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J Periodontal Implant Sci. 2018 Dec 27;48(6):360-372. doi: 10.5051/jpis.2018.48.6.360. eCollection 2018 Dec.

Relationship between cortical bone thickness and implant stability at the time of surgery and secondary stability after osseointegration measured using resonance frequency analysis.

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Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Sendai, Japan.
Division of Fixed Prosthodontics and Biomaterials, University Clinic, Dental Medicine University of Geneva, Geneva, Switzerland.
Dental Implant Center, Tohoku University Hospital, Sendai, Japan.



It has been suggested that resonance frequency analysis (RFA) can measure changes in the stability of dental implants during osseointegration. This retrospective study aimed to evaluate dental implant stability at the time of surgery (primary stability; PS) and secondary stability (SS) after ossseointegration using RFA, and to investigate the relationship between implant stability and cortical bone thickness.


In total, 113 patients who attended the Tohoku University Hospital Dental Implant Center were included in this study. A total of 229 implants were placed in either the mandibular region (n=118) or the maxilla region (n=111), with bone augmentation procedures used in some cases. RFA was performed in 3 directions, and the lowest value was recorded. The preoperative thickness of cortical bone at the site of implant insertion was measured digitally using computed tomography, excluding cases of bone grafts and immediate implant placements.


The mean implant stability quotient (ISQ) was 69.34±9.43 for PS and 75.99±6.23 for SS. The mandibular group had significantly higher mean ISQ values than the maxillary group for both PS and SS (P<0.01). A significant difference was found in the mean ISQ values for PS between 1-stage and 2-stage surgery (P<0.5). The mean ISQ values in the non-augmentation group were higher than in the augmentation group for both PS and SS (P<0.01). A weak positive correlation was observed between cortical bone thickness and implant stability for both PS and SS in all cases (P<0.01).


Based on the present study, the ISQ may be affected by implant position site, the use of a bone graft, and cortical bone thickness before implant therapy.


Cortical bone thickness; Implant stability; Osseointegration; Resonance frequency analysis

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

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