Low reading using Osstell in the maxilla: can I proceed?
osstellI installed 8 implants in the maxilla and tested them with the Osstell at 6 months pos-op. None gave me a number above 61. I had installed implants in the mandible at the same time as the maxilla and they registered 72 to 80 on the Osstell. Can I proceed with restoring and loading the implants in the maxilla at this time?
6 Comments on Low reading using Osstell in the maxilla: can I proceed?
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Peter Fairbairn
3/3/2015
I rely on this reading so find it unusual that all are low, what is the range so were the pegs the correct type and were the seated firmly ( no soft tissue Interference ).
How are things radiographically ?
61 is low but OK are the others lower ?
Peter
antoine
3/3/2015
reading are 58, 59, 60 and 61, i have no bone loss, even in 3 implants i had to cut bone from above the implant. it's not the only case with low ostell readings in the maxilla. i have these low readings in 90% of the cases but this time i decided to put my question here.
i am using the right peg))
no soft tissue between))
i use ostell for a long time and i thing that the acceptable average should be lower in the maxilla
Gary Henkel
3/3/2015
ostell says the risk of failure for an implant increases with readings below 50. yours are all above. you should be fine, especially if you are splinting.
charles schlesinger
3/3/2015
Are you restoring with a roundhouse bridge or a screw retained hybrid? If so- no problem since you have cross arch stabilization. On a single unit, I would also restore. An ISQ of 55 is considered primarily stable and 64 according to Osstell is good for immediate load. It may be that the bone quality is just not that great, but I think you will be OK. Since you are at 6 months, it is likely not going to get any better.
Chuck
Frank Meagher
3/3/2015
I think Professor Peter Moy has the answer to your question in this video from last year's Osstell ISQ forum. Splinting the maxillary implants will certainly aid in spreading the occlusal forces.
Starting at about the 20 minute time point, take note of the success rates with ISQ readings 50 ISQ
http://www.osstell.com/prof-peter-moy-the-isq-scale-in-daily-practice-cut-off-values-for-different-indications
Peter Fairbairn
3/4/2015
Yes the Osstell site explains all very well but I have often heard of variations which are repeated so maybe Implant type plays a part . I personally have not really noticed significantly lower readings in the Maxilla . We get higher readings in grafted sites than into host ridges but this all requires research .
Cross arch splinting on the maxilla is always a good idea but yours should be fine and it is an interesting observation.
I do not believe leaving Implants for longer ( 6 months ) will improve integration safe earlier loading will , due to functional remodelling.
This is why Osstell is such an important part of my surgical protocol as we need some numbers to make decisions . If in a very rare case ( 0.5 % of my cases )that it is below 50 at 3 months I prefer to remove it and start again .
I did a Poster for the EAO ( Rome , published in COIR) , a 10 case prospective study on upper canines , all with big defects and the average ISQ went from 46 to 74 in a 10 week period .
Regards
Peter
