The Effects of Defect Type and Depth, and Measurement Direction on the Implant Stability Quotient Value
The purpose of this study was to evaluate the effect of defect type and depth as well as measurement direction on implant stability in an ex vivo peri-implant bovine rib bone model. Six kinds of defects (3-wall 2.5 mm, 3-wall 5 mm, 1-wall 2.5 mm, 1-wall 5 mm, circumferential 2.5 mm, circumferential 5 mm), and control (no defect) were prepared in 14 bovine rib bones. A total of 84 defects and 14 controls were created. The same type and size of implants (4 × 10 mm) were placed in each group. The thickness of cortical bone and the insertion torque were measured for each defect, and the implant stability quotient (ISQ) value was measured 3 times from 4 different directions. The thickness of cortical bone ranged from 2.71–3.18 mm. Insertion torque decreased as the defect size increased. As the defect size for the same defect depth increased, the ISQ value decreased (P < .001). There were significant differences between the ISQ values obtained with different measurement directions only between the control and 3-wall 5 mm defect (P < .0001). The ISQ value opposite to the defect direction was higher than that in the defect direction in all 3 directions of the 3-wall and 1-wall 5 mm defects. ISQ values were influenced by defect type and depth. Loss of cortical bone reduced the stability of implants and reduced the ISQ value. Measurement direction also influenced ISQ values.

Schematic drawings of defect types (occlusal view) and photo of bovine rib bone after installation of seven implants. (a) 3-wall defects. (b) 1-wall defects. (c) Circumferential defects. (d) Control and 6 kinds of defects in bovine rib bone. From left side (mesial side, opposite side of the defect) no defect, 1-wall 5-mm defect, 1-wall 2.5-mm defect, circumferential 5-mm defect, circumferential 2.5-mm defect, 3-wall 5-mm defect, and 3-wall 2.5-mm defect. The defect side was considered the distal side.
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