Bone density and primary stability in implant therapy

Introduction: To improve patient comfort, deviations from the very successful standard osseointegration protocol are being developed. To keep implant failure rates as low as possible, the most perfect treatment planning and a good patient selection are extremely important. Because bone density plays an important role in implant outcome, known relations of bone density could improve treatment planning. Material and methods: A Pubmed search revealed 66 manuscripts investigating and discussing bone density of human jawbone whether or not related to implant stability or outcome. Forty-five of these will be discussed in this review. Results and discussion: Many pre-operative methods of jawbone density assessment are available. Most of those techniques correlate well with one another. Some are more elaborate to use in clinical practice. Primary stability measurements show significant correlations with different bone densities and also with implant outcome; however, not many studies investigate both at the same time. Conclusion: To investigate the outcome of adaptation methods of the surgical protocol with regard to the jawbone density, an objective pre-surgical determination of bone density is necessary.