Influence of titanium and titanium-zirconium alloy as implant materials on implant stability of maxillary implant retained overdenture: a randomized clinical trial

Abstract

Background: Long-term success of implant restoration depends on many factors one of them is the sufficient implant stability which is lowered in compromised bone density sites such as the maxilla as it is categorized as type III & IV bone, so searching for a new innovation and updates in implant material and features is very mandatory. So, the aim of this study was to compare between two implant materials (roxolid and traditional titanium) on the primary and secondary stability of implant retained maxillary overdenture.

Methods: Eighteen completely edentulous patients were selected. All patients received maxillary implant-retained overdentures and lower complete dentures; patients were divided equally into two groups according to the type of implant materials. Group A received a total number of 36 implants made of roxolid material and Group B received a total number of 36 implants made of traditional titanium alloys. Implant stability was assessed using ostell device, the primary implant stability was measured at the day of implant installation however, secondary implant stability was measured after six weeks of implant placement. Paired t-test was used to compare between primary and secondary stability in the same group and an independent t-test was used to compare between the two groups with a significant level < 0.05.

Results: Independent t-test revealed a significant difference between the two groups with p -value = 0.0141 regarding primary stability and p-value < 0.001 regarding secondary stability, as roxolid implant group was statistically higher stability than titanium group in both. Paired t- test showed a statistically significant difference in roxolid implant group with p-value = 0.0122 however, there was non-statistically significant difference in titanium group with p-value = 0.636. Mann Whitney test showed a significant difference between the two groups regarding amount of change in stability with p value = 0.191. roxolid implant group showed a higher amount of change in stability than the titanium implant group.

Conclusion: Within the limitation of this study, it could be concluded that: Roxolid implants showed promising results regarding primary and secondary stability compared to conventional Titanium implants and can be a better alternative in implant retained maxillary overdentures.

Trial registration: Retrospectively NCT06334770 at 26-3-2024.

Keywords: Implant Stability; Ostell; Roxolid.

Fig. 1

A Completely edentulous maxilla, B Preoperative CBCT

Fig. 2

A CBCT of patient with the maxillary denture, B Digital implant planning and guide designing, C Printed Guide from clear acrylic resin

Fig. 3

Surgical guide stabilized intraorally using stabilizing pins

Fig. 4

A Soft tissue punch, B Point of entry after tissue punch, C Sequential drilling starting the narrowest diameter and gradually increase, D Prepared four osteotomies

Fig. 5

A Implant inserted using ratchet wrench, B Four implants fully seated in the osteotomies

Fig. 6

Measurements of stability: A OSSTELL probe & smart peg, B Reading assessment of Primary Stability, C Implants covered by cover screw, D. Reading assessment of secondary stability

Fig. 7

Bar chart showing comparison between the two groups regarding amount of change in stability