Reduced thread cutting increases the primary stability of Zeramex XT in D4 bone
A recent study in the International Journal of Implant Dentistry confirms the high primary stability of the Zeramex XT ceramic implant system, particularly with reduced thread cutting in soft bone (D4).
In the ex vivo study conducted by Sagheb et al. (2025), four different drilling protocols were tested, which differed in the depth of thread cutting: none, one-third, two-thirds and full thread cutting. The implants were placed in fresh porcine bone (D2/D3 and D4) to simulate different bone densities. The insertion torque was measured as an indicator of primary stability.
The following results were obtained for the Zeramex XT system:
- In D4 bone, the implant with full thread cutting achieved a mean insertion torque of 15.78 Ncm, which was below the recommended range of 20-45 Ncm
- With reduced thread cut (two thirds), the torque increased to 29.26 Ncm, within the recommended range
- With one-third thread cut, a torque of 44.43 Ncm was achieved, close to the upper limit of the recommended range
- Without thread cut, the torque exceeded the recommended range at 50.09 Ncm
In D2/D3 bones, 27.66 Ncm was measured with full thread cutting and 57.42 Ncm with two-thirds thread cutting, with the latter exceeding the recommended range.
The study shows that reduced thread cutting significantly improves the primary stability of Zeramex XT in soft bone D4 without exceeding the recommended torque limits. This emphasises the importance of adapting the drilling protocol to the bone density in order to achieve optimal primary stability.
References
Sagheb, K., Yildirimturk, S., Kaya, S. et al. Ex vivo comparison of drilling techniques for optimising primary stability of zirconia dental implants in different bone densities. Int J Implant Dent 11, 28 (2025). https://doi.org/10.1186/s40729-025-00603-z
