In conclusion, the present study demonstrated that the algorithm applied and provided by Osstell to calculate ISQ values is correct, making the laboratory procedure valuable for future research focused on stiffness aspects of the implant-Smartpeg complex and its possible influence on the overall RFA measurement. Vice versa, the present study demonstrates the correctness of the actual applied algorithm for calculation of ISQ values by Osstell Mentor and Osstell IDx devices. From a clinical perspective, this study adds proof to the finding of ISQ values obtained by original Osstell devices, at least for Straumann tissue level SLA-surfaced implants, that are biased and underestimated. This implies that comparison of implant stability in terms of ISQ for identical implant systems between different studies has to be done with caution and need to be corrected when used for comparisons in systematic reviews.