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(904) 656-1117 · JacksonvilleDentalSpecialists.com · May 2025
OBJECTIVE STABILITY The Advantage of RFA in Dental Implant Practices
Objective assessment of osseointegration is a cornerstone of predictable and successful dental implant outcomes. Systems like Osstell utilize Resonance Frequency Analysis (RFA) to provide quantifiable data on implant stability — a significant improvement over subjective evaluation methods. Integrating RFA into a dental implant practice yields substantial benefits for both the dentist and the patient. Why RFA Matters for Dentists For the dentist, RFA is invaluable for making informed clinical decisions. By measuring the Implant Stability Quotient (ISQ), practitioners gain an objective understanding of the implant’s integration with the surrounding bone. This data- driven approach minimizes the guesswork associated with traditional methods like percussion testing or subjective torque assessment. Dentists can confidently determine the optimal time for loading an implant. This helps reduce the risk of early failure due to insufficient osseointegration. Furthermore, RFA enables the early detection of potential issues such as declining stability. Early identification allows for timely intervention and improved long-term success rates. This predictability enhances the dentist’s reputation and fosters greater patient trust. When to Use RFA in Your Practice RFA isn’t just helpful during implant placement; it can also play an important role throughout the treatment process. Many dentists take an initial ISQ reading during surgery to establish a baseline and then test again to see how well the implant is integrating over time. If the score improves, that’s a good sign. If it drops or stays the same, it may be time to take a closer look. RFA is also useful in cases where early or immediate loading is under consideration. When a patient has softer bone, a history of smoking, or underlying health concerns, having a stability number to guide next steps can make a significant difference. It helps dentists tailor their approach to each patient’s needs, whether that involves delaying loading, adjusting follow-up timing, or making other modifications. In this way, RFA supports more confident decisions and improved outcomes for each phase of care. Benefits of RFA for Patients Patients also directly benefit from the incorporation of RFA into implant procedures. The objective assessment offered by RFA contributes to more predictable
treatment timelines. Accurately determining when an implant is ready for loading helps minimize unnecessary delays, leading to a more efficient and convenient patient experience.
The reduced risk of early implant failure, a
consequence of data-driven loading protocols, translates to fewer complications and a greater likelihood of long-term implant
success. This ultimately leads to increased patient satisfaction and a more positive overall treatment journey. The non-invasive nature of RFA testing also ensures patient comfort and ease during the assessment process. The Smarter Path to Implant Success The use of RFA technology, such as Osstell, represents a significant advancement for dental implant practices. The objective data it provides empowers dentists to make more informed decisions regarding implant loading and the early detection of potential complications. Simultaneously, patients experience more predictable treatment timelines, a reduced risk of early failure, and greater confidence in the longevity of their dental implants. Embracing RFA demonstrates a commitment to precision and predictability, as well as to safer outcomes and better patient experiences. —Lydia Salis Practice Manager
JacksonvilleDentalSpecialists.com · 1
HOW TO USE THE OSSTELL ISQ A STEP-BY-STEP GUIDE
Osstell ISQ (Implant Stability Quotient) is a device that uses Resonance Frequency Analysis (RFA) to measure the stability of dental implants. It provides a numerical value (ISQ) that indicates the degree of implant stability. The higher the ISQ value, the more stable the implant.
MATERIALS NEEDED •
Osstell ISQ device (e.g., Osstell Beacon, Osstell IDx)
• •
SmartPeg (specific to the implant system)
SmartPeg mount
STEP-BY-STEP GUIDE 1. Preparation • Charge the Osstell device: Ensure the device is adequately charged according to the manufacturer’s instructions. • Select the correct SmartPeg: Choose the SmartPeg that is compatible with the specific dental implant system you are using. SmartPegs are single-use in most cases. • Attach the SmartPeg to the Implant: ◊ Attach the SmartPeg using the mount. ◊ Gently screw the SmartPeg into the implant or abutment using the SmartPeg mount with finger force. Do not overtighten (4-6 Ncm is usually recommended). 2. Taking the Measurement • Turn on the Osstell device: The device activates with a motion sensor or a button. • Position the Osstell device: ◊ Hold the Osstell device probe close to the SmartPeg (usually within 1-2 mm) but without touching it. ◊ The device will emit a slight vibration. ◊ An audible sound indicates the start of the measurement. • Obtain the ISQ reading: The ISQ value will be displayed on the device screen. Record the ISQ value.
• Measure in two directions: It is recommended to take measurements in at least two directions (e.g., bucco-lingual and mesio-distal) to get a comprehensive assessment of implant stability. The device will prompt you to measure in different directions. 3. Interpreting the Results • Understand the ISQ scale: The ISQ scale typically ranges from 1 to 100. ◊ Higher values indicate greater stability. ◊ General guidelines: • < 60: Low stability • 60–69: Medium stability • > 70: High stability • Clinical judgment: Always interpret the ISQ values in conjunction with other clinical assessments, such as radiographic evaluation and the dentist’s clinical experience. 4. Post-Measurement • Remove the SmartPeg: After completing the measurements, carefully remove the SmartPeg from the implant using the SmartPeg mount. • Clean the device: Clean the Osstell device according to the manufacturer’s instructions. Use approved disinfectants. Do not autoclave the device itself. SmartPegs are typically single-use and should be thrown out after use. • Record the data: Store the ISQ values in the patient’s record for future reference and comparison. IMPORTANT NOTES • Always follow the manufacturer’s instructions for the specific Osstell device you are using. • Ensure that the SmartPeg is properly attached to the implant. • Avoid applying excessive force when attaching or removing the SmartPeg. • Regularly calibrate the Osstell device as recommended by the manufacturer. • Use proper infection control procedures.
