The phrase: ‘Primary Stability’ has been associated with successful implant therapy. The true meaning of implant stability and what this means biologically is far from understood completely. The mere ‘threading’ of a titanium screw into bone does not signal the endpoint of implant treatment. In fact, it may signal the demise of a successful outcome. How biological tissues react to trauma such as cutting, compression and fracture is of critical importance. The nature and timing of ‘Secondary Stability’ or ‘Osseointegration’ is as important as its predictability. Surgeons have several modalities to quantify the stability of dental implants. Some measures, such as insertion torque value (ITV), are only applicable at the time of implant placement. Others, such as implant stability quotient (ISQ), are repeatable and can be implemented to determine not only stability at any given time, but to evaluate the stability, increase or decrease of ‘Secondary Stability’. Numerous studies have been conducted to determine whether a correlation exists between the two variables. This presentation will critically discuss what is known and what is yet to be determined regarding implant stability. Clinical studies will be presented, and guidelines suggested by various authors questioned. Arbitrary ITV and/or ISQ recommendations regarding loading times will be discussed regarding their viability in current clinical practice.
Learning Objectives:
- To understand the differences that exist between insertion torque value and implant stability quotient
- To evaluate implants placed at time of extraction versus healed/grafted sites regarding the effects of insertion torque on trabecular and cortical bone, and how this may affect crestal bone levels
- To recognize better which immediate implants can be temporized at time of placement
- To understand how to avoid some of the negative by-products of traumatizing alveolar bone during implant placement