The use and abuse of the Periotest for 2-piece implant/abutment systems.

While the Periotest continues to be used in assessing the integrity of implants, there are numerous reports of its inconsistencies. To understand more precisely what the Periotest is actually measuring, a mathematical model was developed that illustrates the effect that various geometric and clinical parameters have on the Periotest value (PTV). In addition, the model was validated with an in vitro experiment. Results of the mathematical model are shown to correlate with those obtained from the experimental test The PTV is very sensitive to the position at which the Periotest impacts the abutment and to angulation of the handpiece. It was shown that a change in position of 1 mm in striking height can produce a difference in PTV of between 1 and 2. Since the angulation of the handpiece can produce a difference in striking position of 2 mm, it must be controlled as well. The model also showed that the Periotest can detect changes in bone height of 0.5 mm.