Three questions on ITV and ISQ

Dental Tribune International

Tue. 21. April 2020

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One of the most critical goals in implant therapy is the achievement of implant stability. In an upcoming webinar, Dr Barry P. Levin will present study findings on the importance of the insertion torque value (ITV) and the implant stability quotient (ISQ) for immediate implants, as well as preliminary findings of a study evaluating ITV and ISQ in grafted sites. Levin leads his own practice in Jenkintown in Pennsylvania in the US with a focus on implant dentistry and periodontics, and is a diplomate of the American Board of Periodontology. Prior to the online lecture, he provided Dental Tribune International with some details about his webinar.

SmartPeg attached in order to record ISQ for an immediate implant replacing tooth #11 prior to immediate temporisation. (Image: Barry P. Levin)

Dr Levin, what is ITV and what is ISQ?
ITV relates to the amount of energy or force—measured in N cm—required to rotate a screw-shaped implant into its designated position. It is a measurement of rotational implant stability. It is a one-time measurement, only determined at the time of implant placement. ISQ is a value obtained by resonance frequency analysis. It measures the stiffness of the implant material, of the implant–bone interface and of the surrounding bone (trabecular and cortical ratio). ISQ measures the axial stability of the implant; it is non-invasive and repeatable.

Why are these two important for immediate implant placement?
Both ITV and ISQ measure the level of implant stability. Because they measure two distinctly different aspects of stability, they are both of importance and should be considered critical when temporising or permanently restoring implants.

Immediate implant placement for tooth #13 after extraction. It was followed by immediate provisionalisation. (Image: Barry P. Levin)

What are the main learning objectives for the viewers of your webinar?
Viewers will learn the value of recording ITV and ISQ measurements at the time of implant placement and how to apply these values with regard to loading protocols. I will also discuss possible negative effects on crestal bone if an excessively high ITV is required to fully seat an implant in healed or grafted sites. In addition, I will highlight the importance of recording ISQ values not only at the time of implant placement but also at follow-up periods to monitor and confirm secondary stability.

Editorial note: The 1-hour webinar, titled “Post-extraction implants, ITV & ISQ—How to value each measurement and when to restore implants in immediate and grafted sites”, will be presented live on Wednesday, 29 April, at 10 p.m. CEST. Participants will have the opportunity to ask questions about the topic, as well as earn a continuing education credit by answering a questionnaire after the lecture. Registration on the Dental Tribune Study Club website is free of charge.

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