New retrospective 7-year study by Tartsch et al. (2025): 98.2% survival rate and stable peri-implant tissue conditions with two-piece zirconia implants Zeramex® XT and NobelPearl™
In a new retrospective study “Two-piece Zirconia Implants: An Office-based Retrospective Study with up to 7 and Mean 3-Year Follow-Up” recently published in the International Journal of Oral & Maxillofacial Implants,
Dr. Jens Tartsch (Private Dental Clinic in Kilchberg, Switzerland),
Prof. Dr. Bruno Chrcanovic (Department of Oral and Maxillofacial Surgery and Oral Medicine, Malmö University, Sweden),
Prof. Dr. Ann Wennerberg (Department of Prosthodontics, University of Gothenburg, Sweden),
Prof. Dr. Ralf Kohal (Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg), and
Prof. Dr. Thomas Albrektsson (Department of Biomaterials, University of Gothenburg, Sweden)
evaluated the clinical performance of two-piece zirconia implants with follow-up periods of up to seven years1. While two-piece zirconia implants represent a promising metal-free alternative to titanium, long-term clinical data remain limited. The aim of this investigation was to assess both the clinical outcomes and the surface topography of two identically designed implant systems (Zeramex® XT and NobelPearl™) placed in a private dental practice.
Between 2017 and 2024, 167 implants were placed in 106 patients and followed for up to 88 months (mean 39.1 months). In addition to survival rate, marginal bone loss, clinical parameters and surface characteristics were analyzed. Statistical evaluation included descriptive methods and life-table survival analysis.
Three implants were lost during follow-up – two due to fracture and one due to failed osseointegration – resulting in an effective survival rate of 98.2 %. Mean marginal bone loss ranged between –0.14 mm and –0.58 mm. The implant surfaces exhibited minimal roughness (Sa ~0.5 µm). No clinical risk factor showed a significant association with implant loss in univariate analysis.
The authors conclude that two-piece, screw-retained zirconia implants Zeramex® XT und NobelPearl™ demonstrated a high survival rate and stable peri-implant tissue conditions over a period of up to 7 years.
The full text of the study can be ordered from Quintessence Publishing.
References
1 Tartsch J, Chrcanovic B, Wennerberg A, Kohal R, Albrektsson T. Two-piece Zirconia Implants: An Office based Retrospective Study with up to 7 and mean 3 Year Follow-Up. Int J Oral Maxillofac Implants. 2025 Jul 30;0(0):1-36. doi: 10.11607/jomi.11469. Epub ahead of print. PMID: 40736783.
