Determination of alveolar bone quality during dental implant surgery by means of compressive testing

Abstract

It has been demonstrated that alveolar bone of poor quality is associated with higher failure rates for dental implants. The aim of this investigation was to test a novel device (BoneProbe) for the determination of bone quality during implant surgery based on compressive testing. The BoneProbe consists of a hollow metal cylinder with a diameter of 3.50 mm divided into six segments and a centrally positioned cone which can be drawn into the cylinder thereby increasing its diameter. This sensor could be inserted into sockets prepared for the placement of dental implants and the diameter increased while recording the forces needed. Implant placement in polyurethane foam materials differing in density and structure as well as in alveolar bone from human cadavers was performed to compare values obtained from the BoneProbe with following parameters: classification of alveolar bone based on drilling resistance, implant insertion torque, primary implant stability, elastic modulus of bone, thickness of cortical bone and density of trabecular bone as determined by cone beam computed tomography. Statistical analysis was done using multivariate analysis of variance (MANOVA) with Pillai's trace (α = 0.05). Pearson correlation coefficients were calculated for all combinations of parameters. For testing in polyurethane foam materials, significant correlations between all parameters were found (p < 0.05). Global MANOVA with Pillai's trace revealed a significant influence of the different polyurethane foam materials on all measurement results (p = 0.000). For testing in human cadaver bone, the values obtained from the BoneProbe in cortical bone significantly correlated with the surgeon's subjective classification based on drilling resistance and implant insertion torque (p < 0.05). Applying BoneProbe measurements, it was possible to differentiate between various levels of bone quality. The measurement system described appears to be useful for the clinical evaluation of bone quality during dental implant surgery. © 2010 International Federation for Medical and Biological Engineering.