Reliability of clinical techniques for evaluating alveolar bone quality and primary implant stability

Objective: A novel device for intraoperative compressive testing of alveolar bone during implant surgery has been introduced. It was the goal of this study to compare the performance of this device with traditional methods used for determining alveolar bone quality and primary implant stability. Method and materials: Implant surgery in human cadaver bone was performed by two implantologists differing in experience. Bone quality was rated radiographically, based on tactile sensation during drilling and using intraoperative compressive tests. Implant stability was evaluated using insertion torque measurements and resonance frequency analysis. Statistical analysis was based on two way ANOVA followed by Tukey multiple comparisons and Pearson's product moment correlation. The level of significance was set at α = .05. Results: Human cadaver bone was ranked according to implant insertion torque. Radiographic assessment, tactile sensation during drilling, and implant stability measurements did not allow differentiating bone types in all instances. Cortical BoneProbe measurements showed a significant trend towards higher measurement values in greater bone quality types (P .01); in trabecular bone this trend was also present but was not statistically significant. Significant correlations existed between BoneProbe measurements and most other parameters evaluated. Conclusion: Despite the limited number of measurements performed, intraoperative compressive testing of bone may be an option for objectively classifying alveolar bone quality.