Resonance Frequency Analysis Tool for Implant Stability

Resonance Frequency Analysis Tool for Implant Stability Dr. Vishwanath Pattar Dr. Anjana Bagewadi MDS â€Å" Resonance frequency analysis (RFA) – A diagnostic tool for implant stability † Dental implants have become a significant aspect of tooth replacement in prosthodontic treatment. High implant success rates of the order of 78-100 % have been published, with more than 15 years of observation time. Treatment success of dental implant mainly depends on the stability of the implant bone support. Implant stability is a mechanical phenomenon which is related to the local bone quality and quantity, type of implant, and placement technique used. The application of a simple, clinically applicable, non-invasive test to assess implant stability and osseointegration is considered highly desirable. Resonance frequency analysis (RFA) is one of such techniques which is most frequently used nowadays. Aim of this paper is to review the technique of Radio frequency analysis and use of it to check the implant stability. Key words: Resonance frequency analysis, Implant stability, Implant stability quotient(ISQ) Introduction : Dental implants have reported success rates of over 90 % over long periods of time. However failures still occur and seem to be unpredictable. One factor that is being increasingly considered in failure of dental implants is occlusal loading . It has been clinically demonstrated that implant stability plays a significant role in determining treatment outcome (Sennerby Meredith 1998, Esposito et al. 1998). Implant stability can be seen as a combination of: 1). Mechanical stability, which is the result of compressed bone holding the implant tightly in place.2). Biological stability, which is the result of new bone cells forming at the site of the implant and osseointegration. Initially implant stability was measured by Surgeon’s perception while placing the implant (Insertion and seating torque), percussion testing, reverse torque test and radiographs etc. But none of them proven to be effective in measuring the implant stability. Resonance Frequency Analysis (RFA) is a non-inv asive diagnostic tool for detecting the implant stability of dental implants during the healing stages and in subsequent routine follow-up care after treatment. Advantages of Rasonance frequency analysis 1) Optimal loading decisions : It makes it easier for dentists to decide when is the optimal time to load implants. At placement, stability can be difficult to quantify objec ­tively by merely relying on tactile perception. Torque measure ­ments are difficult to repeat once the implant has started to integrate and can therefore not provide a baseline for subse ­quent comparisons. The invasive torque method may even damage the healing if used for monitoring osseointegration 2)  Early warnings – preventing failure : Dentists sometimes encounter patients whose initial stability score is low. The reason could be that they have had to undergo a bone graft. In such higher-risk situations, most surgeons would avoid an early-loading protocol. Similarly, a significant decrease in stability indicates a potential problem and should be considered an early warning. The surgeon may prefer to unload the implant – or perhaps place additional implants – and then wait until stability increases. RFA system makes the treatment of high-risk patients easier and more predictable – allowing more of these patients to be treated and more of their treatments to be successful. 3)  Quality assurance : Because RFA system helps the dentist decide when to load and avoid failure in high-risk situations, it becomes a quality-assurance system for the clinic. Most patients intuitively understand the stability measures and how they govern when to load an implant and when to wait. This increases their sense of confidence, security and quality. 4) Data can be transferable : All the stability records measured from start of the treatment and the follow –up records can be transefered from one clinician to other. It makes easy to the one clinician to communicate with other about the treatment modalities. Implant stability quotient (ISQ) ISQ (Implant Stability Quotient) is a measurement scale for use with the RFA (Resonance Frequency Analysis) method of determining implant stability. It’s a mapping of resonance frequencies (kHz), presented as a clinically useful scale of 1-100 ISQ. 1 is the least ISQ value and 100 is the highest ISQ value. ISQ is used RFA to measure stability because Supports making good decision about when to load Allows advantageous protocol choice on a patient-to-patient basis. Indicates situations in which it is best to unload Supports good communication and increased trust Provides better case documentation Instrument kit: Fig.1 Hand held probe Fig.2 MonitorFig.3 Main plug Fig.4 Data cable Fig.5 Testing device Fig.6 Smart-peg Technique : Resonance frequency analysis (RFA) uses a sophisticated technology with computer-based measurement of resonance frequency (RF), which is determined by two parameters: the degree of bone density on implant-bone interface area and the level of marginal alveolar bone around the transducer Osstell is representative of RFA-technique and was tested first in 1997The apparatus consists of an Osstell transducer and Osstell analyzer connected to a PC or independent. The transducer is L-shaped or bolts-like (smartpeg) and firmly screwed in order to be positioned on the implant and its superstructure (4–5 N/cm ²) and consists of 2 small voltage controlled transducers. High-energy pulse-type oscillations of a continuous sinusoidal pulse excite implant, in order to register the mechanical vibration between the implant interconnection zone and the bone. As soon as the apparatus is activated the first electric transducer applies excitation signal of increasing frequency from 5 to 15 kHz to implant. Other voltage-controlled element registers ultrasonic vibrations response, ie resonant frequency of the implant-bone interface area and transmits a created signal to the amplifier, which amplifies it and to the analyzer which reads, evaluates and compares it with the frequency of the original signal. The measured amplitude of resonance frequency is displayed numerically and graphically on the Osstell analyzer, and the maximum amplitude represents the stability of the implant, quantified through the ISQ units. The ISQ value reflects the rigidity of the system transducer- implant-bone and transducer calibration parameters. Measured on a scale from 0 ISQ (3500 Hz) to 100 ISQ units (8500 Hz), a higher ISQ value indicates a greater stability of the implant. After a while ISQ values rise because of osseointegration where implant–bone the connection becomes stronger. Fig. 7 Fig.8 Fig.9 ISQ values: >60 – >70 Immediate loading can be done This graph illustrates the progress of implant stability over time, expressed in ISQ terms. The converging green curves show the two most likely scenarios: implant stability eventually sets at around 70 ISQ. A high initial ISQ value tends to decrease, as mechanical stability is supplanted by osseointegration. And a low initial value tends to increase, as osseointegration sets in. The scenario to watch out for is illustrated by the red curve. Here, osseointegration is not progressing as planned, and loading such an implant may result in a failed treatment†¦ High initial stability (ISQ values of 70 and above) tends not to increase over time despitethe fact that the initial high mechanical stability decreases and is replaced by increased biological stability. Lower initial stability normally increases with time because the lower  mechanical stability is increased by the bone remodeling process (osseointegration). Values of ISQ 55 or lower should be taken as a warning sign and act ions to improve the stability should be considered (larger implant diameter, longer healing time, etc.)* *(Implant stability measurements using Resonance Frequency Analysis. Biological and biomechanical aspects and clinical implications. Periodontology 2000, 2008. Sennerby Meredith) References: Chang WA et al. A newly designed resonance frequency analysis device for dental implant stability detection ; Dent Mater J. 2007 Sep;26(5):665-71 Rajiv KG et al . Resonance frequency analysis ; Indian Journal of Dental Research, 22(4), 2011

