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92 rev port estomatol med dent cir maxilofac. 2017;58(2):91-96

Sistema de análise de frequência de ressonância Osstell, utilizando
um transdutor aparafusado a diferentes pilares de cicatrização

r e s u m o

Palavras-chave: Objetivos: Comparar os valores de ISQ obtidos pelo sistema Osstell, aparafusando o Smartpeg
Desenho de pilares diretamente ao implante ou a pilares de cicatrização com 2, 3,5 e 5 mm de altura.
Interface ossoimplante Métodos: Foram colocados 60 implantes com superfície rugosa em 4 costelas bovinas. 30 implantes
Implantes dentários standard e 30 implantes protótipo foram dividos em grupo A e B, respetivamente. Todos os implan-
Osteointegração tes foram inseridos com um torque de 30N/cm2, de forma a que a interface entre a superfície ru-
gosa e o colo polido ficasse ao nível da crista óssea (definiu-se uma distancia entre implantes de
pelo menos 4 mm). A estabilidade primaria foi medida através do sistema de análise de frequência
de ressonância (AFR) com o transdutor Osstell ISQ colocado diretamente sobre o implante ou co-
locado sobre três pilares de cicatrização com alturas de 2, 3,5 e 5 mm, respectivamente.
Resultados: A média de valores de ISQ foi de de 76,2 ± 4,47 para o grupo protótipo e de 79,8
± 3,7 no grupo standard. A média de valores de ISQ em função de onde o smartpeg foi apa-
rafusado foi de 76,2 ± 4,47 e 75,7 ± 4,72 quando foi diretamente aparafusado ao implante, e
de 78,2 ± 5,78, 77,3 ± 5,90, 76,0 ± 5,90 quando o transdutor se aparafusou aos pilares de 2, 3,5
e 5 mm de altura, respetivamente.
Conclusão: Pode-se concluir da presente investigação que se podem obter valores similares de
ISQ medindo a AFR com o Smartpeg aparafusado diretamente ao implante, bem como apa-
rafusado aos pilares de cicatrização de diferentes alturas, de uma forma precisa e reprodutivel.
(Rev Port Estomatol Med Dent Cir Maxilofac. 2017;58(2):91-96)
© 2017 Sociedade Portuguesa de Estomatologia e Medicina Dentária.
Publicado por SPEMD. Este é um artigo Open Access sob uma licença CC BY-NC-ND
(http://creativecommons.org/licenses/by-nc-nd/4.0/).

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tissue stability. Previous study reported that these facts
Introduction
had an impact in the mucosal barrier and resulted in a more
Primary implant stability is considered an essential require- apically positioned zone of connective tissue what established
ment for appropriate implant osseointegration. Maintaining a consequent bone resorption.
appropriate stability through time is also considered a long- New healing abutments have been designed to allow to
1,2
term success guarantee. Different techniques have been directly screwed the Smartpeg to its top part. These healing
described for non-invasive, clinical evaluation of implant sta- abutments were developed to avoid the dis/reconnection
bility. Resonance Frequency Analysis (RFA) represents a wide- of the healing abutment to measure the implant stability
ly used technique for an objective assessment of implant sta- and to facilitate the ISQs registration (since it is not nec-
bility at any stage of treatment or follow-up, due to its high essary to remove the healing abutment). This also makes
reliability and reproducibility. 3-8 This technique has been the assessment of the stability easier and more convenient
demonstrated to evaluate implant stability as a function of for the clinician because the Smartpeg is placed more ac-
9
interface stiffness. RFA is assessed by the instrument Osstell cessible for the registration (is placed more coronal). An-
(Osstell AB, Göteborg, Sweden.). The unit of measure of Osstell other possible advantage of the new designed abutments
is the implant stability quotient (ISQ) and its scale values is that in cases of low stability, there is no application of
could vary from 1 to 100. The higher the ISQ number, the high- counterclockwise forces. So that, implants with no suffi-
er the stability. Moreover, RFA measurements display the mi- cient stability, during the healing time, are no submitted to
cromobility of dental implants. This micromobility seems to that force.
be determined by the bone density at the implant site. 10 The fact of screwing the Smartpeg to the healing abut-
11
The ISQ values are influenced by different factors as the ment and no directly to the implant could affect the ISQ val-
effective implant length, the distance from the transducer to ues, as the transducer is torqued farther from the bone than
the marginal bone, (the greater the distance from the trans- when it is screwed to the implant. That could produce greater
ducer to the bone, the lower the ISQ value); 1,6,12,13 the osseous vibration of the bone-implant interface and, therefore, the
quality; 14,15 the force with which the Smartpeg (transducer) is decrease of the ISQ values. For that reason, it is necessary to
torqued; 12,16 the presence of soft tissue between the implant assess if the ISQ measurements are comparable when using
and the transducer; 14,16 and the amount of bone in contact the Smartpeg screwed directly to the implant or to the new
with the implant. 14 healing abutments.
It is well known that the disconnections and subsequent The aim of this trial is to compare the ISQ values obtained
reconnections of the abutment compromise the periimplant by the Osstell ISQ, screwing the Smarpeg to the implant or to