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<p>Determining Implant Stability<br>Lieutenant Commander Scott A. Pasieta, DC, USN, CAPT John H. Mumford, DC, USN and Lieutenant Commander Joyce Y. Turner, DC, USN<br><br>Introduction<br>Implants revolutionized dentistry and provide a viable treatment modality in the replacement of missing or unrestorable teeth. Long-term implant survival rates are reported in a range from 85-99% and can be influenced by several elements including healing time, implant surfaces characteristics, bone quality and surgical and restorative techniques. Classic guidelines used to enhance successful implant therapy include an unloaded healing period of 3 to 6 months to promote osseointegration, which is defined as the bone to implant contact at the light microscopic level. However, patients today would like the treatment and healing time shortened to allow for immediate provisionalization and an earlier restoration.<br><br>There are several surgical objectives that are thought to be important in accelerating the healing process of osseointegration. One of the more important of these objectives is to achieve initial primary stability. The torque value at time of placement is one indicator of determining initial stability. The literature shows that at a mini-mum, insertion torque of 20Ncm led to higher success rates. In addition, the initial torque value has been used to determine if an implant can be single-staged by placing a healing abutment/ provisional at the time of surgery or if the implant needs to be submerged and allowed to heal for a longer period. It is prudent, therefore, to ensure that the implant is clinically stable prior to the restorative phase. Several clinical tests can be used to determine stability and are used as indicators of osseointegration, however most are only gross subjective measuring techniques.
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<br>Subjects: Dental Implantation; Endosseous ; Dental Implants</div>
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U.S. Navy. Naval Postgraduate Dental School</div>
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