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Advisory Committee Chair

Perng R Liu

Advisory Committee Members

Daniel Givan

Nicolaas Geurs

Amjad Javed

Document Type

Thesis

Date of Award

2017

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

Objective: This study aims to investigate the correlation between the gray values (GV) of Cone Beam Computed Tomography (CBCT) analyzed by two commonly used implant planning software (coDiagnostiX, and Simplant®) and the primary stability of dental implants by measuring insertion torque value (ITV) and Resonance Frequency Analysis (ISQ). Materials and Methods: Thirty-eight patients planned to receive a total of 102 dental implants (Straumann Bone Level Tapered) were enrolled in the study. At time of implant placement, ITV in Ncm with a Bien-Air iChiropro implant console, resonance frequency analysis (ISQ) with an Osstell device, and the surgeon’s estimated torque of placement were recorded. A versatile and highly reliable workflow was utilized to merge the postoperative position of implant placement with the preoperative virtual implant plans by using InVesalius 3.1, and Autodesk MeshMixer. The relationship of ITV, CBCT gray value of bone density in coDiagnostiX, Outer Simplant, and Inner Simplant, ISQ, surgeon estimated torque were assessed using Spearman correlations. Also, correlations were analyzed according to other variables such as implant length, implant diameter, implant site, type of bone, type of graft, and time of healing. Also, multivariable analysis was conducted to identify independent predictors of ITV Results: The workflow was examined with intraclass correlation coefficient (0.999, 0.995, 0.999, and 1) showing a high degree of correlation p<.0001. Spearman correlation for all variables (coDiagnostiX, outer Simplant, inner Simplant, ISQ, estimated torque, and measured ITV) showed positive and statistically significant correlations with GV in coDiagnostiX (r=0.39, p<0.0001), outer Simplant (r=0.37, p=0.0001), inner Simplant (r=0.33, p=0.0008), ISQ (r=0.52, p<.0001), and surgeon’s estimated torque value (r=0.48, p<.0001) with ITV. The generalized estimated equation (GEE) showed ISQ (p<0.032), surgeon estimated torque (p<0.002), and implant diameter (p<0.020) as independent predictors of measured ITV. Conclusions: Overall, preoperative CBCT GV in coDiagnostiX and Simplant had statistically significant correlations with ITV, suggesting that treatment planning for immediate or early loading protocols can be optimized through virtual planning and GV assessment at potential implant sites. The used methodology for implant position registration into a preoperative scan was validated and found highly predictable and repeatable, and therefore, could be useful in future studies.

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