[Oradlist] Bone dentisty measurement with CBCT : How Reliable?
Allan G Farman
agfarm01 at louisville.edu
Wed May 20 15:55:53 PDT 2009
I still see nothing that is hard science in the Misch book regarding
quality of bone, but remain open to further studies with greater
Allan G. Farman, BDS, PhD, MBA, DSc, Diplomate ABOMR
Prof. Radiology & Imaging Science
Univ. Louisville School of Dentistry: SUHD
501 South Preston Street,
Louisville, Kentucky 40292, USA
Tel: +1(502) 852.1241
>>> Mohamed Elrufaei <dentist at bonbon.net> 05/20/2009 12:02 PM >>>
Dear Dr. Rejane,
Keenly anticipating your follow up studies, I appreciate your input.
Dear Dr. Farman,
I am revisiting this issue with you, as I feel that each exchange with
(and of course the other respected Oradlisters) adds to my IQ few more
Here are few well founded statements from Carls Misch*s well
CLINICAL EVIDENCE DOCUMENTS INFLUENCE OF BONE DENSITY ON SUCCESS RATES
Multiple, independent groups have reported higher failure
rates in poor quality bone compared to higher quality
bone . Following a standard surgical and prosthetic
protocol, Adell et al. reported an approximate 10% greater
success rate in the anterior mandible as compared to the
anterior maxilla. Lower success was also noted in the
posterior mandible as compared to the anterior mandible
when the same protocol was followed by Schnitman et al.
The highest clinical failure rates have been reported in the
posterior maxilla. Hence, a range of implant survival has
been found relative to location.
The anterior mandible has greater bone density than
the anterior maxilla. The posterior mandible has poorer
bone density than the anterior mandible. The poorest bone
quality in the oral environment typically exists in the
posterior maxilla, and it is associated with dramatic failure
rates. Jaffin and Berman reported a 44% failure when poor
density was observed in the maxilla, with the majority of
failures noted at second-stage surgery.
Fifty-five percent of all implant failures within their study sample
occurred in the
soft bone type. The report documented a 35% implant loss
in any region of the mouth when bone density was poor.
Engquist et al. also reported a high percentage of clinical
failures, 78%, in soft bone types.
Friberg et al. observed 66% of their group's implant failures occurred
the maxilla with
soft bone. The reduced implant survival most often is more
related to bone density than location. However as a general
rule, the posterior regions of the mouth have less dense bone
than the anterior regions in both the maxilla and mandible.
Five independent clinical groups, following a standardized
surgical protocol and using the same implant design,
documented the indisputable influence of bone density on
clinical success. The purpose of this chapter (Chapter 8 of
Implant Dentistry) is to provide a
scientific rationale for the modification of the treatment
plan, implant selection, surgery, healing regimen, and initial
loading of the prosthesis to achieve comparable success rates
in all bone density types.
*From:* oradlist-bounces at lists.ucla.edu [mailto:
oradlist-bounces at lists.ucla.edu] *On Behalf Of *Rejane Faria
*Sent:* Monday, May 18, 2009 2:05 AM
*To:* Oral Radiology Discussion Group
*Subject:* Re: [Oradlist] Bone dentisty measurement with CBCT : How
We have been studing the so called "bone quality" (considered for many
bone density, and many other variables) and I would recomend the
attached, which is a systematic review on the efficacy of clinical
to assess jawbone tissue prior to and during endosseous dental implant
Another systematic review regard to the Ambiguity in Bone Tissue
Characteristics as Presented in Studies on Dental Implant Planning and
Placement is about to be publis
hed and will let you konw when it is
A wide clinical study is already set in which we are comparing the
of those methods.
Rejane Faria Ribeiro-Rotta, DDS, MS, PhD
Associate Professor, Department of Oral Medicine, School of Dentistry,
Federal University of Goias, Brazil
rejanefrr at gmail.com, rejanefrr at odonto.ufg.br
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