Assessment of implant stability as a prognostic determinant.

PURPOSE: This paper aims to establish the parameters necessary to monitor successful implant placement and osseointegration. RESULTS AND DISCUSSION: Implant stability is considered to play a major role in the success of osseointegration. Primary implant stability at placement is a mechanical phenomenon that is related to the local bone quality and quantity, the type of implant and placement technique used. Secondary implant stability is the increase in stability attributable to bone formation and remodeling at the implant/tissue interface and in the surrounding bone. Techniques for measuring implant stability and osseointegration, including the clinical measurement of cutting resistance during implant placement and removal torque following osseointegration, are discussed. Nondestructive test methods, including impact-based techniques such as the Periotest and the Dental Fine Tester, are also discussed. An alternative method, resonance frequency analysis, is described in detail. CONCLUSION: It is clear that stability both at placement and during function is an important criterion for the success of dental implants. Quantitative methods, including resonance frequency analysis, can yield valuable information.