Comparison of implant stability measurement devices for bone-anchored hearing aid systems

Statement of problem. The success of implants for bone-anchored hearing aids (BAHA) relies on proper osseointegration at the bone-implant interface. Clinical evaluation of implant stability is important in prescribing loading, identifying the risk of failure, and monitoring the long-term health of the implant. Purpose. The purpose of this in vitro study was to evaluate 2 measurement systems for BAHA implant stability: the most commonly used, Osstell implant stability quotient (ISQ), and a newly developed advance system for implant stability testing (ASIST). Material and methods. BAHA implants (Oticon Medical Ponto and Cochlear BAHA Connect systems) were installed in plastic materials with adhesive to simulate implants integrated in bone with varying levels of interface stiffness. Different lengths of BAHA abutments were used with each implant specimen, and stability measurements were obtained with both the Osstell ISQ and the ASIST systems. The measurement systems were evaluated in terms of sensitivity to differences in interface stiffness and the effect of abutment length on the stability measurement. Repeated measures ANOVA followed by post hoc t tests were used for the comparisons with a Bonferroni adjusted alpha value of.05/15 = .003 to control for potential type 1 errors. Results. Changing the abutment length of a single implant installation had minimal effect on the ASIST stability coefficient, whereas large variations were observed in the Osstell implant stability quotient (ISQ). The Osstell showed a clear relationship of decreasing ISQ with increasing abutment length for both the Oticon Medical and the Cochlear implant systems. Both the ASIST and the Osstell were found to be sensitive to changes in interface properties, with the ASIST being more sensitive to these changes. Conclusions. The ASIST system is more sensitive to changes in interface properties and shows smaller variation because of changes in abutment length than the Osstell ISQ system.