#Education 13. Apr 2026

Titanium-zirconium implants: clinical evaluation and bone loss prediction

A selected scientific recommendation by Dr. Marcin Maj: "Clinical evaluation and bone loss prediction of titanium -zirconium implants: A retrospective study of 1 -5-year follow -up" by Zhaoting Ling, Cong Chen, Siyuan Wang, Yun Zhu, Xiaoting Shen, Kefang Sun, Hongye Lu, Fuming He.

STUDY OBJECTIVES AND METHODS

The aim of this study was to evaluate the clinical and radiographic outcomes of titanium -zirconium implants, identify risk factors and develop predictive models for bone loss progression. Patients with titanium -zirconium implants were screened for inclusio n and underwent follow -ups. Cumulative survival rates at the implant and patient levels were calculated using life tables. Clinical and radiographic data were retrospectively analyzed for implant/restoration success rates and peri - implant marginal bone los s. Factors influencing marginal bone loss were examined using generalized estimating equations (GEE). Support vector machine (SVM), artificial neural network (ANN), logistic regression (LR), and random forest (RF) were used to develop the prediction models of bone loss.


RESULTS

  • 573 titanium -zirconium implants from 399 patients were included, with an average observation time of 27.6 ± 11.5 months (12 -63 months).
  • The cumulative 5 -year survival rate was 99.1% at the implant level, and 98.8% at the patient level.
  • The mean probing depth was 3.1 ± 1.2 mm, with 23.6% incidence of bleeding on probing.
  • The mean marginal bone loss was 0.37 -0.52 mm. GEE analysis showed that marginal bone loss was significantly influenced by follow -up time, advanced age, narrow - diameter implant, location, and fixed partial denture. LR and ANN models demonstrated optimal pre dictive performance, both with 93.5% accuracy.
  • Baseline marginal bone level emerged as the most significant predictor, with an importance score of 41.3.

CONCLUSIONS

The 1-5-year outcomes revealed that titanium -zirconium implants achieved high survival and success rates, with limited marginal bone loss. The prediction model demonstrated 93.5% accuracy, identifying baseline marginal bone level as the primary determinant of bone loss progression. Adapted from Z Ling et al., J Dent. 2026 Mar:166:106516 ., for more info about this publication, click  HERE.

This review is part of the Straumann "Scientific Highlights Newsletter 1/26".

More studies:

  • One-Year Analysis of Clinical and Radiological Outcomes of Two-Piece Zirconia Compared to Titanium Implants: A Multicenter Prospective Randomized Clinical Trial
  • Osteogenic Differentiation on Nonthermal Atmospheric Plasma-Treated versus SLActive® Titanium and Titanium-Zirconium Implants: An In Vitro Comparative Study
  • The Effect of Age and Use of Enamel Matrix Derivative on Implant Loss
  • Impact of Zirconia and Titanium Implant Surfaces of Different Roughness on Oral Epithelial Cells
  • Impact of Two Implant-Abutment Connection Types on Crestal Bone Stability: A 3-Year Comparative Split-Mouth Clinical Trial
  • Full-Arch Implant Rehabilitation Integrating Mandibular Movement Records Using Complete Digital Workflows: A Case Report
  • Clinical evaluation and bone loss prediction of titanium-zirconium implants: A retrospective study of 1-5-year follow-up
  • Scientific evaluation of design and surface advances in Straumann implants