Clin Oral Implants Res. 2006;17:346–50.
- Rasmusson L, Meredith N, Kahnberg KE. Stability assessments and histology of titanium implants placed simultaneously with autogenous onlay bone in the rabbit tibia. Int J Oral Maxillofac Surg. 1998;27:229–35.
- Bornstein MM, Hart CN, Halbritter SA, Morton D, Buser D. Early loading of nonsubmerged titanium implants with a sandblasted and acid-etched (SLA) surface: 3-year results of a prospective study in partially edentulous patients. Int J Oral Maxillofac Implants. 2009;24:887–93.
- Sim CP, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell mentor during implant healing: a systematic review. Clin Oral Implants Res. 2010;21:598–607.
- Atsumi M, Park SH, Wang HL. Methods used to assess implant stability: current status. Int J Oral Maxillofac Implants. 2007;22:743–54.
Evaluation of insertion torque and implant stability using the osstell device according to connection method and practitioner variability
Abstract
Purpose: This study aimed to evaluate the effects of SmartPeg connection methods and practitioner-related variability on insertion torque and implant stability measurements using the Osstell device.
Materials and Methods: Four oral and maxillofacial surgeons each placed 40 implants into bovine femur bone blocks with D1 bone quality. The study was conducted at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hatay Mustafa Kemal University (Hatay, Türkiye). SmartPeg insertion torque was measured using a digital torque wrench. Resonance Frequency Analysis (RFA) was performed immediately after SmartPeg placement. Data were analyzed using ANOVA and Intraclass Correlation Coefficient (ICC).
Results: The mean insertion torque values were 69.88 ± 2.11 Ncm for the group with lower applied torque, 81.66 ± 1.43 Ncm for the group with higher manual torque, and 80.88 ± 1.55 Ncm for the standardized angulated adapter group. Statistically significant differences were observed among the groups. The highest intergroup consistency was recorded between the manual high-torque group and the angulated adapter group (ICC = 0.655, 95% CI: 0.045–0.955, p = 0.026). Additionally, ISQ values showed a positive correlation with torque consistency, suggesting that uniform application methods may enhance measurement reliability.
Conclusion: Practitioner-related variability affects SmartPeg insertion torque and subsequent ISQ measurements. The use of a standardized connection method, such as an angulated adapter applying fixed torque, may improve the reliability and reproducibility of RFA-based implant stability assessments.
Keywords
Implant stability insertion torque resonance frequency analysis practitioner variability SmartPeg
Ethical Statement
This study was conducted using bovine femur bone specimens and did not involve human participants or live animals. Nevertheless, ethical approval was obtained from the Non-Interventional Clinical Research Ethics Committee of Hatay Mustafa Kemal University (Meeting Date: 01.04.2024, Meeting No: 03, Decision No: 25). The study was reviewed and approved unanimously by the committee, confirming compliance with ethical and scientific standards.
References
- Bafijari D, Pirayesh R, Memari Y, Nezafati S, Jafari M. Influence of resonance frequency analysis (RFA) measurements for successful osseointegration of dental implants during the healing period and its impact on implant assessed by Osstell Mentor device. Open Access Maced J Med Sci. 2019;7:4110–5.
- Herrero-Climent M, Falcao A, Tondela J. Relevant aspects of the dental implant design on the insertion torque, resonance frequency analysis (RFA) and micromobility: an in vitro study. J Clin Med. 2023;12:1–12.
- Dos Santos MV, Elias CN, Cavalcanti Lima JH. The effects of superficial roughness and design on the primary stability of dental implants. Clin Implant Dent Relat Res. 2011;13:215–23.
- Petersson A, Sennerby L. On standard calibration of ISQ transducer pegs: prerequisites for accurate and comparable RFA measurements. Integr Diagn Updat. 2016;1:1–3.
- Monje A, Ortega-Oller I, Galindo-Moreno P, Catena A, Monje F, O'Valle F et al. Sensitivity of resonance frequency analysis for detecting early implant failure: a case-control study. Int J Oral Maxillofac Implants. 2014;29:456–61.
- 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;7:261–7.
- Kästel I, Hüttig F, Wegner B, Kirchner E, Heinemann F. Does the manual insertion torque of smartpegs affect the outcome of implant stability quotients (ISQ) during resonance frequency analysis (RFA)? Int J Implant Dent. 2019;5:1–7.
- Geckili O, Bilhan H, Cilingir A, Mumcu E, Bural C. A comparative in vitro evaluation of two different magnetic devices detecting the stability of osseointegrated implants. J Periodontal Res. 2012;47:508–13.
- Salatti DB, Pelegrine AA, Gehrke S, Teixeira ML, Moshaverinia A, Moy PK. Is there a need for standardization of tightening force used to connect the transducer for resonance frequency analysis in determining implant stability? Int J Oral Maxillofac Implants. 2019. doi:10.11607/jomi.7361
- Al-Otaibi HN, Almutairi A, Alfarraj J, Algesadi W. The effect of torque application technique on screw preload of implant-supported prostheses. Int J Oral Maxillofac Implants. 2017;32:259–63.
- Leyk D, Gorges W, Ridder D, Wunderlich M, Rüther T, Sievert A et al. Hand-grip strength of young men, women and highly trained female athletes. Eur J Appl Physiol. 2007;99:415–21.
- Petersson A, Sennerby L. On standard calibration of ISQ transducer pegs: prerequisites for accurate and comparable RFA measurements. Integr Diagn Updat. 2016;1:1–3.
- Balleri P, Cozzolino A, Ghelli L, Momicchioli G, Varriale A. Stability measurements of osseointegrated implants using Osstell in partially edentulous jaws after 1 year of loading: a pilot study. Clin Implant Dent Relat Res. 2002;4:128–32.
- Scarano A, Inchingolo F, Quaranta M, Piattelli A. A 5-year follow-up of osseointegrated implants inserted without flap surgery. Clin Implant Dent Relat Res. 2010;12:1–6.
- Huang HM, Pan YH, Lin DJ, Lee SY. Effects of various tightening torques of the smartpeg on resonance frequency measurements. Clin Oral Implants Res. 2006;17:346–50.
- Rasmusson L, Meredith N, Kahnberg KE. Stability assessments and histology of titanium implants placed simultaneously with autogenous onlay bone in the rabbit tibia. Int J Oral Maxillofac Surg. 1998;27:229–35.
- Bornstein MM, Hart CN, Halbritter SA, Morton D, Buser D. Early loading of nonsubmerged titanium implants with a sandblasted and acid-etched (SLA) surface: 3-year results of a prospective study in partially edentulous patients. Int J Oral Maxillofac Implants. 2009;24:887–93.
- Sim CP, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell mentor during implant healing: a systematic review. Clin Oral Implants Res. 2010;21:598–607.
- Atsumi M, Park SH, Wang HL. Methods used to assess implant stability: current status. Int J Oral Maxillofac Implants. 2007;22:743–54.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgery (Other) |
| Journal Section | Research |
| Authors | |
| Publication Date | June 30, 2025 |
| Submission Date | May 28, 2025 |
| Acceptance Date | June 25, 2025 |
| Published in Issue | Year 2025 Volume: 50 Issue: 2 |