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From Fear to Fragrance The Neuroscience of Scent and Patient Experience in Dentistry In a dental office, smell can significantly sway a
• Chamomile (Roman and German): Both types of chamomile have calming properties, but Roman chamomile is noted for its gentle and restorative effects. • Frankincense: This woody and spicy scent can help slow breathing and reduce stress and is often used for grounding and relaxation. • Ylang Ylang: This sweet, floral scent can help reduce anxiety and lower blood pressure and heart rate. • Sandalwood: Sandalwood is grounding and helps quiet the mind and reduce nervous tension. • Clary Sage: This herbaceous scent has sedative properties that may help induce relaxation and calmness. • Rose: Rose oil’s sweet, floral scent can help reduce stress and anxiety and promote emotional well-being. • Vetiver: Vetiver is known for its grounding and centering properties, helping to reduce overthinking and promote focus. • Neroli (Orange Blossom): This light, sweet,
the thalamus, olfactory information bypasses this relay station and heads straight to the amygdala, the brain region involved in processing emotions, and the hippocampus, which is crucial for memory. This direct pathway explains why smells evoke immediate emotional responses. An unpleasant dental odor might unconsciously trigger anxiety from past experiences, while a calming scent can foster positive associations and relaxation. Therefore, dental professionals should be mindful of the olfactory environment they cultivate. Strategically using subtle, pleasant scents can create a more welcoming and reassuring atmosphere, ultimately improving patients’ experience. The following scents are known to have calming effects on the nervous system: • Lavender: Lavender is believed to interact with neurotransmitters in the brain to promote calmness and improve sleep quality. • Bergamot: This citrusy oil has been shown to reduce stress, improve mood, and lower heart rate and blood pressure.
patient’s experience. A clean, subtly minty aroma can instill a sense of hygiene and care, easing anxieties. Conversely, the scent of harsh chemicals or a sterile, odorless environment can inadvertently trigger unease. The neuroscience behind this lies in the intricate connection between our olfactory system and the brain’s emotional centers. When odor molecules enter the nasal cavity, they bind to olfactory receptors. Unlike other senses, which are first processed by
and citrusy floral scent is calming, soothing, and uplifting, potentially relieving stress and anxiety. UNMASKING FAILURE Best Practices for Diagnosing Failing Dental Implants
• Peri-implant Soft Tissue Health: Even without bone loss visible on radiographs, inflammation or changes in the soft tissues surrounding the implant are red flags. Persistent BOP or increased probing depths warrant close monitoring. • Periapical Health: While less
Maintaining dental implant health is crucial for long-term success. While X-rays and CT scans are essential, relying solely on them can delay diagnosis. A combined clinical and radiographic approach is best practice. The initial stages of implant evaluation involve a thorough patient history. Asking about pain (even subtle discomfort), changes in bite, swelling, or mobility (even perceived movement) can provide vital clues. Also, always review implant history, complications, hygiene habits, and the patient’s overall health. Clinical examination is equally critical. Visual inspection of the peri-implant tissues can reveal inflammation, redness, recession, or suppuration. Gentle probing around the implant helps assess the peri-implant pocket depths and detect bleeding on probing (BOP), an early sign of peri-implantitis. Implant mobility should also be evaluated. While significant mobility is a late sign of failure, subtle movement may be detected with careful manipulation. Now, what about when radiographs appear normal? This is where a keen clinical eye and astute questioning become even more important. In these situations, consider the following. • Patient Symptoms: Never dismiss patient complaints, even if imaging is clear. Persistent discomfort, pressure, or a change in how the implant feels during function can be significant. • Functional Assessment: Evaluate the implant’s function. Is the patient experiencing any difficulty chewing or biting? Are there any occlusal discrepancies that might be overloading the implant?
common for implants, rule out any periapical pathology that might indirectly affect the implant’s stability. • Advanced Diagnostic Tools: In
some cases, dynamic loading tests or resonance frequency analysis (RFA) devices can provide objective data on implant stability even when radiographs are inconclusive.
These tools can detect subtle changes in implant osseointegration. Diagnosing implant failure without
radiographic signs requires a holistic approach. Combining patient history, meticulous clinical examination, and diagnostic tools improves early detection and timely intervention to support the long-term success of dental implants.
JacksonvilleDentalSpecialists.com · 3
PRST STD US POSTAGE PAID BOISE, ID PERMIT 411
11512 Lake Mead Ave. #532 Jacksonville, FL 32256
INSIDE Using RFA to Strengthen Implant Outcomes
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Mastering Implant Stability With Osstell
How Fragrance Shapes Patient Experience
Implant Failures Hiding in Plain Sight
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