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Currently in development with a major digital dental X-ray equipment manufacturer, TBS® Dental is a dedicated medical imaging software technology, which will provide useful information as to a patient’s trabecular bone microarchitecture and overall quality. This will help dental surgeons better predict primary implant stability before dental implant placement.

TBS Dental is under investigation.

MEDICAL USE

Current situation

As of now, surgeons do not have preoperative information pertaining to the quality of their patient’s trabecular bone. Since dental implants are fixed in the trabecular bone area, a standard procedure carried out on a fragile bone can lead to implant complication or failure.

How TBS Dental
can help

With the critical information provided by TBS, dental surgeons will be able to choose appropriate implants and procedures according to the quality of the bone; better determine time to implant loading; reduce the overall number of dental implant revisions; and save consultation and surgery time.

How TBS Dental can help

With the critical information provided by TBS, dental surgeons will be able to choose appropriate implants and procedures according to the quality of the bone; better determine time to implant loading; reduce the overall number of dental implant revisions; and save consultation and surgery time.

How it works

Based on the analysis of either 2D X-ray periapical images or 3D Cone Beam CT scans, the TBS algorithm computes a specific score to assess the trabecular bone quality, which is related to its 3D-microarchitecture. Results are obtained with no additional patient radiation exposure nor scan time.

2D image of the maxilla

TBS texture assessment where the implant is to be placed

Control after implant placement

Results are easy to interpret. In the above example the bone is degraded.

Low bone quality

High bone quality

This product is currently under investigation and the proposed clinical claims are being evaluated.

SELECTED ONGOING RESEARCH

Early results of studies conducted within the company showed that TBS can be used to assess implant stability:

A first ex-vivo study was conducted to evaluate the link between primary implant stability – as measured using RFA method (Osstell) -, and the bone trabecular quality – as assessed using Trabecular Bone Score (TBS) – before the implantation. It showed a strong correlation between TBS (computed from intraoral images before implants placement) and the primary stability (ISQ) measured after placement.

This study was the first to report a link between the primary implant stability and bone mandibular quality before implantation.

In conclusion, TBS seemed to be a good surrogate parameter to ISQ after surgery.

  • Le Nost, P., Villate, P., Michelet, F., Winzenrieth, R., Ella, B., Lelong, C., 2013. TBS is a Major Key Factor of Implant Primary Stability. IADR/AADR/CADR Conference, General Session and Exhibition. [Link]

A second in-vivo study showed a strong correlation between TBS and ISQ (primary stability). It confirmed the previous ex-vivo study, which showed a strong correlation.

In conclusion, TBS seemed to be a good surrogate parameter of primary stability, in-vivo.

  • Simmons, D.E., Le Nost, P., Orellana, D., Audebert, A., Porras Smith, L., Winzenrieth, R., Lelong, C., 2014. TBS assesses primary implant stability in daily clinical routine. IADR Conference, General Session and Exhibition. [Link]

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