Osstell SmartPegs were designed specifically for the Osstell RFA technology and are an integral part of the system that make up the technique for measuring implant stability. Because the SmartPeg is so important to getting reliable and accurate ISQ values with the Osstell instrument, it has to meet specific technical requirements. After all, without the SmartPeg the technology and the technique would not provide the clinician with the valuable information needed to measure implant stability and make effective treatment decisions.
The first thing that makes the SmartPeg “smart” is that it is customized to fit each implant system and type. That ensures that the design of the SmartPeg fits with the design of the implant in order to have ISQ readings that are valid. It is important that the right SmartPeg is used for the implant being measured so that the Smartpeg can compensate for the length and type of implant. Using the wrong SmartPeg for the implant being tested can, and often does, lead to a false reading. A current and updated SmartPeg reference list is always available here.
Another thing that is “smart” about SmartPegs is that they are made of aluminum. Since aluminum is softer than titanium, and most implants are titanium, the SmartPeg will not damage the implant threads. The integrity of the implant is of course the most important thing for the patient, thus the SmartPeg is made of a material that will not compromise the implant while doing its job.
Finally the SmartPeg is made and approved for single patient use to be sure that the sterile environment is not compromised. Since the SmartPeg is made of aluminum with a magnetic top, as described above, it cannot be sterilized as most sterilization processes will damage it.
Therefore, it should only be used on the same patient, in the same visit. If a SmartPeg is sterilized, there is a risk that it will not give accurate readings as the magnetic top may be damaged. In that case, the clinician cannot trust that the ISQ value is reliable for the implant being measured.
Also, if the SmartPeg is reused too many times, there is some risk that the soft aluminum will begin to deteriorate and leave microscopic flecks of aluminum in the implant or at the site. A recent study by Duddeck and Faber (COIR, 2015) concludes that:
“The multiple reuse of Osstell’s SmartPegs, numerous remounting processes and consecutive autoclave sterilization have significant effects on the device and should be avoided. Only minor savings on the economic side have to pay for less precise and reliable ISQ data and for serious prosthetic complications due to detached aluminum particles that could finally prevent or make it almost impossible to realize a precise fit and stability of the abutment.”
So keep your SmartPegs smart by using them in the way they were designed. You won’t be sorry and your patients will thank you.