CBCT based Radiographic Assessment of Implant Stability at Different Post-Operative Timings as Seen in Patients with Primary and Secondary Osteoporosis: A Clinical (Original Research) Study

Abstract

Aim: This study aims to assess implant stability at various post-operative time points in patients with primary and secondary osteoporosis using CBCT evaluation.

Materials and Methods: This study evaluated 45 patients with a missing mandibular right first molar who sought implant placement. Participants, aged 35 to 60 and diagnosed with primary or secondary osteoporosis, underwent thorough screening and provided informed consent. Cone Beam Computed Tomography (CBCT) scans assessed bone density and implant size. Surgical procedures were performed by the same operator using a standardised protocol, including local anaesthesia and a mucoperiosteal flap for implant placement. Healing abutments were fitted after two months, with prostheses placed three months later. The cohort was divided into three groups: Group 1 (15 patients with primary osteoporosis), Group 2 (15 with secondary osteoporosis), and Group 3 (15 without osteoporosis). Implant stability was assessed through radiofrequency analysis and ongoing CBCT diagnostics, focusing on the radiographic stability of implants across different osteoporosis statuses.

Statistical Analysis and Results: The study involved 45 patients (ages 35 to 60) with missing mandibular first molars, consisting of 25 males and 20 females, categorized into three groups based on osteoporosis status: Group 1: 15 patients with primary osteoporosis, monitored for implant stability via radiofrequency analysis at various intervals up to 16 weeks post-implantation, alongside Cone Beam Computed Tomography (CBCT). Group 2: 15 patients with secondary osteoporosis, assessed using the same methods. Group 3: 15 patients without osteoporosis, with similar monitoring. Results (ISQ values) were as follows: Group 1: Immediately after placement (49±5 Ncm), 1-2 weeks (52±3 Ncm), 1-3 months (55±2 Ncm), 16 weeks (57±2 Ncm). Group 2: Immediately after placement (48±6 Ncm), 1-2 weeks (51±5 Ncm), 1-3 months (54±3 Ncm), 16 weeks (56±3 Ncm). - Group 3: Immediately after placement (70±8 Ncm), 1-2 weeks (72±9 Ncm), 1-3 months (75±7 Ncm), 16 weeks (78±6 Ncm). A one-way ANOVA was conducted for a comprehensive statistical analysis across all groups, highlighting significant differences in implant stability.

Conclusion: This study concluded that patients with secondary osteoporosis face increased implant instability and a higher risk of complications like peri-implantitis, leading to potential implant failure. In contrast, non-osteoporotic patients show better implant stability four months post-surgery, emphasising the importance of bone health for osseointegration. The findings highlight the need for further research on the factors affecting implant stability in various osteoporosis classifications to improve clinical practices and patient outcomes in dental implantology.