Project Management Essay

1. Discuss why many information technology professionals may overlook project cost management and how this might affect completing projects within budget. Information technology professionals do not understand basic accounting and finance principles to be able to do a net present value analysis return on investment and payback analysis. It should also be considered that new technologies or software development expenses are very inaccurate as it is hard to put a figure on something has not been developed. The problems they face may be they estimate too quickly, do not have the estimating experience, may be biased towards underestimating and management may require more accuracy. The book states that IT professionals understand the value of a balanced portfolio aligned with business objectives but lack a well-defined and consistent process for managing the origination, evaluation and execution of IT investments. As far as contemplating projects with budgets it would not be an accurate estimate of cost unless all the stakeholders are involved to make these determinations. 4. Explain what happens during the process to determine the project budget. A project budget involves allocating cost estimates to individual work over the time of the project and is based on the WBS. The budget is determined using the cost estimates, basis of estimates, scope baseline, schedule, resource calendar, contracts and organizational process assets. The main goal is cost budgeting which creates a cost baseline for measuring performance and funding requirement and taking into consideration document updates. It is also important to understand how the company operates so the budget is created appropriately. 6. What is project portfolio management? Can project managers use it with earned value management? Project portfolio management allows organizations to collect and control an entire suite of projects or investments as on set of interrelated activities. Project managers can use it with earned value management as it is a performance measurement technique that let them know how well the project is meeting scope, time and cost goals by entering actual information and then comparing it to a baseline. 7. Describe several types of software that project managers can use to support project cost management. Spreadsheets are a common tool used for cost estimating, budgeting and control. Microsoft Project is a project management software that allows for the following to be created such as: cash flow, budgets, over budget tasks, over budget resources and earned value reports. Some project managers simply use the company’s accounting software and spreadsheets to receive more flexibility. They have also learnt to connect their accounting software to the project management software for more accurate information.

Essay about Homosexuality - 1071 Words

Homosexuality My frustration with debate about homosexuality stems not so much from the arguments themselves, but the actual method of argument. Often, two â€Å"experts† will approach the topic from two radically different â€Å"expert† fields. One may be a New Testament scholar and thus draws out the intricacies of Romans 1:18-28 and the true meaning of the word â€Å"homosexual offender† (i.e. older man sleeping with a young boy) in that case. The other may be a biologist who appeals to natural logic and reproduction to defend sex as a behavior meant for heterosexuals. Both of them are right within their own expertise. But they cannot, then, debate, for it would be like Chuck pitching to a batter on another baseball field. I was†¦show more content†¦He believes that if Paul, as a scholar, were writing today, he would take into account the revealed wisdom of genetic, social/behavioral, and cultural research. 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Ethics in the Editing Business - 599 Words

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