title: Bone density assessments of dental implant sites: 3. Bone quality evaluation during osteotomy and implant placement.
abstract: OBJECTIVE
  In previous publications of this series of studies on human cadaver jaws, bone densities were assessed and compared using subjective evaluation, conventional computed tomography (CT), and cone-beam computed tomography (CBCT). The aim of this study was to compare subjective bone quality during osteotomy and implant insertion resistance torque to noninvasive subjective and objective radiographic bone density assessments.
  
  
  METHODS
  Forty-two designated implant sites were selected. Self-tapping implants were inserted into these sites. The operator subjectively rated the bone density during the osteotomy procedure. Resistance torque was recorded during insertion of the implants.
  
  
  RESULTS
  Subjective drilling resistance was modestly correlated to subjective radiographic density evaluation (Lekholm and Zarb; Spearman's rho of 0.53, P < .001). Subjective drilling resistance compared to the bone density in Hounsfield units (HU) obtained using CT and CBCT showed correlation coefficients of 0.61 and 0.59, respectively (P < .001). Significant overlap of density values was found for adjacent drilling ratings. On average, a difference in bone density of 180 HU was required to identify differences between drilling resistance groups. Comparisons of 2 implant insertion resistance torque variables (highest reading and regression slope of available readings) with CT and CBCT HU showed correlation coefficients of 0.61 to 0.63 (P < .01).
  
  
  CONCLUSIONS
  Insertion torque resistance was modestly correlated with objective CT and CBCT measurements of bone density. The merit of these assessments of cadavers awaits clinical study.
authors.affiliation: Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Lee
authors.forename: Bernard
authors.initials: B
authors.lastname: Gantes
authors.forename: Matt
authors.initials: M
authors.lastname: Riggs
authors.forename: Max
authors.initials: M
authors.lastname: Crigger
mesh_terms: D015519:Bone Density; D002102:Cadaver; D003720:Densitometry / Q000379:methods; D003758:Dental Implantation, Endosseous / Q000379:methods*; D003799:Dental Stress Analysis; D006801:Humans; D007568:Jaw / Q000000981:diagnostic imaging / Q000502:physiology*; D016014:Linear Models; D010027:Osteotomy; D014057:Tomography, X-Ray Computed / Q000379:methods; D019415:Torque