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Niger J Clin Pract. 2019 Jul;22(7):982-987. doi: 10.4103/njcp.njcp_22_19.

Evaluating cortico-cancellous ratio using virtual implant planning and its relation with immediate and long-term stability of a dental implant- A CBCT-assisted prospective observational clinical study.

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Department of Periodontology and Oral Implantology, Rambabu Dental Hospital, Ongole, India.
Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia.
Department of Periodontics, Dr. Vijay's Multi Speciality Dental Care, Implant and Laser Center, Bangalore, India.
Department of Occupational Health and Safety Management, Lambton College of Applied Arts and Technology, Scarborough, Toronto, Ontario, Canada.



Primary and long-term implant stabilities are crucial in predicting the success of dental implants. We aimed to evaluate corticocancellous ratio (CCR) around virtual implant using cone beam computed tomography (CT) and assess its relationship with immediate and long-term stability of the implants placed.

Materials and Methods:

A total of 135 image records of posterior mandibular implant sites planned for dental implant were included in our study. CCR was calculated using CT images and implants were placed after stent preparation. Implant stability was calculated immediately, 4 months later, and 2 years later.


Pearson's correlation test showed a significant correlation (P and lt; 0.001) between CCR and implant stability. ANOVA and post-hoc Tukey tests showed a significant difference in implant stability between groups with different CCRs at all follow-up timepoints. No significant difference was found between mean implant stability quotient values for low CCR at 2-year follow-up and high CCR immediately after implant placement.


Implant stability is improved with greater CCR. Cortical bone seems to be crucial factor for immediate and long-term stability of a dental implant. Virtual planning using CT can assess implant stability. Further histological studies are required to confirm the relation between CCR and implant stability. The escalating demand of the implant treatment in the dental practice necessitates measuring the several predictors of procedure success. This study introduces a novel predictor (CCR) around virtual implant for detecting the immediate and long-term stability of a dental implant.


Cancellous bone; cone-beam computed tomography; cortical bone; dental implant

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