The Use of the Periotest Value as the Initial Success Criteria of an Implant: 8-Year Report
Osseointegration is a histometric process that occurs gradually over a period of time. The load that an implant is able to bear depends upon, among other parameters, the quality of the bone-implant contact. For 8 years the damping capacity of 1,182 Branemark implants inserted consecutively in 315 patients was measured using the Periotest method. The following clinical observations were made: (1) a relationship was found between implants with a specific Periotest value range that, at the moment of the transepithelial connection, were considered to be clinically stable, asymptomatic, and whose radiograph image was not radiolucent; (2) a relationship was found between clinically nonintegrated implants with a different Periotest value range; (3) variations in the Periotest value were related to the type of bone in which the implant was placed; (4) a small percentage of borderline implants with a Periotest value between the osseointegrated and the nonosseointegrated Periotest values was detected; (5) the percentage of secondary failures was related to an initial Periotest value corersponding to a borderline implant; (6) the healing time of each implant was individualized in accordance with the successively obtained Periotest value; (7) the load and the design of the prosthesis were individualized; (8) early detection of failing implants before fabrication of prostheses is possible; (9) communication was improved between the surgeon and the prosthodontist; and (10) variations in Periotest value wre related to bone remodeling. The sensitivity of the principal clinical test in evaluating osseointegration is dicussed regarding the moment of its application. The use of Periotest values as an initial success criteria of an implant is proposed.