Ultrasonic Evaluation of the Bone-Implant Interface.

While implant surgical interventions are now routinely performed, failures still occur and may have dramatic consequences. The clinical outcome depends on the evolution of the biomechanical properties of the bone-implant interface (BII). This chapter reviews studies investigating the use of quantitative ultrasound (QUS) techniques for the characterization of the BII.First, studies on controlled configurations evidenced the influence of healing processes and of the loading conditions on the ultrasonic response of the BII. The gap of acoustical properties at the BII increases (i) during healing and (ii) when stress at the BII increases, therefore inducing a decrease of the reflection coefficient at the BII.Second, an acoustical model of the BII is proposed to better understand the parameters influencing the interaction between ultrasound and the BII. The reflection coefficient is shown to decrease when (i) the BII is better osseointegrated, (ii) the implant roughness decreases, (iii) the frequency of QUS decreases and (iv) the bone mass density increases.Finally, a 10 MHz device aiming at assessing dental implant stability was validated in vitro, in silico and in vivo. A comparison between QUS and resonance frequency analysis (RFA) techniques showed a better sensitivity of QUS to changes of the parameters related to the implant stability.