Clinical Significance of the Use of Resonance Frequency Analysis in Assessing Implant Stability: A Systematic Review (original) (raw)

2018, The International Journal of Prosthodontics

O sseointegration is a dynamic process that continues with time and contributes to the secondary stability of implants following insertion. Primary stability is a prerequisite for the development of secondary stability, 1 as relative micromotion beyond an acceptable biologic threshold during initial healing is detrimental to the formation of a quality bone-implant interface. 2-4 After initial healing and a period of remodeling, the bone-implant interface should reach an equilibrium with little changes in the bone level while the implants are providing their designated function. 1,5 It is therefore useful to have an objective and quantitative assessment of the stability of implants, which may enable determination of an optimal loading time and long-term monitoring of implant health. 6 Based on observations, osseointegration has been described to include three partially overlapping phases: (1) healing phase; (2) remodeling phase; and (3) steady/ equilibrium phase. 5 After implant placement, the first stage of healing consists of formation of a hematoma and circulatory changes due to a cascade of chemical products that function as mediators, acting on vessels and surviving cells, as well as attracting cells from blood and surrounding tissue. There are also local changes in pH, oxygen tension, growth factors, and other biochemical substances. The second stage Purpose: To assess any correlations between resonance frequency analysis (RFA) and other clinical measurements, namely changes in marginal bone level. Materials and Methods: A systematic review was performed to investigate the relationship between RFA and changes in marginal bone level. Clinical studies published up to May 1, 2018, were searched in electronic databases, including PubMed/MEDLINE, Embase, and Cochrane, using the following MeSH terms: resonance frequency analysis; implant stability quotient; RFA; and ISQ, in combination with marginal bone level; marginal bone loss; and marginal bone resorption. Results: A total of 62 articles were included in this review after all abstracts and full-text articles were examined according to the inclusion/exclusion criteria. The Results and Discussion sections of investigations reporting both marginal bone level changes and RFA measurements were presented. Relevant findings regarding relationships between RFA and bone quality or insertion torque were also summarized. Most articles reported an overall increase in ISQs over the observation time; however, contradictory findings were found regarding the relationships between RFA measurements, marginal bone loss, and other parameters. Conclusion: A definitive conclusion could not be made, as mixed results were found in the few articles that reported significant associations and correlations between RFA measurements and bone loss, while others concluded the opposite. Heterogeneity between the studies further complicated interpretation. Longitudinal RFA measurements may still be valuable for evaluating implant stability when applied as a supplementary tool to radiographic assessments and other clinical examinations.