Electronic Percussive Testing of the Stability of an Immediately Provisionalized Implant Placed Into a Fresh Extraction Socket: A Pilot Evaluation
It is important to achieve primary stabilization of dental implants that will be immediately loaded. Noninvasive devices that test the stability of immediately provisionalized implants placed into fresh extraction sockets are discussed. A titanium threaded implant was placed into a fresh extraction socket of a patient's nonrestorable mandibular right canine. The implant received an interim restoration immediately following its placement. The stability of the bone-implant complex was evaluated from the day of implant insertion through day 246 using an electronic percussive testing instrument. During the first month the bone-implant complex became progressively less stable reaching a peak measured level of instability at 30 days postimplantation. This was followed by progressive stabilization first measured on day 46 as the implant continued to osseointegrate. These findings suggest that the bone-implant complex became less stable during the first month after implant placement and was followed by a period of progressive stabilization reflecting bone maturation around the implant. A search of the literature found similar results in a study of single-stage implants (not immediately provisionalized) using resonance frequency analysis. The known sequence of wound healing around dental implants is reviewed to explain the findings of this pilot evaluation. Studies that use noninvasive testing devices to assess implant stability at placement and during healing may provide information that can help to optimize implant treatment outcomes.Abstract


Contributor Notes
Ira H. Orenstein, DDS, is a staff dentist at the James J. Peters VA Medical Center, Bronx, NY, and an assistant clinical professor at the Division of Restorative Dentistry, Columbia University School of Dental Medicine, New York, NY. Address correspondence to Dr Orenstein at James J. Peters VA Medical Center, Dental Service (160), 130 West Kingsbridge Rd., Bronx, NY 10468 (ira.orenstein@med.va.gov)
Daniel E. MacDonald, DMD, MSD, is an assistant clinical professor in the Division of Periodontics, Columbia University School of Dental Medicine, New York, NY; an associate research scientist at Fu School of Graduate Engineering, Columbia University, New York, NY; an associate research scientist at the Hospital for Special Surgery affiliated with the Weill Medical College of Cornell University, New York, NY; and a periodontist at the Dental Service, James J. Peters VA Medical Center, Bronx, NY
Anita C. Tao, DDS, is a former general practice dental resident at the Mount Sinai/James J. Peters VA Medical Center, Bronx, NY
Harold F. Morris, DDS, MS, is a staff prosthodontist at the VA Medical Center, Ann Arbor, Mich, and a professor in the Department of Restorative Dentistry, Temple University, School of Dentistry, Philadelphia, Pa