Measuring the stability of the implant: Periotest vs. Osstell ISQ?

I've used both of these devices, and here are my findings and recommendations: 1. The periotest works by hitting the implant with a small metal tapper, and the deceleration of the tapper is measured and converted into a number. This number is related to implant stability. I found it clumsy to use, and the tapping was very unpleasant for some patients. Especially in the anterior maxilla. Using it on posterior implants was very clumsy. Additionally, you have to have a tall healing cap or abutment on the implant to measure. The real problem with this device was the lack of repeatable results.Very often I would check the same implant three times in a row, and get three different numbers. I spoke to the company several times about this, and I even demanded to be sent a new unit. But even with the new unit my results were all over the place. 2. The osstell is a much better concept. You have implant specific pegs that stick up high, and the test is not unpleasant in any way for the patient. The results are very repeatable, and the ISQ is a number that is meaningful when communicating to other practitioners. It is a much better investment, and if you are trying to quantify osseo-integration, this is the best we have so far. The concept of the reverse torque test was always frightening to me. So now, in cases where i'm concerned about implant survival, I have a way to rationalize my treatment decisions. It has revolutionized the way I do immediate implants and temporaries, and made me much more confident in this arena. That being said, you need to know how to use it and understand the results. I do not use it for every case, as a matter of fact, i probably only use it for 10%. There is good literature out there on the concept of ISQ. Read it, and learn from your investment. If any of you are more computer savvy then me, you can post some links for the poster. I do not work for osstell btw, I think they just have a good product. The real science here is understanding how bone implant contact, primary stability, and biologic stability interact.

Well said sb the cost is a bit steep but worth it and if you are to do ant research the Osstell is the universally accepted method of measurement of stability. Peter

I would be uncomfortable with 45 , anything below 60 would worry me . Most integrated readings range 65 to 75 , I have never had a reading in the 80s . I am doing work on early loading in big graft cases and find this tool really helpful. Peter ps I see Osseonews has a spell check now for all those hurried posts , great news

Appreciate the sharing . How about the simple mirror handle tapping test vertically and laterally like the way we percused a tooth ? Is it possible.to have implants with isq 60 and above readings failed after loading and what are the likely causes? Thanks for the sharing again.koay.

I use both and am most comfortable with the ostell readings. Most of my reading are in the 70's and up. I've only had a couple of 60s at loading and eventually it became 70+ as well. I've never had a failure with the ostell but have with the periotest even though the readings were in the high negatives which is a good number. I believe each implant has an individual isq range but I could be wrong. Spend the extra dough for the ostell as it is the best we have right now for measuring stability but remember that it's still not a guarentee. Best of luck.

I do not regret getting our Ostell and paying for individual smartpegs - they are about $120 for 5 of them! The customer service is great - Amanda D is contactable by e-mail and they helped me get a loaner while my one was sent in to tighten some screws at the probe. My concern was mainly for medical contraindications - I routinely make sure pt do not wear a pacemaker/indwelling defibrillator. Other than that, I am using for every implant I placed (yes, it all adds up!). I also prefer numbers at 60 or above, did not get any below 50 so far that I can remember, almost sound too good to be true, but that goes for implants placed by others and have not had to test on some that had sign of failure. Just my 2 cents. LCM

The Osstell measures general bone impedance, but not the process of osteointegration around implant specifically. In other words, the depth of the wave penetration and reflection is unknown, and the rest bone density can mask/distort the real situation.

Thanks A lot for all your replies and suggestions !

I am all about advancing with technology that is necessary. Including my years as a resident, I have been placing implants for 25 years and have never needed anything other than comprehensive clinical signs, imaging and syptomotology as a " tool " to asses completion of integration. Just as the orthopaedic doctor will not use any tools to asses the rigidity of the screws / plates / cribs and AUTOGENOUS BONE he placed in my back 4 days ago. It all goes back to placing the implant correctly in the appropriate bone. Baker Vinci

Greg, To check my information you can simply ask the manufacture.

I acted as an expert for a case in Australia. The implant dentist charged 150-200 for each reading. Is this standard practice? Bv

Is either instrument preferred for 1 piece zirconia implant.