Stability of a New Trioval Implant in Bone Surrogate Model

Objectives: Implant stability is an important parameter to predict treatment success and inform loading protocols (i.e. immediate, early, or delayed). Here, we used bone surrogate models (Sawbones®, Pacific Research Laboratories) to evaluate implant stability of a new trioval implant design (Nobel Biocare N1™, Nobel Biocare AB, Gothenburg, Sweden) in both extraction and healed site simulations.
Methods: Sixty-four implants were distributed into four groups based on platform diameter (narrow platform, NP; or regular platform, RP) and type of site (healed site, HS; extraction site, ES). For HS, the clinically successful NobelReplace CC (NR) implant (Nobel Biocare) was used as a control and NobelActive™ (NA, Nobel Biocare) was the control group for ES. To evaluate stability, maximum insertion torque (IT) was recorded at placement and tilting and micromotion (MM) were measured throughout 50’000 cycles of sinusoidal compressive loading (2Hz) at 30°. Statistical analysis was performed using the Mann–Whitney U test (significance, p<0.05).
Results: In the HS model, N1 had the highest IT and smallest tilting and MM compared to NR for both diameters (p<0.05, Table 1.) In ES, N1 performed better than NA for both platform sizes after dynamic loading (p<0.05), despite having comparable or slightly lower IT at insertion.
Conclusions: In all tests, N1 showed sufficient IT to withstand cyclic loading of at least 70N. In this in vitro study, the new trioval implant design significantly outperformed two implant designs with well documented clinical success in the respective indications. Further studies will be required to assess how these findings translate into clinical performance.