Diagnosis and planning of implantation are complex of techniques aimed at clarifying the possibility of implantation in principle, the determination of implant type and size of implants and prosthetic rehabilitation. One of the most important methods of diagnosis is radiological technique. The most common method of research is orthopantomography. However orthopantomography has several disadvantages.
For accurate information about the structure of the study area and precise implant planning the use of a computer axial tomography is recommended. The newest and more progressive technology of computer axial tomography is a cone-beam computed tomography.
The purpose of this study was to compare the primary stability of implants installed according to diagnostic data of orthopantomography and cone — beam computed tomography. This study includes 46 patients with partial secondary adentia of lower jaw, which have indications to installation of one implant in the lateral section. Patients were divided into two equal groups.
In the control group the diagnosis and implant planning was performed using conventional methods of digital orthopantomography.
To determine the mechanical stability of the implant set, the method of resonance frequency analysis was carried out using intraoperative device Osstell mentor (“Integration Diagnostics”,Sweden). This analysis was repeated at opening implant on second stage. The patients of the main group in addition to the described research were subjected to cone — beam computed tomography implantation area before surgery and after it. Diagnosis and planning of surgery in the study group was performed according to the cone-beam computed tomography.
The stability of the implant according to the postoperative study was higher in patients of the main group. In the study group in 20 (87%) cases implant stability Quotient (ISQ) was higher than or equal to 65, which allows for one-stage implant prosthetics. In the control group such ISQ value was obtained in only 10 (43.5%) cases. The average value of the ISQ in the study group was 68.9±8.4, in control — 62.6±13.1. In the study group ISQ was significantly (p<0.05) higher.
At second stage ISQ in the main group exceeded the control (main — 70.3±3.1, control — 69.1±4.7), however, the differences between the two groups were not statistically significant (p>0.05), indicating that even with the lack of initial mechanical fixation of the implant in deferred load, the improved stability of the implant can be expected due to osseointegration. Intragroup differences were expressed in a statistically significant increase (p<0.05) of the stability of the implant in both groups, more pronounced in the control group. This fact is consistent with the known literature data, indicating that the implants during the installation have a low ISQ, over time the stability increases.
Cone-beam computed tomography can be considered the method of choice for the evaluation of the local state of the bone in the diagnosis and planning implantation.