Stability and Marginal Bone Level Changes of SLActive Titanium-Zirconium Implants Placed with Flapless Surgery: A Prospective Pilot Study

Clin Implant Dent Relat Res. 2016 Dec;18(6):1193-1199. doi: 10.1111/cid.12392. Epub 2016 Feb 14.


Background: Immediately-loaded, narrow-diameter implants can be a less invasive alternative for the implant-supported fixed rehabilitation of narrow, posterior crests.

Purpose: To determine the stability and marginal bone level (MBL) changes of narrow-diameter, titanium-zirconium (TiZr) implants placed with flapless surgery and loaded immediately in the posterior region.

Materials and methods: Thirty-eight TiZr implants (3.3 mm diameter, 10 mm length, Roxolid, Straumann AG) were placed in the posterior crests of 14 patients with computer-guided flapless surgery as a support of 3-unit posterior bridges. Eighteen implants were loaded immediately, and 20 implants were loaded conventionally. The implant stability quotients were determined at the 1, 2, 4, and 8. weeks of healing before conventional loading, and at the 3, 6, and 12. months after loading by resonance frequency analysis. The MBL changes were measured by digital radiography.

Results: The surgical protocols were accomplished without any biological complications. There was no significant difference in the stability changes of TiZr implants between the loading groups (p > .05). The MBL changes were -0.18 ± 0.27 mm and -0.24 ± 0.27 mm at the 12. month of immediate and conventional loading, respectively, which was not statistically significant (p > .05).

Conclusion: The stability and MBL changes of TiZr implants supporting posterior 3-unit bridges were clinically acceptable at the first year of loading.

Keywords: flapless surgery; immediate loading; marginal bone level; resonance frequency analysis; titanium-zirconium implant.

MeSH terms

  • Adult
  • Dental Implants*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Titanium* / analysis
  • Zirconium* / analysis


  • Dental Implants
  • Zirconium
  • Titanium