title: Influence of Skeletal and Local Bone Density on Dental Implant Stability in Patients with Osteoporosis.
abstract: OBJECTIVE
  Osteoporosis is a major skeletal disease affecting millions of people worldwide. Recent studies claim that patients with osteoporosis do not have a higher risk of early implant failure compared to non-osteoporotic patients. The aim of this study was to assess the effect of skeletal osteoporosis and local bone density on initial dental implant stability.
  
  
  METHODS
  Seventy-three patients were recruited and were assigned (based on a Dual-energy X-ray Absorptiometry scan) to either the osteoporosis (Opr), osteopenia (Opn), or control (C) group. Forty nine of the 73 patients received dental implants and had implant stability measured by means of resonance frequency analysis (RFA) at implant placement and at prosthetic abutment placement. On the computerized tomography scans, the cortical thickness and the bone density (Hounsfield Units) at the sites of implant placement were measured.
  
  
  RESULTS
  At implant placement, primary stability was on average lower in group Opr (63.3 ± 10.3 ISQ) than in group Opn (65.3 ± 7.5 implant stability qutient (ISQ)), and group C (66.7 ± 8.7 ISQ). At abutment placement, a similar trend was observed: group Opr (66.4 ± 9.5 ISQ) scored lower than group Opn (70.7 ± 7.8 ISQ), while the highest average was for group C (72.2 ± 7.2 ISQ). The difference between groups Opr and C was significant. Implant length and diameter did not have a significant effect on implant stability as measured with RFA. A significant correlation was found between local bone density and implant stability for all regions of interest.
  
  
  CONCLUSIONS
  Implant stability seems to be influenced by both local and skeletal bone densities. The lower stability scores in patient with skeletal osteoporosis reinforce the recommendations that safe protocols and longer healing times could be recommended when treating those patients with dental implants.
authors: Unit of Periodontology, Department of Oral Health Sciences, University of Leuven, Leuven, Belgium.
authors: Joe
authors: J
authors: Merheb
authors: Unit of Periodontology, Department of Oral Health Sciences, University of Leuven, Leuven, Belgium.
authors: Andy
authors: A
authors: Temmerman
authors: Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Lars
authors: L
authors: Rasmusson
authors: Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Wuerzburg, Germany.
authors: Alexander
authors: A
authors: Kübler
authors: Department of Oral and Maxillofacial Surgery, Institute of Surgical Sciences, Uppsala University, Uppsala, Sweden.
authors: Andreas
authors: A
authors: Thor
authors: Unit of Periodontology, Department of Oral Health Sciences, University of Leuven, Leuven, Belgium.|Research Group Periodontology & Oral microbiology, Department of Oral Health Sciences, University of Leuven, Leuven, Belgium.
authors: Marc
authors: M
authors: Quirynen
mesh_terms: D015519:Bone Density; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention; D006801:Humans; D016348:Osseointegration; D010024:Osteoporosis
chemical_list: D015921:Dental Implants
keywords: ISQ; Osstell; density; dual-energy X-ray absorptiometry; implant; osteoporosis; resonance; resonance frequency analysis; stability