Table 1.
Current available methods for implant stability assessment at pre-, intra-, and postsurgical time points; for each method, advantages and disadvantages have been reported.
| Method | Evaluation | Presurgery | Intrasurgery | Postsurgery | Advantages | Disadvantages | Objectivity | |
|---|---|---|---|---|---|---|---|---|
| Noninvasive methods | ||||||||
| Percussion test | Percussion with tool handle | Qualitative: resonance of the implant in the bone, clear sound, gloomy sound |
Not possible | Certain reliability | Certain reliability | Simple and not expensive | Subjective, poor sensitivity | Doubtful reliability |
| Radiographic analysis | Endoral RX | Quantitative and qualitative: radiating transparency along the bone implant surface and marginal bone level | Certain reliability | Certain reliability | Certain reliability | Simple and not expensive | Two-dimensional examination, not standardizable, not for short follow-ups (<6 weeks) | Not evaluable |
| Periotest | Electronic pulse sequence | Quantitative. damping of the periodontium and tooth mobility | Certain reliability | Certain reliability | Certain reliability | Subjective, poor sensitivity, values are not significant | Certain reliability, but more information is needed | |
| Measurement of shear strength (Osseo-Care) | Surgical, for example, by means of a tap | Quantitative: cut resistance of the implant site and bone density | Certain reliability | Highest reliability | Certain reliability | Limited to surgery | Certain reliability | |
| Reverse torque test | Reverse torque test of 20 N/cm of the exposed implant | Quantitative: unscrewing the implant | Not possible | Not possible | Certain reliability | Bone deformation, provocation of failures, false positives on implants longer than 13 mm | Certain reliability | |
| RFA | Magnetic pulses picked up by SmartPeg | Quantitative and qualitative: evaluation of the degree of bone-implant contact on a scale from 1 to 100 | Not possible | Highest reliability | Highest reliability | Evaluation of immediate loading and evaluation of the increase in the bone-implant contact for the purpose of final prosthetics | Certain reliability, but more information is needed | |
|
| ||||||||
| Invasive methods | ||||||||
| Histologic analysis | Sampling using a milling technique | Bone quantity and bone quality (histomorphometry) | Doubtful reliability | Doubtful reliability | Doubtful reliability | High quality | Invasive | Highest reliability |
| Removal torque measurement | Disarming test, manual/electronic force application on the implant | Quantitative: force necessary to separate bone-implant unit | Not possible | Doubtful reliability | Certain reliability | Invasive, depends on the implant geometry | Certain reliability | |