Protocol for Determining Osseointegration

Dr. Stewart asks:

With the increased frequency of immediate provisionalization on dental implants today, I am wondering how your “protocol” for determination of osseointegration sucess may have changed.

Having placed dental implants since 1984 and having gone from 6 months submerged healing to ‘progressive loading” of healing caps, to immediate loading in select cases, it seems that the determinants of osseointegration “success” have become a bit more vague. In the past, radiographs (along with percussion testing) were used to qualify “success” ( with little scientific justification). Now it seems that the primary determinant of osseointegration is the ability of the abutment to withstand the manufacturers “maximum torque value” after an appropriate time of healing. Current research says that “Caution should be used when judging dental implant systems on the basis of resonance frequency analysis and torque value.”

So, I am wondering what the current thinking is on this subject ? What determinants of osseointegration “success” do you use and why? Thanks.