Correlation between primary, secondary stability, bone density, percentage of vital bone formation and implant size

Vasilena Ivanova*, Ivan Chenchev, Stefan Zlatev, Eitan Mijiritsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background: This study aims to evaluate whether there is a correlation between implant stability, bone density, vital bone formation and implant diameter and length. Methods: Ninety patients were enrolled in this study. They underwent a socket preservation procedure with allograft or PRF and after 4 months, a total of 90 implants were placed. CBCT scans were assigned prior to implant placement in order to assess the bone density. During the surgical re-entry, a bone biopsy was harvested with a trephine drill. Immediately after implant insertion, the primary stability was measured. The secondary stability was measured 4 months after implant placement. Results: Primary stability showed a significant positive linear correlation with bone density (r = 0.471, p < 0.001) as well as with percentage of new bone formation (r = 0.567, p < 0.001). An average significant association of secondary stability with bone density (rs = 0.498, p < 0.001) and percentage of newly formed bone (r = 0.477, p < 0.001) was revealed. The mean values of primary stability in all three implant sizes, regarding the diameter of the implants, were similar (narrow 67.75; standard 66.78; wide 71.21) with no significant difference (p = 0.262). The same tendency was observed for secondary stability (narrow 73.83; standard 75.25; wide 74.93), with no significant difference (p = 0.277). Conclusions: The study revealed a high correlation between primary and secondary implant stability, and bone density, as well as with the percentage of vital bone formation. Implant length and diameter revealed no linear correlation with the implant stability.

Original languageEnglish
Article number6994
JournalInternational Journal of Environmental Research and Public Health
Issue number13
StatePublished - 1 Jul 2021


FundersFunder number
Medical University of Plovdiv-Bulgaria


    • Bone density
    • Dental implants
    • Implant diameter
    • Implant length
    • Primary stability
    • Secondary stability


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