Influence of Implant Geometry on Primary Insertion Stability and Simulated Peri-implant Bone Loss: An In Vitro Study Using Resonance Frequency Analysis and Damping Capacity Assessment

Purpose: To investigate the influence of implant geometry on primary stability and on peri-implant bone loss in an in vitro model using the Periotest and Osstell devices. Materials and Methods: Screw-type implants of various diameters and lengths were inserted into bovine bone blocks of different densities, and the primary insertion stability was recorded. To study the influence of implant geometry on implant stability with different levels of peri-implant bone loss, implants were inserted into acrylic resin blocks to mimic osseointegration, and different amounts of the peri-implant acrylic resin were removed. Measurements with both devices at each millimeter step yielded the threshold for the least detectable attachment loss. Results: The predominant factors influencing implant stability were bone quality and attachment loss. Implant type and length exerted some influence on implant stability values, while variations in implant diameter produced only minor alterations in the measurements. In simulations of peri-implant attachment loss, implant stability decreased more dramatically for the shorter and narrower implants. The inclusion of more variables in the analyses resulted in less focused measurements. Conclusions: The results of this study clearly show that the outcome of implant stability assessment depends on environmental factors such as bone quality and implant geometry. While the authors do not recommend the use of the Periotest or Osstell devices for a comparison of the stability of two individual implants, both should be useful to monitor the state of an individual implant over time. Keywords: bone loss, damping capacity assessment, implant geometry, implant stability, peri-implantitis, resonance frequency analysis