The Impact of Gender on Dental Implant Stability assessed using Resonance Frequency: A Systematic Review

Abstract

Resonance Frequency Analysis (RFA) is a non-invasive surrogate method of measuring implant stability and measuring changes in the bone implant interface over time. Factors that can influence this value include bone density, preparation of the osteotomy, the length and diameter of the implant, and design of the implant. There are inherent gender differences in bone density, particularly with respect to post-menopausal women. The purpose of this systematic review was to determine if there was a difference in RFA value based on patient gender. A comprehensive literature search up to March 15, 2014 was performed using Medline and Embase for all literature related to implant stability as measured by RFA in humans. Inclusion criteria consisted of controlled studies including healthy men and women, RFA value at the time of placement, and the mean and standard deviation separately for gender. Exclusion criteria excluded studies where implants were not placed in alveolar bone, and studies where implants were placed in conjunction with sinus lifts, biologics, or grafting. A comprehensive search yielded 2712 articles; 2591 articles failed to meet the inclusion criteria, and of the remaining 131, 117 were excluded based on a lack of data with regard to gender, leaving 14 articles for review and 7 for meta-analysis. The meta-analysis showed no significant difference in RFA value with respect to gender. These results must be interpreted with caution, given the limited available data. Two studies reported females having higher RFA values than males, although one study reported more mandibular implants were placed in women than men. Research stratified by age is necessary to determine whether age-related changes in bone density are related to RFA values. Such an association would necessitate changes in recommendations for ISQ stability values based on age and gender.