Comparison of histomorphometry and <scp>microradiography</scp> of different implant designs to assess primary implant stability
Georgios E. Romanos, Michael Damouras, Alexander Veis, Pablo Hess, Frank Schwarz, Silvia Brandt
Abstract
OBJECTIVES: To contribute toward optimizing the long-term stability of dental implants. Our working hypothesis was that the degrees of immediate implant-bone contact, and hence of primary stability, would demonstrably differ between implant systems due to their different external geometries and thread designs (macro-design). This demonstration was provided in a bovine model (ex vivo) by employing and comparing histomorphometry and microradiography as evaluation methods. MATERIALS AND METHODS: A total of 120 implants, representing six different implant thread designs, were inserted following the recommended surgical protocol in ribs of freshly slaughtered cattle. Twenty specimens of implants with surrounding bone were prepared per system and were divided into two equally sized groups of 60 specimens for analysis by either histomorphometry or micro-computed tomography. Data were analyzed by Mann-Whitney U test (P ≤ .05). RESULTS: One of the implant systems, featuring a slight tapered external geometry and a progressive thread design, consistently revealed the most favorable bone-implant contacts in both histomorphometric and microradiographic evaluations. Overall, consistently higher values of bone-implant contact were obtained with the microradiographic than the histomorphometric approach, and this difference reached statistical significance in three of the six implant systems tested. CONCLUSIONS: Progressive threads offering a bone-condensing effect can significantly help to maximize implant-bone contact percentages. Compared to histomorphometry, microradiography is likewise a suitable method to evaluate bone-implant contact, offering the additional benefits of being noninvasive and less time consuming.