Correlation of Crestal Bone Thickness and Buccolingual Cortical/Cancellous Bone Ratio With Implant Stability and Insertion Torque

Dental implant (DI) stability is a key factor in achieving successful osseointegration and ensuring the long-term survival of the implant. This study aimed to explore the relationship between crestal bone thickness (CBT), the ratio of cortical to cancellous bone (C/CR), and the stability of DI. This prospective observational study involved 19 patients received 30 implants. Preoperative cone-beam computed tomography (CBCT) was used to measure the crestal cortical bone thickness and cortical/cancellous bone ratios at 3 mm and apical levels. Implant stability was assessed immediately after insertion and at 12 weeks postoperatively using resonance frequency analysis (RFA) via the Osstell® device with Smartpeg™ transducers. Insertion torque (IT) was recorded during implant placement. Data were analyzed to explore correlations between bone measurements and implant stability parameters. The study found a strong positive correlation CBT and primary implant stability and a moderate positive correlation with secondary stability. C/CR at 3 mm depth strongly correlated with primary stability, while the apical ratio showed a moderate correlation. No significant correlation was detected between C/CR and secondary stability. Insertion torque increased significantly with thicker crestal bone and higher C/CR. In conclusion, preoperative CBCT measurements of CBT and C/CR are reliable predictors of implant stability. These anatomic parameters should be considered in surgical planning to enhance implant success and prognosis.