Evaluation of bone density by cone‑beam computed tomography and its relationship with primary stability of dental implants

Abstract

Background: One of the critical factors determining the success of dental implants is primary
stability. This study aimed to determine the density of jawbones in the implant candidate sites via
cone‑beam computed tomography (CBCT) and its correlation with the values obtained from
resonance frequency analysis during surgery.
Materials and Methods: In this descriptive‑analytic study seventeen implant sites requiring
implant placement were selected. Impressions were sent to the laboratory to construct a surgical
guide via the stereolithographic method. An electronic surgery was performed on the chosen
implant sites according to each patient’s CBCT information entered into the Kaveh surgical
guide software. The bone density of the target areas was calculated using the gray value (voxel
value). After preparing the final osteotomy, an implant was installed in the area according to the
manufacture’s recommendation. The relevant Osstell® SmartPeg was selected and installed on the
implant body to determine the primary stability. Kolmogorov–Smirnov test and the correlation
pearson correlation statistical test. used for statistical analyze. P value amounts < 0.05 was
considered significant.
Results: The mean and standard deviation of the gray scale in this study were 563.7 ± 218.8 and
65.3 ± 7.7 implant stability quotient (ISQ) respectively. The correlation between gray scale and
ISQ was evaluated by the Pearson correlation test, and the results indicated a strong correlation
between the two variables.
Conclusion: The voxel value and primary stability had a normal distribution and strong correlation.
In other words, the gray scale determined by CBCT imaging techniques at the proposed implant
site could be used to assess the bone density before the surgery.
Key Words: Cone‑beam computed tomography, dental implant, implant stability, resonance
frequency analysis