Resonance Frequency Research Tool for Implant Stability

Dr. Vishwanath Pattar Dr. Anjana Bagewadi MDS

" Resonance frequency evaluation (RFA) - A diagnostic tool for implant balance "

Dental implants have become a significant aspect of tooth substitution in prosthodontic treatment. High implant success rates of the order of 78-100 % have been shared, with more than 15 years of observation time. Treatment success of dental implant mainly depends on the stability of the implant bone support. Implant stability is a mechanised phenomenon which relates to the neighborhood bone quality and variety, kind of implant, and placement technique used. The use of a simple, medically relevant, non-invasive test to examine implant steadiness and osseointegration is known as highly advisable. Resonance frequency evaluation (RFA) is one of such techniques which is most regularly used nowadays. Aim of this paper is to examine the approach of Radio rate of recurrence evaluation and use of computer to check on the implant stableness.

Key words: Resonance rate of recurrence analysis, Implant balance, Implant stability quotient(ISQ)

Introduction :

Dental implants have reported success rates of over 90 % over extended periods of time. However failures still occur and seem to be to be unstable. One factor that is being significantly considered in inability of oral implants is occlusal launching. It has been clinically demonstrated that implant stableness plays a significant role in deciding treatment result (Sennerby & Meredith 1998, Esposito et al. 1998). Implant stability is seen as a blend of: 1). Mechanised balance, which is the result of compressed bone having the implant firmly in place. 2). Biological stableness, which is the result of new bone cells forming at the website of the implant and osseointegration. In the beginning implant stability was assessed by Surgeon's understanding while positioning the implant (Insertion and seats torque), percussion trials, reverse torque ensure that you radiographs etc. But none of them proven to be effective in measuring the implant stableness. Resonance Frequency Examination (RFA) is a non-invasive diagnostic tool for detecting the implant stableness of dental care implants through the healing stages and in following routine follow-up treatment after treatment.

Advantages of Rasonance occurrence analysis

1) Optimal loading decisions : It creates it easier for dentists to choose when is the perfect time to insert implants. At placement, steadiness can be difficult to quantify objectively by simply counting on tactile understanding. Torque measurements are difficult to repeat after the implant has started to incorporate and can therefore not give a baseline for subsequent comparisons. The intrusive torque method could even damage the treatment if used for monitoring osseointegration

2) Early warnings - preventing failure : Dentists sometimes face patients whose primary stability rating is low. The reason why could be they have had to endure a bone graft. In such higher-risk situations, most doctors would avoid an early-loading protocol. Likewise, a significant decrease in stability indicates a potential problem and really should be considered an early on warning. The cosmetic surgeon may want to unload the implant - or perhaps place additional implants - and then hang on until stability raises. RFA system makes the treatment of high-risk patients easier and much more predictable - allowing more of the patients to be treated and more of the treatments to reach your goals.

3) Quality confidence : Because RFA system helps the dental practitioner make a decision when to weight and avoid inability in high-risk situations, it becomes a quality-assurance system for the center. Most patients intuitively understand the balance measures and exactly how they govern when to download an implant so when to wait. This raises their sense of confidence, security and quality.

4) Data can be transferable : All the stability records measured from start of treatment and the follow -up files can be transefered in one clinician to other. It makes easy to the one clinician to communicate with other about the procedure modalities.

Implant steadiness quotient (ISQ)

ISQ (Implant Stableness Quotient) is a measurement scale for use with the RFA (Resonance Rate of recurrence Analysis) method of determining implant balance. From the mapping of resonance frequencies (kHz), presented as a clinically useful level of 1-100 ISQ. 1 is the least ISQ value and 100 is the best ISQ value. ISQ can be used RFA to evaluate stability because

  • Supports making great decision about when to load
  • Allows advantageous protocol choice on the patient-to-patient basis.
  • Indicates situations in which it is advisable to unload
  • Supports good communication and increased trust
  • Provides better circumstance documentation

Instrument kit:

 

Fig. 1 Handheld probe Fig. 2 MonitorFig. 3 Main plug

 

Fig. 4 Data cable tv Fig. 5 Tests device Fig. 6 Smart-peg

Technique :

Resonance frequency examination (RFA) uses a complex technology with computer-based way of measuring of resonance regularity (RF), which depends upon two variables: the degree of bone density on implant-bone software area and the level of marginal alveolar bone around the transducer Osstell is representative of RFA-technique and was examined first in 1997The apparatus contains an Osstell transducer and Osstell analyzer connected to a PC or self-employed. The transducer is L-shaped or bolts-like (smartpeg) and firmly screwed to become positioned on the implant and its own superstructure (4-5 N/cm) and includes 2 small voltage handled transducers. High-energy pulse-type oscillations of a continuous sinusoidal pulse excite implant, to be able to register the mechanised vibration between the implant interconnection zone and the bone. When the apparatus is activated the first electric transducer can be applied excitation transmission of increasing occurrence from 5 to 15 kHz to implant. Other voltage-controlled factor registers ultrasonic vibrations response, ie resonant regularity of the implant-bone interface area and transmits a created indication to the amplifier, which amplifies it and the analyzer which reads, evaluates and compares it with the regularity of the initial transmission. The measured amplitude of resonance rate of recurrence is shown numerically and graphically on the Osstell analyzer, and the utmost amplitude symbolizes the balance of the implant, quantified through the ISQ systems. The ISQ value displays the rigidity of the system transducer- implant-bone and transducer calibration guidelines. Measured on a range from 0 ISQ (3500 Hz) to 100 ISQ products (8500 Hz), an increased ISQ value reveals a greater stability of the implant. After a while ISQ values climb because of osseointegration where implant-bone the connection becomes more robust.

 

Fig. 7 Fig. 8 Fig. 9

ISQ worth:

  • >60 - < 70 ISQ value - 2 stage implant can be done
  • >70 - Immediate loading can be done

 

This graph illustrates the progress of implant stableness over time, indicated in ISQ terms. The converging renewable curves show the two most likely situations: implant stableness eventually packages at around 70 ISQ. A high original ISQ value tends to decrease, as mechanised stableness is supplanted by osseointegration. And a low initial value will increase, as osseointegration pieces in. The scenario to consider is illustrated by the red curve. Here, osseointegration is not progressing as designed, and loading this implant may bring about a failed treatment. . . High preliminary stability (ISQ ideals of 70 and above) tends never to increase over time despitethe idea that the original high mechanical stability decreases which is changed by increased biological steadiness. Lower initial stability normally increases as time passes because the low mechanical steadiness is increased by the bone remodeling process (osseointegration). Values of ISQ 55 or lower should be taken as a warning sign and actions to improve the stability is highly recommended (larger implant diameter, longer recovering time, etc. )* *(Implant stability measurements using Resonance Occurrence Evaluation. Biological and biomechanical aspects and specialized medical implications. Periodontology 2000, 2008. Sennerby & Meredith)

References:

Chang WA et al. A newly designed resonance occurrence analysis device for oral implant stability diagnosis ; Dent Mater J. 2007 Sep;26(5):665-71

Rajiv KG et al. Resonance rate of recurrence evaluation ; Indian Journal of Tooth Research, 22(4), 2011

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