How to enhance implant treatment outcomes
Dec 15, 2015
Highlights from the Osstell Corporate Forum at the Annual meeting of the Academy of Osseointegration with Drs Peter Moy, Scott Ganz and Jeffrey Ganeles.
How to enhance implant treatment outcomes with ISQ measurements
During this years’ Osstell Corporate Forum at AO, Dr Peter Moy presented four clinical cases that were discussed during an interactive session with panelists Dr. Ganeles and Dr. Ganz and the audience.
Dr Moy presented 4 unique cases with ISQ measurements taken at placement and before restoration during the session. The cases and associated treatment plans were analyzed and discussions of how the decision-making affected outcomes with each case scenario were held between the experts and the attendees. While the audience is answering the polling questions, the panelist would discuss the case and give their recommendations on how they would have treated the patient/case. The highlights from each case are listed below.
45 year old female. Presents with complaint of “pain and infection”, concerned with esthetics, and does not want a removable prosthesis. ISQ measurement at placement 73/78; Second ISQ measurement is 84.
70% of the audience considered an ISQ value in the 73-78 range to represent high stability, while 28% considered this range to represent medium stability. Also, 88% of the audience agreed this range of ISQ values would give them the confidence to immediately load this case.
38 year old female. Presents with complaint of “fractured tooth”, concerned with esthetics, does not want a removable prosthesis. Restorative dentist ready to perform any procedure.
ISQ measurement at placement is 61; Second ISQ measurement 82
How long do you wait? How many measurements are necessary?
76% of the audience considered an ISQ value of 61 to represent medium stability and 21% considered this value to represent low stability. Also, based on this ISQ value of 61, 69% of audience agreed they would leave the implant exposed with a healing abutment; 21% said they would submerge it and 4% said they would immediately load the case. When asked how long they would wait to definitively load this case, 55% said they would wait 3-6 months and 40% said 2-3 months.
49 year old male. Presents with complaint of “a grinding habit, tooth split”, concerned with esthetics, prefers to have treatment as quickly as possible. Restorative dentist ready to perform any procedure.
ISQ measurement at placement is 52; Second measurement 57; Final measurement 71
The 2nd measurement is not much higher. What next?
75% of the audience considered an ISQ of 52 to represent low stability and 25% considered this value to represent medium stability. Also, based on this ISQ value of 52, 84% of audience agreed they would submerge it; 12% said they would leave it exposed with a healing abutment and 3% said they would immediately load the case. When ask what they would do after the second measurement reading of 57, 82% agreed they would allow 3 months of healing, then take another measurement.
60 year old female. Presents with complaint of “I can’t chew”, concerned with function, would prefer a fixed prosthesis. Restorative dentist ready to perform guided procedures.
Fully edentulous case with multiple implants giving multiple ISQ values, patient wants immediate restoration/loading.
This case was planned for immediate loading. The audience was ask if they would proceed with the original plan, based on these ISQ values. 77% agreed they would not proceed and 23% said they would proceed. As the case proceeds, the audience is shown the ISQ values at 6 months for this patient and ask what they would do. 63% agreed they would go to definitive restoration and 33% said they would let the implants heal 3 months, then take another measurement.