Evaluation of bone density by cone-beam computed tomography and its relationship with primary stability of dental implants

BACKGROUND: One of the critical factors determining the success of dental implants is primary stability. This study aimed to determine the density of jawbones in the implant candidate sites via cone-beam computed tomography (CBCT) and its correlation with the values obtained from resonance frequency analysis during surgery. MATERIALS AND METHODS: In this descriptive-analytic study seventeen implant sites requiring implant placement were selected. Impressions were sent to the laboratory to construct a surgical guide via the stereolithographic method. An electronic surgery was performed on the chosen implant sites according to each patient's CBCT information entered into the Kaveh surgical guide software. The bone density of the target areas was calculated using the gray value (voxel value). After preparing the final osteotomy, an implant was installed in the area according to the manufacture's recommendation. The relevant Osstell(®) SmartPeg was selected and installed on the implant body to determine the primary stability. Kolmogorov–Smirnov test and the correlation pearson correlation statistical test. used for statistical analyze. P value amounts < 0.05 was considered significant. RESULTS: The mean and standard deviation of the gray scale in this study were 563.7 ± 218.8 and 65.3 ± 7.7 implant stability quotient (ISQ) respectively. The correlation between gray scale and ISQ was evaluated by the Pearson correlation test, and the results indicated a strong correlation between the two variables. CONCLUSION: The voxel value and primary stability had a normal distribution and strong correlation. In other words, the gray scale determined by CBCT imaging techniques at the proposed implant site could be used to assess the bone density before the surgery.